Lamos-Duarte Andrés Felipe, Parra-Medina Rafael, Rivadeneira-Chamorro Carlos Santiago, Castañeda-González Juan Pablo, Escobar Alejandro, Rojas-Villarraga Adriana, Rodríguez-Vargas Gabriel Santiago, Arredondo Ana María, Cubides Héctor, Polo José Fernando, Capasso Juan José, Ibañez Claudia, Cajamarca-Barón Jairo Hernán
Departamento de Reumatología, Fundación Universitaria de Ciencias de la Salud - FUCS, Hospital de San José, Bogotá, D. C., Colombia.
Laboratorio de Patología, Instituto Nacional de Cancerología y Fundación Universitaria de Ciencias de la Salud - FUCS, Bogotá, D. C., Colombia.
Biomedica. 2025 Mar 28;45(1):80-93. doi: 10.7705/biomedica.7315.
Sjögren’s syndrome is a systemic autoimmune disease. The usefulness of immunohistochemistry in minor salivary gland biopsies has been described to be helpful in indirectly characterizing the lymphocyte phenotype in difficult diagnosis cases.
To describe sociodemographic, clinical, serological, histopathological, and immunohistochemical variables in patients with sicca syndrome and a minor salivary gland biopsy focus score greater than or equal to one.
We conducted an observational, retrospective study that included patients under study for potential sicca syndrome whose minor salivary gland biopsy was available and had obtained a focus score greater than or equal to one. Immunohistochemistry was performed on the minor salivary gland biopsy with chromogen red staining for CD8 T lymphocytes and brown staining for CD4 T lymphocytes. Expression ratio of CD20:CD3 and CD4:CD8 markers was determined with the MoticEasyScan Pro 6™ (MOTIC) device and the QuPath™ software. Qualitative variables were analyzed using the chi-square or Fisher’s exact test, and quantitative variables were analyzed according to their assumption of normality.
Twenty-eight patients were analyzed: 16 patients had Sjögren’s syndrome, and 8 of them had polyautoimmunity. An association was found between atrophy in the minor salivary gland biopsy and development of polyautoimmunity (OR = 11.1; 95% CI: 1.12-112; p value = 0.033). The CD20:CD3 and CD4:CD8 ratios were normal, with no statistically significant differences between patients with and without Sjögren’s syndrome. In the subgroup of patients with Sjögren’s syndrome, CD4 T lymphocytes were predominant, with 15 cases out of 16 with CD4:CD8 ratios equal to or greater than 2:1.
Glandular atrophy was associated with the development of polyautoimmunity and a predominance of CD4 T lymphocytes in patients with Sjögren’s syndrome. This finding highlights the potential value of immunohistochemistry of minor salivary gland biopsies in this group.
干燥综合征是一种全身性自身免疫性疾病。免疫组化在小唾液腺活检中的应用已被描述为有助于在疑难诊断病例中间接表征淋巴细胞表型。
描述干燥综合征患者且小唾液腺活检灶性评分大于或等于1的社会人口统计学、临床、血清学、组织病理学和免疫组化变量。
我们进行了一项观察性回顾性研究，纳入了因潜在干燥综合征接受研究且有小唾液腺活检结果且灶性评分大于或等于1的患者。对小唾液腺活检标本进行免疫组化，用红色显色剂检测CD8 T淋巴细胞，棕色显色剂检测CD4 T淋巴细胞。使用MoticEasyScan Pro 6™（麦克奥迪）设备和QuPath™软件测定CD20:CD3和CD4:CD8标志物的表达比率。定性变量采用卡方检验或Fisher精确检验进行分析，定量变量根据其正态性假设进行分析。
分析了28例患者：16例患有干燥综合征，其中8例有多发性自身免疫。发现小唾液腺活检中的萎缩与多发性自身免疫的发生之间存在关联（比值比=11.1；95%置信区间：1.12-112；p值=0.033）。CD20:CD3和CD4:CD8比率正常，干燥综合征患者与非干燥综合征患者之间无统计学显著差异。在干燥综合征患者亚组中，CD4 T淋巴细胞占主导，16例中有15例CD4:CD8比率等于或大于2:1。
在干燥综合征患者中，腺体萎缩与多发性自身免疫的发生以及CD4 T淋巴细胞占主导有关。这一发现凸显了小唾液腺活检免疫组化在该组中的潜在价值。
