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Histopathological environment besides the focus score in Sjögren's syndrome
Author(s) -
LlamasGutierrez Francisco J.,
Reyes Edgardo,
Martínez Braulio,
HernándezMolina Gabriela
Publication year - 2014
Publication title -
international journal of rheumatic diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.795
H-Index - 41
eISSN - 1756-185X
pISSN - 1756-1841
DOI - 10.1111/1756-185x.12502
Subject(s) - medicine , fibrosis , pathology , atrophy , hyperplasia , salivary gland , gastroenterology , high power field , immunohistochemistry
Aim To compare the prevalence of diverse histopathologic features among patients with Sjögren's syndrome ( SS ) and controls, and to evaluate their relationship with age, a focus score ( FS ) ≥ 1 and some clinical and serological SS features. Methods A blinded pathologist examined 63 SS and 11 control minor salivary gland biopsies. Focal lymphocytic sialadenitis ( FLS ) was defined as a focus score ( FS ) ≥ 1. We also evaluated lymphoepithelial lesions, germinal centers ( GC s), epithelial metaplasia, dilatation and hyperplasia in the main secretory duct, perivascular cell infiltrate, adipose infiltration, acinar atrophy, interstitial fibrosis and lymphocytes/plasma cells remote from the FLS . We registered demographics, anti‐Ro/La status and clinical features. We used Kendall's tau coefficients and logistic regression analysis. Results Sjögren's syndrome patients had a higher frequency of FS ≥ 1 (92% vs . 27%), acinar atrophy (78% vs . 18%), lymphocytes and plasma cells external to the FSL (92% vs . 64%) and stromal fibrosis (68% vs . 36%). A FS ≥ 1 correlated with the presence of GC s and acinar atrophy; whereas age correlated with duct dilation, duct epithelial hyperplasia, adipose infiltration and fibrosis. SS patients with hepatic involvement exhibited more frequent duct dilatation. After adjusting by age, anti‐Ro/ SSA (odds ratio [ OR ] 30.8, 95% CI 2.2–423.5, P = 0.01), a FS ≥ 1 ( OR 54.3, 95% CI 4.8–612, P = 0.001) and fibrosis ( OR 15.2, 95% CI 1.2–186.2, P = 0.03) were associated with SS . Conclusion Other histologic findings coexist with FLS , but only GC formation and acinar atrophy correlated with a FS ≥ 1. Age is mostly correlated with the remaining histological features. However, the clinical relevance of these findings is unknown.