Contribution of salivary gland ultrasonography to the diagnosis of Sjögren's syndrome: Toward new diagnostic criteria?
| العنوان: | Contribution of salivary gland ultrasonography to the diagnosis of Sjögren's syndrome: Toward new diagnostic criteria? |
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| المؤلفون: | Divi Cornec, Sandrine Jousse-Joulin, Pierre Youinou, Emmanuel Nowak, Béatrice Cochener, Valérie Devauchelle-Pensec, Thierry Marhadour, Alain Saraux, Sylvie Boisramé-Gastrin, Jacques-Olivier Pers |
| المساهمون: | Immunologie et Pathologie (EA2216), Université de Brest (UBO)-IFR148, CHRU Brest - Service de Rhumatologie (CHU - BREST - Rhumato), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Université de Brest (UBO), Centre d'Investigation Clinique (CIC - Brest), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire d'Immunologie et Immunothérapie |
| المصدر: | Arthritis and Rheumatism Arthritis and Rheumatism, Wiley, 2013, 65 (1), pp.216-25. ⟨10.1002/art.37698⟩ |
| بيانات النشر: | HAL CCSD, 2013. |
| سنة النشر: | 2013 |
| مصطلحات موضوعية: | Adult, Male, Pathology, medicine.medical_specialty, Immunology, Logistic regression, Sensitivity and Specificity, Salivary Glands, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, stomatognathic system, Major Salivary Gland, Immunology and Allergy, Medicine, Humans, Pharmacology (medical), Prospective cohort study, 030304 developmental biology, Aged, Ultrasonography, 030203 arthritis & rheumatology, 0303 health sciences, Receiver operating characteristic, Salivary gland, business.industry, Middle Aged, Parotid gland, medicine.anatomical_structure, Cross-Sectional Studies, Sjogren's Syndrome, [SDV.IMM]Life Sciences [q-bio]/Immunology, Female, Sjogren s, business, Nuclear medicine |
| الوصف: | Objective To determine the accuracy of salivary gland ultrasonography (SGUS) for diagnosing primary Sjogren's syndrome (SS) and to suggest modifications of the American–European Consensus Group (AECG) classification criteria. Methods We conducted a cross-sectional study in a prospective cohort of patients with suspected primary SS that was established between 2006 and 2011. The echostructure of the bilateral parotid and submandibular glands was graded from 0 to 4, and the gland size was measured; blood flow to the parotid gland was assessed using Doppler waveform analysis. The reference standard was a clinical diagnosis of primary SS as determined by a group of experts blinded to the results of SGUS. Receiver operating characteristic (ROC) curve analysis was performed to compare the diagnostic value of the 0–4-point echostructure grade for each of the 4 major salivary glands, the sum of the grades for the 4 glands, and the highest grade among the 4 glands. Results Of the 158 patients in the study, 78 had a diagnosis of primary SS according to the experts, including 61 patients (78.2%) who met the AECG criteria. Doppler waveform analysis and gland size measurement showed poor diagnostic performance. The results of ROC curve analysis showed that the highest grade among the 4 glands provided the best diagnostic value. The optimal grade cutoff was 2 (62.8% sensitivity and 95.0% specificity). A weighted score was constructed using scores for the 5 variables selected by logistic regression analysis, as follows: (salivary flow × 1.5) + (Schirmer's test × 1.5) + (salivary gland biopsy × 3) + (SSA/SSB × 4.5) + (SGUS × 2). According to ROC curve analysis, a score of ≥5 of 12.5 had 85.7% sensitivity and 94.9% specificity, compared with 77.9% sensitivity and 98.7% specificity for the AECG criteria. The addition of SGUS to the AECG criteria increased sensitivity to 87.0% but did not change specificity. Conclusion Modifications of the AECG criteria, including the addition of a SGUS score, notably improved diagnostic performance. |
| اللغة: | English |
| تدمد: | 0004-3591 1529-0131 |
| DOI: | 10.1002/art.37698⟩ |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::c13a52f7950bafd40757ec45a8ef6c03 https://hal.univ-brest.fr/hal-00777327 |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....c13a52f7950bafd40757ec45a8ef6c03 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 00043591 15290131 |
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| DOI: | 10.1002/art.37698⟩ |