TY - JOUR

T1 - Value of multilevel sectioning of labial salivary gland biopsies in the diagnosis of Sjögren's syndrome

AU - Bredahl, Simon Kold

AU - Reibel, Jesper

AU - Pedersen, Anne Marie Lynge

PY - 2021

Y1 - 2021

N2 - Objectives. The objective of this study was to examine the diagnostic value of cutting labial salivary gland (LSG) biopsies at 2 levels in the histological evaluation for Sjogren's syndrome (SS).Study Design. This retrospective study included LSG biopsy specimens from 112 consecutive patients evaluated for SS from 2007 to 2019. Three observers, blinded with regard to patient data, independently scored the degree of focal lymphocytic infiltration (foci) and calculated the focus score in specimens cut at 2 levels 60 mu m apart.Results. Unblinded analysis revealed that the LSG specimens derived from 107 women and 5 men, aged 49.2 +/- 22.3 years. Seventy-six patients had SS (70 primary SS and 6 secondary SS) according to the American-European Consensus Group and American College of Rheumatology/European League Against Rheumatism criteria. The average number of LSGs was 5.0 +/- 1.4 and the focus scoring area was 16.1 +/- 7.6 mm(2). Compared to baseline, the average number of foci (4.4 vs 5.1, P <.001), focus score (1.7 vs 1.9, P = .01), and cases with focus score >1.0 (61 vs 74%; P = .03) were higher in the second level. Subsequently, an additional 11 cases of SS were confirmed (14%), and 8 non-SS cases were reclassified as SS (22%).Conclusions. Histological assessment of an additional section level improves the diagnostic accuracy of the labial salivary gland biopsy to detect histopathological changes consistent with the diagnosis of SS.

AB - Objectives. The objective of this study was to examine the diagnostic value of cutting labial salivary gland (LSG) biopsies at 2 levels in the histological evaluation for Sjogren's syndrome (SS).Study Design. This retrospective study included LSG biopsy specimens from 112 consecutive patients evaluated for SS from 2007 to 2019. Three observers, blinded with regard to patient data, independently scored the degree of focal lymphocytic infiltration (foci) and calculated the focus score in specimens cut at 2 levels 60 mu m apart.Results. Unblinded analysis revealed that the LSG specimens derived from 107 women and 5 men, aged 49.2 +/- 22.3 years. Seventy-six patients had SS (70 primary SS and 6 secondary SS) according to the American-European Consensus Group and American College of Rheumatology/European League Against Rheumatism criteria. The average number of LSGs was 5.0 +/- 1.4 and the focus scoring area was 16.1 +/- 7.6 mm(2). Compared to baseline, the average number of foci (4.4 vs 5.1, P <.001), focus score (1.7 vs 1.9, P = .01), and cases with focus score >1.0 (61 vs 74%; P = .03) were higher in the second level. Subsequently, an additional 11 cases of SS were confirmed (14%), and 8 non-SS cases were reclassified as SS (22%).Conclusions. Histological assessment of an additional section level improves the diagnostic accuracy of the labial salivary gland biopsy to detect histopathological changes consistent with the diagnosis of SS.

KW - CLASSIFICATION CRITERIA

KW - CLINICAL-TRIALS

KW - HISTOPATHOLOGY

KW - CONSENSUS

U2 - 10.1016/j.oooo.2020.09.013

DO - 10.1016/j.oooo.2020.09.013

M3 - Journal article

C2 - 33189649

VL - 131

SP - 85

EP - 91

JO - Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

JF - Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

SN - 2212-4403

IS - 1

ER -