Bodeutsch C, de Wilde P C, Kater L, van den Hoogen F H, Hené R J, van Houwelingen J C, van de Putte L B, Vooijs G P
Department of Pathology, University Hospital, Nijmegen, The Netherlands.
J Clin Pathol. 1993 Feb;46(2):123-8. doi: 10.1136/jcp.46.2.123.
To determine the prevalence of plasma cell monotypia in labial salivary gland tissue of patients with and without Sjögren's syndrome, and to evaluate its relation to the development of systemic monoclonal lymphoproliferative disorders.
A quantitative immunohistological study was performed on labial salivary gland tissue of 45 patients with Sjögren's syndrome, 18 with rheumatoid arthritis without Sjögren's syndrome, and 80 healthy controls. In none of the patients with Sjögren's syndrome was there evidence of systemic monoclonal lymphoproliferative disease at the time of biopsy.
Monotypic plasma cell populations, defined by a kappa:lambda ratio of > or = 3, were only observed in older patients (above 43 years) with Sjögren's syndrome. In almost all these patients monotypic plasma cell populations were present in multiple labial salivary gland tissues and the IgM/kappa monotypia was observed most frequently. The prevalence of monotypic plasma cell populations in the group with Sjögren's syndrome was 22% (10/45) and there was no significant predilection for primary Sjögren's syndrome. Of special clinical interest was the observation that progression to systemic monoclonal lymphoproliferative disease had occurred exclusively in this subgroup of patients with Sjögren's syndrome, with a prevalence of 30% (3/10).
Quantitative immunohistological examination of labial salivary gland tissues provides pathologists with a simple method to select those patients with Sjögren's syndrome who have an increased relative risk at the time of biopsy to develop benign or malignant lymphoproliferative disorders.
确定患有和未患有干燥综合征患者唇腺组织中浆细胞单克隆性的患病率，并评估其与系统性单克隆淋巴细胞增殖性疾病发生的关系。
对45例干燥综合征患者、18例无干燥综合征的类风湿关节炎患者以及80名健康对照者的唇腺组织进行了定量免疫组织学研究。在活检时，所有干燥综合征患者均无系统性单克隆淋巴细胞增殖性疾病的证据。
仅在年龄较大（43岁以上）的干燥综合征患者中观察到kappa:lambda比值≥3定义的单克隆浆细胞群。几乎所有这些患者的多个唇腺组织中都存在单克隆浆细胞群，且最常观察到IgM/kappa单克隆性。干燥综合征组中单克隆浆细胞群的患病率为22%（10/45），且原发性干燥综合征无明显偏好。特别具有临床意义的是观察到系统性单克隆淋巴细胞增殖性疾病仅在该干燥综合征患者亚组中发生进展，患病率为30%（3/10）。
唇腺组织的定量免疫组织学检查为病理学家提供了一种简单的方法，以选择那些在活检时发生良性或恶性淋巴细胞增殖性疾病相对风险增加的心干燥综合征患者。
