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Ultrasound of the salivary glands is a strong predictor of labial gland biopsy histopathology in patients with sicca symptoms
Author(s) -
Astorri Elisa,
Sutcliffe Nurhan,
Richards Polly S.,
Suchak Krishna,
Pitzalis Costantino,
Bombardieri Michele,
Tappuni Anwar R.
Publication year - 2016
Publication title -
journal of oral pathology and medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.887
H-Index - 83
eISSN - 1600-0714
pISSN - 0904-2512
DOI - 10.1111/jop.12387
Subject(s) - medicine , concordance , histology , ultrasound , biopsy , histopathology , salivary gland , pathology , radiology , predictive value of tests
Background The international classification criteria for Sjögren's syndrome necessitate the presence of either extractable nuclear antibody or a characteristic focal inflammatory infiltrate in a minor salivary gland. Thus, patients who are extractable nuclear antibody‐negative will need to have a labial salivary gland biopsy, which is an invasive procedure associated with morbidity. The aim of this study was to evaluate the viability of ultrasound imaging of the major salivary glands as a predictor of the histology to explore whether ultrasound can help in stratifying Sjögren's patients and reduce the need for biopsy. Methods The records of 85 patients suspected of having Sjögren's syndrome and who have had biopsy and ultrasound were analysed retrospectively. The histology and the ultrasound were reported by experts independently. The reporting was impartial as the examiners were blinded to the results of the other investigations and to the diagnosis. Results Out of the 85 patients, 34 had positive ultrasound, 29 of whom also had positive histology. Fifty‐one patients had negative ultrasound, of whom 49 were also negative for histological features of Sjögren's syndrome. The results show that the ultrasound had a positive predictive value of 85% and a striking negative predicative value of 96% of the histology results. The overall concordance between the ultrasound and the histology was 91% (Kappa = 0.826). Conclusions 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 .