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. 2025 Jan-Mar;29(1):24-29.
doi: 10.4103/jomfp.jomfp_547_23. Epub 2025 Mar 28.

Evaluation of CD20 in labial minor salivary gland biopsies in Sjogren's syndrome

Ayesha Tabassum  1 , Malathi Narasimhan  1 , Thamizhchelvan Hari  1 , Sharada T Rajan  1 , Vijaya Nirmala Subramani  1
Affiliations

Evaluation of CD20 in labial minor salivary gland biopsies in Sjogren's syndrome

Ayesha Tabassum et al. J Oral Maxillofac Pathol. 2025 Jan-Mar.

Abstract

Context: Sjogren's syndrome (SjS) is an auto-immune disease with a chronic inflammation causing dysfunction of salivary and lacrimal glands, leading to dry eyes and dry mouth. Focal lymphocytic sialadenitis (FLS) and focus score (FS) are significant diagnostic criteria in SjS.

Aims: To evaluate the FLS and FS and quantify FS in H&E sections of normal salivary gland, inflammatory conditions, and SjS group.

Settings and design: A total of 60 cases were included and divided equally among the groups - SjS, inflammatory conditions, and normal salivary gland.

Methods and material: The clinical symptoms, associated disease, and serological tests (ANA, SSA, SSB, RF) were obtained from the records of the patient. Immunohistochemistry (IHC) staining was done (anti-CD20 monoclonal antibody). All the H&E and IHC slides were assessed by independent observers and were taken up for evaluation.

Results and conclusions: In H&E sections, FLS and FS were found only in the SjS patients and not in normal and inflammatory conditions. CD20 expression was found to be positive in 55% of SjS cases but negative in the normal and inflammatory groups. FS had been upgraded in IHC CD20 staining. FLS and FSs should be strictly evaluated according to the criteria. It was found only in SjS patients and not in normal and inflammatory conditions. Furthermore, CD20 can be used as an adjunct marker to decide the theranostic and prognostic markers of SjS. The results showed that criteria for scoring FS should be strictly followed and CD20 IHC can be used as a prognostic marker.

Keywords: CD20; Sjogren’s syndrome; focal lymphocytic sialadenitis; focus score; lip biopsies.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
complaints recorded in sjogren syndrome
Figure 2
Figure 2
Comparison of three groups in H&E. (a) 40X H&E view of normal salivary gland. (b) 40× H&E view of Inflammatory (Sialadenitis) showing presence of lymphocytes and plasma cells along with dilation of acini and destruction of acini. (c) 40 × H&E view of SjS showing periductular foci of lymphocytic infiltration ≥50 lymphocytes around normal acini
Figure 3
Figure 3
COMPARISON OF THREE GROUPS IN IHC (CD20). (a) 40 × IHC View of SjS showing expression of CD20, FLS ≥50 lymphocytes. (b) 10 × view IHC showing normal salivary gland negative to CD20. (c) 10x IHC view of inflammatory group (sialadenitis) negative to CD20. (d) 40 × IHC view showing inflammatory group (sialadenitis) expressing CD20 less than 50 lymphocytes; hence, it was scored as FS 0
See this image and copyright information in PMC

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