PDF(Pubmed)
Abstract：
(1) Objective: To determine the diagnostic accuracy of major salivary gland ultrasonography (SGUS) in primary Sjogren\'s syndrome (SS), we used the Outcome Measures in Rheumatology Clinical Trials (OMERACT) scoring system on a large single-centre cohort of patients with sicca syndrome. (2) Method: We retrospectively collected the clinical, imaging and serological data of all the patients referred with a suspicion of SS who underwent SGUS and minor salivary glands biopsy. (3) Results: A total of 132 patients were included. The SGUS scores were correlated between the two sides (p < 0.001). The diagnostic cut-off for SS (AUROC: 0.7408) was 6 for the SGUS-global sum (sensitivity: 32.43%; specificity: 96.84%). The cut-off with the highest specificity for SS diagnosis was 7. In the patients with a final diagnosis of SS, the mean SGUS score was significantly higher (p < 0.001) than that of the non-SS patients (3.73 vs. 1.32 for the SGUS-global sum). A significant correlation was demonstrated between the SGUS scores and final SS diagnosis (p < 0.001), biopsy positivity (p < 0.001), ANA positivity (p = 0.016), Ro-SSA positivity (p = 0.01), and gland fibrosis (p = 0.02). (4) Conclusions: SGUS, using the OMERACT scoring system, has moderate sensitivity and high specificity for the diagnosis of SS. The scoring showed a strong and direct correlation with all the clinical hallmarks of SS diagnosis, such as the positivity of a labial salivary gland biopsy, ANA and Ro-SSA statuses, and salivary gland fibrosis. Because of its high specificity, a SGUS-global score > 6 could be therefore employed for the diagnosis of SS in the case of ANA negativity or the unavailability of a biopsy.
摘要：
(1)目的:探讨大涎腺超声检查(SGUS)对原发性干燥综合征(SS)的诊断价值。我们在干燥综合征患者的大型单中心队列中使用了风湿病学临床试验结局指标(OMERACT)评分系统.(2)方法:回顾性收集临床,所有怀疑SS的患者接受SGUS和小唾液腺活检的影像学和血清学数据。(3)结果:共纳入132例患者。SGUS评分在两侧之间具有相关性(p<0.001)。对于SGUS-全局总和,SS(AUROC:0.7408)的诊断界限为6(灵敏度:32.43%;特异性:96.84%)。对SS诊断具有最高特异性的截断值为7。在最终诊断为SS的患者中，平均SGUS评分明显高于（p<0.001）非SS患者（3.73vs.SGUS-globalsum的1.32)。SGUS评分与最终SS诊断之间存在显着相关性（p<0.001），活检阳性（p<0.001），ANA阳性（p=0.016），Ro-SSA阳性（p=0.01），和腺体纤维化（p=0.02）。(4)结论：SGUS，使用OMERACT评分系统，对SS的诊断具有中等敏感性和高特异性。评分显示出与SS诊断的所有临床标志有很强的直接相关性，例如唇腺活检的阳性，ANA和Ro-SSA状态，和唾液腺纤维化。由于其高特异性,因此,在ANA阴性或无法进行活检的情况下,SGUS-全局评分>6可用于SS的诊断.
