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High frequency of light chain restriction in labial gland biopsies of Sjögren's syndrome detected by in situ hybridization
Author(s) -
Jordan Richard C. K.,
Pringle J. H.,
Speight Paul M.
Publication year - 1995
Publication title -
the journal of pathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.964
H-Index - 184
eISSN - 1096-9896
pISSN - 0022-3417
DOI - 10.1002/path.1711770107
Subject(s) - sialadenitis , medicine , lymphoma , pathology , immunoglobulin light chain , digoxigenin , gastroenterology , population , biopsy , in situ hybridization , salivary gland , immunohistochemistry , antibody , biology , immunology , gene expression , gene , biochemistry , environmental health
A well‐recognized complication of Sjögren's syndrome (SS) is the development of malignant lymphoma, with a risk 44 times that of the general population. Although a few clinical signs may indicate the onset of lymphoma, there are few reliable laboratory markers which predict the development of neoplasia. A non‐isotopic in situ hybridization technique has been applied to routinely processed labial salivary gland (LSG) biopsies of patients under investigation for SS. Serial sections of 70 LSGs were examined for a κ and λ immunoglobulin light chain mRNA using digoxigenin‐labelled oligonucleotide probes. As controls, 39 biopsies from non‐SS‐associated sialadenitis were also examined. Sections were analysed using computer‐assisted quantification to determine the percentage of κ‐expressing cells in each case. The range of κ expression in the SS group was 24·1–93·4 per cent and in the non‐SS group 48·3–75·4 per cent. Light chain restriction was found in 13/70 (18·6 per cent) cases from the SS group but in no cases of the control group. Of the SS cases showing restriction, 4/13 (30·7 per cent) have subsequently developed extrasalivary gland lymphoma. Two patients not showing light chain restriction in LSG have subsequently developed lymphoma. The positive predictive value of this test to identify patients at risk of lymphoma was 30·7 per cent with a detection rate (sensitivity) of 66·47 per cent and a false‐positive rate of 14·1 per cent (specificity 85·9 per cent). This study has identified a high prevalence of light chain restriction in labial gland biopsies of patients with SS and provides objective quantitative criteria to identify those patients at greater risk of lymphoma development.