Sjögren's disease & overlap diseases
Increased Diagnostic Accuracy of the Labial Gland Biopsy in Primary Sjögren Syndrome When Multiple Histopathological Features Are Included
Authors' conclusion
The diagnostic accuracy of the labial gland biopsy increases when other histopathological features besides FS are taken into account, by reducing the number of false-positive biopsies.
Study context
- Population
- Patients from a diagnostic sicca cohort with clinically suspected primary Sjögren syndrome (pSS) who underwent a labial gland biopsy38 pSS, 65 non-SS sicca
- Comparison
- Labial gland biopsy: two or more of four histopathological features vs focus score (FS) ≥1 alone
- Outcome
- Diagnostic accuracy (sensitivity, specificity) of labial gland biopsy for pSS vs expert panel diagnosis
Methodological detailsdiagnostic sicca cohort, expert panel reference standard (vignettes), ROC analysis
- Diagnostic sicca cohort
- Expert panel reference standard (vignettes)
- ROC analysis
Performance
As reported in the abstract
| Test or model | Sensitivity | Sensitivity (prevalence in pSS) | Specificity (range for the three non-FS features) | Specificity |
|---|---|---|---|---|
| FS ≥1 | 82% | — not stated in the abstract | — not stated in the abstract | — not stated in the abstract |
| Lesions | — not stated in the abstract | 68% | 98%-100% | — not stated in the abstract |
| IgG plasma cell shift | — not stated in the abstract | 63% | 98%-100% | — not stated in the abstract |
| Germinal centers | — not stated in the abstract | 24% | 98%-100% | — not stated in the abstract |
| ≥2 of 4 features | — not stated in the abstract | — not stated in the abstract | — not stated in the abstract | 100% |
Sensitivity
FS ≥182%
Lesions— not stated in the abstract
IgG plasma cell shift— not stated in the abstract
Germinal centers— not stated in the abstract
≥2 of 4 features— not stated in the abstract
Sensitivity (prevalence in pSS)
FS ≥1— not stated in the abstract
Lesions68%
IgG plasma cell shift63%
Germinal centers24%
≥2 of 4 features— not stated in the abstract
Specificity (range for the three non-FS features)
FS ≥1— not stated in the abstract
Lesions98%-100%
IgG plasma cell shift98%-100%
Germinal centers98%-100%
≥2 of 4 features— not stated in the abstract
Specificity
FS ≥1— not stated in the abstract
Lesions— not stated in the abstract
IgG plasma cell shift— not stated in the abstract
Germinal centers— not stated in the abstract
≥2 of 4 features100%
— not stated in the abstract
Further findings
Specificity for fulfilment of ACR/EULAR criteria, abnormal biopsy definition
Specificity
Original publication
Increased Diagnostic Accuracy of the Labial Gland Biopsy in Primary Sjögren Syndrome When Multiple Histopathological Features Are Included. Arthritis Rheumatol. Published 9 January 2024. doi:10.
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