Basset C, Pers J O, Youinou P, Pennec Y L
Laboratory of Immunology, Brest University Medical School, France.
Clin Exp Rheumatol. 1997 Mar-Apr;15(2):157-61.
To evaluate the relevance of IgA-containing immune complexes (IC) as a predictor of lymphocytic infiltration of the minor salivary glands, and thus to determine the necessity of the minor salivary gland biopsy as a diagnostic test for primary Sjögren's syndrome (SS) in patients complaining of dryness of the mouth.
IgA-containing IC, as well as anti-SSA and anti-SSB antibodies, were measured using enzyme-linked immunosorbent assays in 116 consecutive patients presenting with dry mouth but no connective tissue disease. The specificity, sensitivity, and positive (PPV) and negative predictive values (NPV) of these tests were calculated in relation to the results of the minor salivary gland biopsy and to the criteria for primary SS.
Sixty-five patients had a focus score > or = 1.IgA-containing IC were detected in 45 of them, compared with five of the remainder (specificity 89%, sensitivity 69%, PPV = 88% and NPV = 69%). When the IgA-containing IC, and the anti-SSA and anti-SSB tests were associated, the sensitivity and NPV were improved (81 and 79%, respectively), while specificity and PPV were maintained (88 and 90%, respectively).
Given the reliability of this combination of tests for the diagnosis of primary SS, the minor salivary gland biopsy might be indicated only in those patients without any serological abnormality.
评估含IgA免疫复合物（IC）作为小唾液腺淋巴细胞浸润预测指标的相关性，从而确定对于主诉口干的原发性干燥综合征（SS）患者，小唾液腺活检作为诊断性检查的必要性。
采用酶联免疫吸附测定法，对116例连续就诊的主诉口干但无结缔组织病的患者检测含IgA的IC以及抗SSA和抗SSB抗体。根据小唾液腺活检结果和原发性SS的标准，计算这些检测的特异性、敏感性、阳性预测值（PPV）和阴性预测值（NPV）。
65例患者的灶性评分≥1。其中45例检测到含IgA的IC，其余患者中有5例检测到（特异性89%，敏感性69%，PPV = 88%，NPV = 69%）。当联合检测含IgA的IC、抗SSA和抗SSB时，敏感性和NPV有所提高（分别为81%和79%），而特异性和PPV保持不变（分别为88%和90%）。
鉴于这种联合检测对原发性SS诊断的可靠性，仅在那些无任何血清学异常的患者中可能需要进行小唾液腺活检。
