摘要 ：目的：唾液腺超聲檢查(SGUS)已應用於診斷幹燥綜合征(SS)。本研究的目的是探討SGUS表現與SS的臨床、病理和血清學特征的相關性。

方法：共有104例疑似SS的患者進行了SGUS檢查以評價唾液腺受累的情況。根據SS分類標準確定原發性SS患者。雙側腮腺和頜下腺的實質不均勻改變分級為0(均勻)至4分(明顯均勻)。應用受試者工作特征曲線(ROC)分析不同SGUS評分方法的診斷效能。比較依據SGUS評分分組的患者臨床和血清學特征。多變量線性回歸分析評價SGUS和SS這些特征的相關性。

結果：研究對象主要為女性(96.2%)，平均年齡為54.1歲。分別有87例和88例患者基於AECG標準和ACR/EULAR SS的分類標準確定為原發性SS。不同的評分方法中，四個唾液腺評分的總和(範圍0-16)具有最好的診斷效能，區分原發性SS和非SS性Sicca的敏感性為77.3%，特異性為87.5%(閾值，7)。SGUS評分與唇腺活檢病灶評分(β= 0.240，P = 0.033)和抗Ro/SSA抗體陽性(β= 0.283，P = 0.016)正相關，與非刺激性唾液流率負相關(β= -0.298，P = 0.011)。

結論：唾液腺超聲表現與小涎腺組織病理學、SS血清學和唾液腺功能相關。

附原文：Abstract OBJECTIVE:Salivarygland ultrasonography (SGUS) has been applied in the diagnosis ofSjögren'ssyndrome(SS). The aim of this study is to investigate theassociation of SGUS findings with clinical, histological, and serologicfeatures of SS.METHODS:A total of 104 patients with suspected SS underwent SGUSfor evaluation of salivary gland involvement. Patients with primary SS weredetermined according to the classification criteria for SS. The parenchymalinhomogeneity of bilateral parotid and submandibular glands was graded from 0(homogeneity) to 4 (gross inhomogeneity). Receiver operating characteristiccurve analysis was performed to compare the diagnostic performance of differentSGUS scoring methods. Clinical and serologic features were compared between groupsclassified by SGUS score. The association between SGUS and these features of SSwas explored by multivariable linear regression analysis.RESULTS:Studyparticipants were predominantly women (96.2%) and had a mean age of54.1years. Eighty-seven patients and 88 patients with primary SS wereidentified based on AECG criteria and ACR/EULAR classification criteria for SS,respectively. Among the different scoring methods, the sum of the grades offour salivary glands (range 0-16) had the best diagnostic performance, withsensitivity of 77.3% and specificity of 87.5% (cutoff value, 7) fordistinguishing primary SS from sicca non-SS. SGUS score was associated withfocus score in labial salivary gland biopsy (β=0.240,p=0.033) and anti-Ro/SSA serology (β=0.283,p=0.016) and inversely associated with unstimulated whole salivaryflow (β=-0.298, p=0.011).CONCLUSION:Ultrasonography ofmajor salivary glands is associated with histopathology of minor salivaryglands, serology of SS, and salivary gland function.

引自：

Kim JW,Lee H,Park SH,Kim SK,Choe JY,Kim JK.Salivary gland ultrasonography findings areassociated with clinical, histological, and serologic features ofSjögren'ssyndrome.Scand J Rheumatol.2018 Feb 7:1-8.doi: 10.1080/03009742.2017.1374451.[Epub ahead of print]