Stewart CM, Bhattacharyya I, Berg K, Cohen DM, Orlando C, Drew P, Islam NM, Ojha J, Reeves W. Labial salivary gland biopsies in Sjögren's syndrome: still the gold standard?
ACTA ACUST UNITED AC 2008;
106:392-402. [PMID:
18602295 DOI:
10.1016/j.tripleo.2008.04.018]
[Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2008] [Revised: 03/26/2008] [Accepted: 04/18/2008] [Indexed: 11/18/2022]
Abstract
OBJECTIVES
The accuracy and diagnostic benefits of the labial salivary gland (LSG) biopsy for Sjögren's syndrome (SS) have received mixed reviews. This study was conducted to assess (1) the inter-rater agreement among 5 pathologists, and (2) the relationship between biopsy findings and clinical disease parameters.
STUDY DESIGN
Three oral pathologists (OP) and two surgical pathologists (SP) provided independent diagnoses, focus scores, and plasma cell characterizations for 37 LSG biopsies. Inter-rater reliability was assessed using percentage of overall agreement and intraclass correlation coefficients. Relationships between diagnoses and clinical parameters were assessed by nonparametric correlations.
RESULTS
Overall agreement among the pathologists was poor, although the intra-specialty agreement was good. The ratings of OP were most highly correlated with serological measures, while those of SP were correlated with salivary flow rate and disease damage.
CONCLUSION
Since the LSG biopsy can be the determining factor in SS diagnoses, these demonstrated inconsistencies merit further consideration.
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