唇唾液腺活检是诊断原发性和继发性淀粉样变性的可靠检查。一项针对59例患者的前瞻性临床和免疫组织学研究。

Labial salivary gland biopsy is a reliable test for the diagnosis of primary and secondary amyloidosis. A prospective clinical and immunohistologic study in 59 patients.

作者信息

Hachulla E, Janin A, Flipo R M, Saïle R, Facon T, Bataille D, Vanhille P, Hatron P Y, Devulder B, Duquesnoy B

机构信息

Department of Internal Medicine, Hôpital Claude Huriez, University of Lille, France.

出版信息

Arthritis Rheum. 1993 May;36(5):691-7. doi: 10.1002/art.1780360518.

DOI:10.1002/art.1780360518

PMID:7683882

Abstract

OBJECTIVE

Reports of the detection of amyloidosis by labial salivary gland (LSG) biopsy have been mostly anecdotal. The aim of this study was to assess the value of this method in the diagnosis of amyloidosis.

METHODS

LSG biopsy tissues were studied with a combination method using Congo red stain and immunohistologic characterization using an antibody directed against the serum amyloid P (SAP) component. Electron microscopy was performed in all cases. In a prospective study, we evaluated 30 patients with biopsy-proven AA or AL amyloidosis. We compared these patients with a control group of 29 age-matched patients without clinical or biologic evidence of amyloid disease (14 had rheumatoid arthritis and 15 had plasma cell dyscrasia).

RESULTS

In 26 of the 30 patients with known systemic amyloidosis, amyloid deposits were identified on LSG biopsy (sensitivity of 86%). In 1 of the remaining patients, amyloid deposits were identified on LSG biopsy and systemic amyloidosis was confirmed by abdominal fat biopsy and 123I-labeled SAP scintigraphy.

CONCLUSION

This study emphasizes the high sensitivity of LSG biopsy in the diagnosis of amyloidosis, even in the absence of oral symptoms.

摘要

目的

唇腺活检检测淀粉样变性的报告大多为个案报道。本研究旨在评估该方法在淀粉样变性诊断中的价值。

方法

采用刚果红染色和针对血清淀粉样蛋白P（SAP）成分的抗体进行免疫组织学特征分析的联合方法对唇腺活检组织进行研究。所有病例均进行了电子显微镜检查。在一项前瞻性研究中，我们评估了30例经活检证实为AA型或AL型淀粉样变性的患者。我们将这些患者与29例年龄匹配、无淀粉样变性疾病临床或生物学证据的对照组患者进行了比较（14例患有类风湿性关节炎，15例患有浆细胞发育异常）。