原发性干燥综合征患者涎腺超声评分与唇腺病理分级的相关性研究

Correlation between ultrasonographic scoring system and pathological grading of the salivary glands in primary Sjogren＇s syndrome

目的探讨pSS患者涎腺超声评分与唇腺病理分级间的相关性，并对比两者的临床诊断价值。方法对57例临床疑似pSS患者进行涎腺超声评分与唇腺活检。涎腺的超声半定量评分为0-4分，≥2分为阳性；唇腺病理结果分为0-4级，≥3级为阳性。绘制受试者工作特征曲线（ROC）计算曲线下面积（AUC），评价2种方法诊断pSS的临床应用价值，同时采用Spearman等级相关性分析比较二者之间的相关性。结果57例疑似患者中，临床确诊pSS共39例。涎腺超声检查评价pSS的敏感性、特异性、ROC曲线下面积（AUC）分别为87.2%、77.8%、0.893；唇腺病理评价pSS的敏感性、特异性、ROC曲线下面积（AUC）分别为74.4%、88.9%、0.870；涎腺超声评分与病理分级之间呈正相关（r=0.755，P〈0.01）。结论涎腺超声评分与唇腺病理活检分级有较高的一致性，可作为pSS的重要诊断标准。

ObjectiveTo investigate the correlation and diagnostic value between ultrasonographic scoring system and pathological grading of the salivary glands in primary Sj？gren＇s syndrome （pSS）.MethodsFifty-seven patients with a suspected diagnosis of pSS were examined by ultrasonography and salivary gland biopsy. The ultrasound imaging of the salivary glands were analyzed and graded according to a 5-point （0-4） ultrasonographic scoring system. The results of salivary gland biopsy were graded according to the degree of lymphocytic infiltration. The receiver operating curve （ROC） was drawn and the area under curve （AUC） was calculated to test the diagnostic performance of the two methods. Spearman rank correlation analysis was used to compare the correlation between the two methods.ResultsAmong the 57 patients, a definite diagnosis of pSS was established in 39 patients. The sensitivity, specificity and AUC of the ultrasonographic scoring system were 87.2%, 77.8% and 0.893 respectively, the sensitivity, specificity, and AUC of the salivary gland biopsy were 74.4%, 88.9% and 0.870 respectively. The ultrasonographic scoring system and grading of salivary gland biopsy showed a significant positive correlation （r=0.755, P〈0.01）.ConclusionThere is a good consistency between the ultrasonographic scoring system and the grading of salivary gland biopsy. As the diagnostic value of the two methods are similar, ultrasonography reaches great diagnostic efficiency in pSS.