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. 2014 Aug;73(8):1537-40.
doi: 10.1136/annrheumdis-2013-204634. Epub 2014 Feb 13.

The prognostic value of routinely performed minor salivary gland assessments in primary Sjögren's syndrome

Anna P Risselada  1 , Aike A Kruize  1 , Roel Goldschmeding  2 , Floris P J G Lafeber  1 , Johannes W J Bijlsma  1 , Joel A G van Roon  1
Affiliations

The prognostic value of routinely performed minor salivary gland assessments in primary Sjögren's syndrome

Anna P Risselada et al. Ann Rheum Dis. 2014 Aug.

Abstract

Objectives: To investigate the prognostic value of the lymphocytic focus score (LFS) and the percentages of IgA+, IgM+ and IgG+ plasma cells for disease severity of primary Sjögren syndrome (pSS).

Methods: Medical charts of 174 pSS patients were retrospectively analysed, comparing histology results (LFS and percentages of IgA+, IgM+ and IgG+ plasma cells) with disease outcomes as non-Hodgkin lymphoma (NHL) and clinical scores including cumulative EULAR (European League against Rheumatism) Sjögren syndrome disease activity index (ESSDAI) and the total number of extraglandular manifestations.

Results: The mean LFS was significantly higher in patients developing NHL (3.0±0.894 vs 2.25±1.086; p=0.021). The threshold of ≥3 foci has a positive predictive value of 16% for lymphoma, and a negative predictive value of 98%. Only LFS ≥3 contributed significantly and independently to NHL development in a standard multiple regression model. Ig class distribution of plasma cells did not help to identify patients developing lymphoma. Patients with LFS ≥3, ≤40% IgA+ or ≥25% IgM+ plasma cells in salivary gland biopsy specimens had significantly enhanced systemic disease.

Conclusions: Routine histopathological minor salivary gland assessment has important prognostic value. The LFS might help to identify patients with an increased risk for lymphoma.

Keywords: Disease Activity; Outcomes Research; Sjøgren's Syndrome.

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Comment in

  • Survival analysis versus event count.
    Arnaud L, Devilliers H, Amoura Z. Arnaud L, et al. Ann Rheum Dis. 2014 Jul;73(7):e37. doi: 10.1136/annrheumdis-2014-205433. Epub 2014 Mar 7. Ann Rheum Dis. 2014. PMID: 24608402 No abstract available.

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