Cortés José S, Carvajal Wilder, Correa Alejandro, Veloza Karen, Díaz Eybar, Cajas Luis J
Especialidad en Reumatología, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, 111321, Colombia.
Departamento de Reumatología, Hospital Universitario Nacional de Colombia, 111321, Bogotá, Colombia.
Clin Rheumatol. 2025 Sep 15. doi: 10.1007/s10067-025-07650-2.
INTRODUCTION/OBJECTIVES: Sjögren's disease is an autoimmune disease that primarily affects the exocrine glands. Agreement between glandular ultrasound and focus score has been described as moderate to strong. The objective of this study was to assess the agreement between ultrasound findings of salivary and lacrimal glands and the histopathological results of minor salivary gland biopsies in patients with sicca syndrome seen at a quaternary care hospital in Colombia.
This was an ambispective cohort study. A total of 66 patients were included, of whom 42 were classified as having Sjögren's disease and 24 as having non-Sjögren sicca syndrome, according to the 2016 ACR/EULAR classification criteria. Focus scores were obtained from minor salivary gland biopsy reports, and ultrasound of the lacrimal and salivary glands was performed.
Ultrasound findings showed that 57.6% of patients presented glandular abnormalities, most frequently in the submandibular glands. The agreement between ultrasound findings and minor salivary gland biopsy was low (agreement rate: 57%, Kappa: 0.178). Advanced age (> 68 years) was identified as a factor negatively influencing the agreement. Parotid gland ultrasound had high specificity (100%) for the diagnosis of Sjögren's disease, but limited sensitivity (24-30%). No significant association was found between abnormalities in lacrimal glands and the diagnosis of Sjögren's disease.
Although glandular ultrasound may serve as a complementary tool, it cannot yet replace minor salivary gland biopsy for the diagnosis of Sjögren's disease. Further studies are needed to confirm its diagnostic performance and agreement with salivary gland histopathology. Key Points • Overall agreement between ultrasound and minor salivary gland biopsy was low in this cohort • Older age (>68 years) was associated with reduced agreement between imaging and histopathology • Parotid gland ultrasound showed high specificity but limited sensitivity for classifying Sjögren's disease.
引言/目的：干燥综合征是一种主要影响外分泌腺的自身免疫性疾病。腺超声检查结果与灶性评分之间的一致性已被描述为中等至高度。本研究的目的是评估在哥伦比亚一家四级护理医院就诊的干燥综合征患者中，唾液腺和泪腺的超声检查结果与小唾液腺活检的组织病理学结果之间的一致性。
这是一项双向队列研究。根据2016年美国风湿病学会/欧洲抗风湿病联盟分类标准，共纳入66例患者，其中42例被分类为患有干燥综合征，24例被分类为患有非干燥综合征性口干症。从小唾液腺活检报告中获取灶性评分，并对泪腺和唾液腺进行超声检查。
超声检查结果显示，57.6%的患者存在腺体异常，最常见于下颌下腺。超声检查结果与小唾液腺活检之间的一致性较低（一致率：57%，kappa值：0.178）。高龄（>68岁）被确定为对一致性有负面影响的因素。腮腺超声对干燥综合征的诊断具有高特异性（100%），但敏感性有限（24%-30%）。未发现泪腺异常与干燥综合征诊断之间存在显著关联。
尽管腺超声检查可作为一种辅助工具，但在干燥综合征的诊断中，它尚不能取代小唾液腺活检。需要进一步研究以证实其诊断性能以及与唾液腺组织病理学的一致性。要点 • 本队列中超声与小唾液腺活检的总体一致性较低 • 高龄（>68岁）与影像学和组织病理学之间的一致性降低相关 • 腮腺超声在干燥综合征分类方面显示出高特异性但敏感性有限
