- 期刊
Anti-SSA和Anti-SSB自體抗體陰性的疑似休格蘭式症患者之小唾液腺切片檢查
Minor Salivary Gland Biopsy in Suspected Sjogren's Syndrome Patients with Negative Anti-SSA and Anti-SSB Antibodies
摘要
BACKGROUND: Sjogren's syndrome is a common condition; however, it is often difficult to diagnose because of its slow progression and non-specific symptoms. Serological tests of anti-SSA/Ro and anti-SSB/La antibodies are minimally invasive, but the levels of these antibodies may be within the normal range. Therefore, further histopathological studies are even more important in such patients. The main purpose of this study was to evaluate the diagnostic value of minor salivary gland biopsy in patients suspected with Sjogren's syndrome who are negative for both anti-SSA and anti-SSB antibodies.METHODS: We conducted a retrospective analysis of 29 patients with suspected Sjogren's syndrome with negative anti-SSA and anti-SSB antibodies, who underwent minor salivary gland biopsy at the En-Chu-Kong hospital from August 2008 to November 2012. On the basis of the American-European consensus group criteria, all patients showed one or more subjective symptoms and evidence of diminished salivary and lacrimal flow preoperatively. We analyzed the biopsy results, serological markers, and safety of the minor salivary gland biopsy.RESULTS: Of the 29 patients (2 males and 27 females) with a mean age of 55.4 years (range, 26–82 years), 1 patient underwent biopsy twice because of insufficient sample at the first attempt. The effective specimen collection rate was 96.7%. The diagnosis of Sjogren's syndrome was confirmed in 11 patients by biopsy, and the positive rate of biopsy was 37.9 %. The differences in the surgical duration (p ＜ 0.001) between the patients with positive and negative biopsy results were statistically significant. Patients who had positive biopsy results had a longer surgical duration. Among serological markers, positive erythrocyte sedimentation rate had the highest sensitivity (72.7%), and a combined positivity for rheumatoid factor and antinuclear antibodies had the best specificity (91.7%).CONCLUSIONS: Sjogren's syndrome patients with anti-SSA and anti-SSB antibody levels within the normal ranges are not uncommon. Minor salivary gland biopsy is a useful, simple, safe diagnostic tool for patients having mucosal dryness with abnormal serological tests such as positive rheumatoid factor, positive antinuclear antibodies, or increased erythrocyte sedimentation rate.
並列摘要
BACKGROUND: Sjogren's syndrome is a common condition; however, it is often difficult to diagnose because of its slow progression and non-specific symptoms. Serological tests of anti-SSA/Ro and anti-SSB/La antibodies are minimally invasive, but the levels of these antibodies may be within the normal range. Therefore, further histopathological studies are even more important in such patients. The main purpose of this study was to evaluate the diagnostic value of minor salivary gland biopsy in patients suspected with Sjogren's syndrome who are negative for both anti-SSA and anti-SSB antibodies.METHODS: We conducted a retrospective analysis of 29 patients with suspected Sjogren's syndrome with negative anti-SSA and anti-SSB antibodies, who underwent minor salivary gland biopsy at the En-Chu-Kong hospital from August 2008 to November 2012. On the basis of the American-European consensus group criteria, all patients showed one or more subjective symptoms and evidence of diminished salivary and lacrimal flow preoperatively. We analyzed the biopsy results, serological markers, and safety of the minor salivary gland biopsy.RESULTS: Of the 29 patients (2 males and 27 females) with a mean age of 55.4 years (range, 26–82 years), 1 patient underwent biopsy twice because of insufficient sample at the first attempt. The effective specimen collection rate was 96.7%. The diagnosis of Sjogren's syndrome was confirmed in 11 patients by biopsy, and the positive rate of biopsy was 37.9 %. The differences in the surgical duration (p ＜ 0.001) between the patients with positive and negative biopsy results were statistically significant. Patients who had positive biopsy results had a longer surgical duration. Among serological markers, positive erythrocyte sedimentation rate had the highest sensitivity (72.7%), and a combined positivity for rheumatoid factor and antinuclear antibodies had the best specificity (91.7%).CONCLUSIONS: Sjogren's syndrome patients with anti-SSA and anti-SSB antibody levels within the normal ranges are not uncommon. Minor salivary gland biopsy is a useful, simple, safe diagnostic tool for patients having mucosal dryness with abnormal serological tests such as positive rheumatoid factor, positive antinuclear antibodies, or increased erythrocyte sedimentation rate.
延伸閱讀
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