Ultrasound of the salivary glands is a strong predictor of labial gland biopsy histopathology in patients with sicca symptoms

Astorri, Elisa; Sutcliffe, Nurhan; Richards, Paula J.; Suchak, Krishna; Pitzalis, Costantino; Bombardieri, Michèle; Tappuni, Anwar R.

doi:10.1111/jop.12387

Cited by 47 publications

(36 citation statements)

References 27 publications

(38 reference statements)

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“…In accordance with our findings, Astorri et al 23 reported that positive sUS was highly predictive of positive labial gland biopsies. Therefore, one could consider not performing a labial gland biopsy in patients with a positive sUS.…”

Section: Discussionsupporting

confidence: 93%

“…There are some possible explanations for this discrepancy. None of the ‘non-Sjögren sicca patients’ in the study of Astorri et al 23 had a positive labial gland biopsy, while some of our ‘non-Sjögren sicca patients’ did have a positive biopsy. These biopsies may be false-positive,24 25 or these patients have SS not meeting the classification criteria.…”

Section: Discussioncontrasting

confidence: 50%

“…These biopsies may be false-positive,24 25 or these patients have SS not meeting the classification criteria. Moreover, Astorri et al 23 did not mention the time interval between sUS and labial gland biopsy, which may be longer than in our study and a different sUS scoring system was used.…”

Section: Discussionmentioning

confidence: 72%

“…Astorri et al 23 stated that labial gland biopsies should not be performed in extractable nuclear antigen (ENA)-negative patients with negative sUS, unless there are other strong clinical indications for SS. Based on our data, we cannot support this conclusion.…”

Section: Discussionmentioning

confidence: 99%

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Ultrasonography of major salivary glands compared with parotid and labial gland biopsy and classification criteria in patients with clinically suspected primary Sjögren’s syndrome

et al. 2017

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Section: Discussionsupporting

confidence: 93%

Section: Discussioncontrasting

confidence: 50%

Section: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 99%

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Ultrasonography of major salivary glands compared with parotid and labial gland biopsy and classification criteria in patients with clinically suspected primary Sjögren’s syndrome

et al. 2017

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“…In a blinded, retrospective study of minor salivary gland histopathology and major salivary gland ultrasonography, SGUS had a positive predictive value of 85% and a negative predicative value of 96% for the histology results. Overall concordance between SGUS and histopathology was 91% (71).…”

Section: Major Salivary Gland Ultrasonographymentioning

confidence: 92%

Current concepts on Sjögren's syndrome – classification criteria and biomarkers

Jönsson

Brokstad

Jonsson

et al. 2018

European J Oral Sciences

113

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Sjögren's syndrome is a lymphoproliferative disease with autoimmune features characterized by mononuclear cell infiltration of exocrine glands, notably the lacrimal and salivary glands. These lymphoid infiltrations lead to dryness of the eyes (keratoconjunctivitis sicca), dryness of the mouth (xerostomia), and, frequently, dryness of other surfaces connected to exocrine glands. Sjögren's syndrome is associated with the production of autoantibodies because B-cell activation is a consistent immunoregulatory abnormality. The spectrum of the disease extends from an organ-specific autoimmune disorder to a systemic process and is also associated with an increased risk of B-cell lymphoma. Current treatments are mainly symptomatic. As a result of the diverse presentation of the syndrome, a major challenge remains to improve diagnosis and therapy. For this purpose an international set of classification criteria for primary Sjögren's syndrome has recently been developed and validated and seems well suited for enrolment in clinical trials. Salivary gland biopsies have been examined and histopathology standards have been developed, to be used in clinical trials and patient stratification. Finally, ultrasonography and saliva meet the need of non-invasive imaging and sampling methods for discovery and validation of disease biomarkers in Sjögren's syndrome.

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Performance of salivary glands ultrasonography, shear wave elastography and their combined use for the diagnosis of primary and secondary Sjögren's syndrome

Cheng,

Yang,

2024

J Applied Clin Med Phys

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BackgroundSjögren's syndrome (SS) is a common rheumatic disease for which finding the right imaging tool remains a challenge.PurposeThis study aimed to evaluate the performance of salivary gland ultrasonography (SGUS), shear wave elastography (SWE) and their combined use for the diagnosis of primary and secondary SS (pSS and sSS).MethodsThis retrospective study included patients with dry symptoms who underwent routine examinations between May 2019 and December 2023. Patients were categorized into the pSS (n = 41), sSS (n = 26), and control (n = 27) groups based on the American College of Rheumatology/European League Against Rheumatism classification criteria (2016). A comparison of SGUS and shear wave velocity (SWV) results was conducted among the three groups. The diagnostic capabilities of different ultrasound methods for SS were evaluated using receiver operating characteristic (ROC) curves and the area under the curve (AUC) for specificity.ResultsCompared to the control group, both the pSS (1.80 ± 1.03 vs. 0.67 ± 0.48, p < 0.001) and the sSS (1.85 ± 0.88 vs. 0.67 ± 0.48, p < 0.001) groups exhibited significantly elevated SGUS scores. However, there was no statistically significant difference between the pSS and sSS groups (p = 0.849). The SWV values in both the pSS and sSS groups were significantly higher than those in the control group (all p < 0.001). The AUC for diagnosing SS using only SGUS scores was 0.823 (95% confidence interval [CI]: 0.731–0.894). Combining SGUS scores and SWV values resulted in improved diagnostic accuracy (AUC: 0.883, 95% CI: 0.801–0.940).ConclusionsSGUS and SWE are pivotal in the diagnosis of Sjögren's syndrome, with their synergistic application poised to bolster diagnostic precision. This combined approach also furnishes substantial backing for the clinical assessment and management of Sjögren's syndrome.

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Ultrasound of the salivary glands is a strong predictor of labial gland biopsy histopathology in patients with sicca symptoms

Abstract: Our study shows that potentially the ultrasound has a role in stratifying patients who are extractable nuclear antibody-negative and can help to prioritize the biopsy for those who have sonographic evidence of SS.

Cited by 47 publications

References 27 publications

Ultrasonography of major salivary glands compared with parotid and labial gland biopsy and classification criteria in patients with clinically suspected primary Sjögren’s syndrome

Ultrasonography of major salivary glands compared with parotid and labial gland biopsy and classification criteria in patients with clinically suspected primary Sjögren’s syndrome

Current concepts on Sjögren's syndrome – classification criteria and biomarkers

Performance of salivary glands ultrasonography, shear wave elastography and their combined use for the diagnosis of primary and secondary Sjögren's syndrome

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