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2016, Volume 32, Number 2, Page(s) 065-069     
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DOI: 10.5146/tjpath.2015.01346
The Importance of Minor Salivary Gland Biopsy in Sjögren Syndrome Diagnosis and the Clinicopathological Correlation
Gürdeniz SERÝN1, Gonca KARABULUT2, Yasemin KABASAKAL2, Gülþen KANDÝLOÐLU3, Taner AKALIN3
1Department of Pathology, Buca Gynaecology, Obstetrics and Pediatrics Hospital, ÝZMÝR, TURKEY
2Department of Rheumatology, Ege University, Faculty of Medicine, ÝZMÝR, TURKEY
3Department of Pathology, Ege University, Faculty of Medicine, ÝZMÝR, TURKEY
Keywords: Sjögren syndrome, Minor salivary gland, Biopsy, Autoantibodies

Objective: Minor salivary gland biopsy is one of the objective tests used in the diagnosis of Sjögren syndrome. The aim of our study was to compare the clinical and laboratory data of primary and secondary Sjögren syndrome cases with a lymphocyte score 3 and 4 in the minor salivary gland biopsy.

Material and Method: Data from a total of 2346 consecutive minor salivary gland biopsies were retrospectively evaluated in this study. Clinical and autoantibody characteristics of 367 cases with lymphocyte score 3 or 4 and diagnosed with primary or secondary Sjögren syndrome were compared.

Results: There was no difference between lymphocyte score 3 and 4 primary Sjögren syndrome patients in terms of dry mouth, dry eye symptoms and Schirmer test results but Anti-Ro and Antinuclear Antibody positivity was statistically significantly higher in cases with lymphocyte score 4 (p= 0.025, p= 0.001). Anti-Ro test results were also found to be statistically significantly higher in secondary Sjögren syndrome patients with lymphocyte score 4 (p= 0.048).

Conclusion: In this study, the high proportion of cases with negative autoantibody but positive lymphocyte score is significant in terms of showing the contribution of minor salivary gland biopsy to Sjögren syndrome diagnosis. Lymphocyte score 3 and 4 cases were found to have similar clinical findings but a difference regarding antibody positivity in primary Sjögren syndrome. We believe that cases with lymphocyte score 4 may be Sjögren syndrome cases whose clinical manifestations are relatively established and higher autoantibody levels are therefore found.

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