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Abstract：
This was an ambispective cohort study evaluating the prognostic significance of lymphocytic foci and its lymphoid composition in minor salivary gland biopsy (MSGB) for short-term disease flare and severity in Sjögren\'s syndrome (SS).
The inclusion criteria comprised individuals meeting the ACR/EULAR 2016 criteria who underwent MSGB with an infiltration of more than 50 lymphocytes and received clinical diagnosis between September 2017 and December 2018. Patients with inadequate biopsy samples were excluded. The number of lymphocytic foci and their lymphoid composition in MSGB were assessed using immunofluorescence staining. Major organ damage and improvements in the EULAR Sjögren\'s Syndrome Disease Activity Index (ESSDAI) were measured. Statistical analyses, including Cox and linear regressions, were conducted.
A total of 78 patients with at least one lymphocytic focus were included in the study. The presence of higher T-cell counts in lymphocytic foci in MSGB was associated with severe disease flare, and a logarithmic transformation of T-cell count indicated increased risk (HR 1.96, 95% CI 0.91-4.21). Improvements in the ESSDAI were associated with higher total lymphocyte count and T- and B-cell numbers in the lymphoid composition of the lymphocytic foci. Seropositive patients exhibited higher T CD4+ cell numbers. Correlation analysis showed negative associations between age and lymphocytic foci and the T-cell count. Positive correlations were observed between antinuclear antibody (ANA) titers and total lymphocyte numbers.
Patients with a higher number of T cells in the lymphocytic infiltrates of lymphocytic foci may have a two-fold risk of severe disease flare. The number of B cells and T CD4+ cells in the lymphocytic infiltrates of lymphocytic foci showed a weak but positive relation with the ESSDAI improvement during follow-up. Age and seropositivity appeared to influence the lymphoid composition of the lymphocytic foci.
The inclusion criteria comprised individuals meeting the ACR/EULAR 2016 criteria who underwent MSGB with an infiltration of more than 50 lymphocytes and received clinical diagnosis between September 2017 and December 2018. Patients with inadequate biopsy samples were excluded. The number of lymphocytic foci and their lymphoid composition in MSGB were assessed using immunofluorescence staining. Major organ damage and improvements in the EULAR Sjögren\'s Syndrome Disease Activity Index (ESSDAI) were measured. Statistical analyses, including Cox and linear regressions, were conducted.
A total of 78 patients with at least one lymphocytic focus were included in the study. The presence of higher T-cell counts in lymphocytic foci in MSGB was associated with severe disease flare, and a logarithmic transformation of T-cell count indicated increased risk (HR 1.96, 95% CI 0.91-4.21). Improvements in the ESSDAI were associated with higher total lymphocyte count and T- and B-cell numbers in the lymphoid composition of the lymphocytic foci. Seropositive patients exhibited higher T CD4+ cell numbers. Correlation analysis showed negative associations between age and lymphocytic foci and the T-cell count. Positive correlations were observed between antinuclear antibody (ANA) titers and total lymphocyte numbers.
Patients with a higher number of T cells in the lymphocytic infiltrates of lymphocytic foci may have a two-fold risk of severe disease flare. The number of B cells and T CD4+ cells in the lymphocytic infiltrates of lymphocytic foci showed a weak but positive relation with the ESSDAI improvement during follow-up. Age and seropositivity appeared to influence the lymphoid composition of the lymphocytic foci.
摘要：
■这是一项综合队列研究，评估小唾液腺活检（MSGB）中淋巴细胞灶及其淋巴组成对Sjögren综合征（SS）短期疾病发作和严重程度的预后意义。
■纳入标准包括符合ACR/EULAR2016标准的个体，他们在2017年9月至2018年12月期间接受了超过50个淋巴细胞浸润的MSGB，并接受了临床诊断。排除活检样本不足的患者。使用免疫荧光染色评估MSGB中淋巴细胞灶的数量及其淋巴组成。测量了主要器官损伤和EULARSjögren综合征疾病活动指数（ESSDAI）的改善。统计分析，包括考克斯和线性回归，进行了。
■总共78例至少有一个淋巴细胞病灶的患者被纳入研究。MSGB淋巴细胞灶中存在较高的T细胞计数与严重的疾病发作有关，T细胞计数的对数转换表明风险增加(HR1.96,95%CI0.91-4.21).ESSDAI的改善与淋巴细胞灶的淋巴样成分中更高的淋巴细胞总数以及T细胞和B细胞数量有关。血清阳性患者表现出更高的CD4T细胞数。相关分析显示，年龄与淋巴细胞灶和T细胞计数之间呈负相关。抗核抗体（ANA）滴度与淋巴细胞总数呈正相关。
■淋巴细胞灶的淋巴细胞浸润中T细胞数量较高的患者可能有两倍的严重疾病发作风险。在随访期间，淋巴细胞灶的淋巴细胞浸润中的B细胞和TCD4细胞的数量与ESSDAI改善呈微弱但正相关。年龄和血清阳性似乎会影响淋巴细胞灶的淋巴组成。
■纳入标准包括符合ACR/EULAR2016标准的个体，他们在2017年9月至2018年12月期间接受了超过50个淋巴细胞浸润的MSGB，并接受了临床诊断。排除活检样本不足的患者。使用免疫荧光染色评估MSGB中淋巴细胞灶的数量及其淋巴组成。测量了主要器官损伤和EULARSjögren综合征疾病活动指数（ESSDAI）的改善。统计分析，包括考克斯和线性回归，进行了。
■总共78例至少有一个淋巴细胞病灶的患者被纳入研究。MSGB淋巴细胞灶中存在较高的T细胞计数与严重的疾病发作有关，T细胞计数的对数转换表明风险增加(HR1.96,95%CI0.91-4.21).ESSDAI的改善与淋巴细胞灶的淋巴样成分中更高的淋巴细胞总数以及T细胞和B细胞数量有关。血清阳性患者表现出更高的CD4T细胞数。相关分析显示，年龄与淋巴细胞灶和T细胞计数之间呈负相关。抗核抗体（ANA）滴度与淋巴细胞总数呈正相关。
■淋巴细胞灶的淋巴细胞浸润中T细胞数量较高的患者可能有两倍的严重疾病发作风险。在随访期间，淋巴细胞灶的淋巴细胞浸润中的B细胞和TCD4细胞的数量与ESSDAI改善呈微弱但正相关。年龄和血清阳性似乎会影响淋巴细胞灶的淋巴组成。
