Correlations between salivary gland scintigraphy and histopathologic data of salivary glands in patients with primary Sjogren's syndrome

Clin Rheumatol. 2022 Oct;41(10):3083-3093. doi: 10.1007/s10067-022-06269-x. Epub 2022 Jun 30.

Abstract

Objectives: Our aim was to evaluate the association between salivary gland scintigraphy and the clinical parameters, including histological characteristics of salivary glands, in patients with primary Sjogren's syndrome (pSS).

Methods: Forty-one pSS patients were included in the study. The patients who had received salivary gland scintigraphy and minor salivary gland biopsy were retrospectively analyzed. Salivary gland scintigraphy was interpreted via semi-quantitative methods obtained by calculating the peak uptake and washout of each gland using regions of interest. All specimens were examined by pathologists for focus scores and leukocyte common antigen (LCA) to determine the degree of inflammatory infiltration.

Results: The mean age of pSS patients was 46.4 years, 82.9% were female, and the mean duration of symptoms was 2.5 years. The focus score was negatively correlated to the mean peak uptake (r = ‒0.396; p = 0.019), mean uptake (r = ‒0.388; p = 0.021), and mean percentage washout (r = ‒0.391; p = 0.02). In addition, the focus score and number of LCA positive cells per mm2 were correlated with the clinical parameters including erythrocyte sedimentation rate, globulin, rheumatoid factor, unstimulated whole saliva, and stimulated whole saliva flow. The number of LCA positive cells per mm2 was negatively correlated to leukocytes and hemoglobin.

Conclusion: Although the diagnostic role of salivary gland biopsy is widely accepted and features in the classification criteria of Sjogren's syndrome, salivary gland scintigraphy may be an acceptable alternative method especially if a non-invasive test is required.

Keywords: Minor salivary gland biopsy; Salivary gland scintigraphy; Sjogren’s syndrome; Unstimulated/stimulated whole saliva flow rate.

MeSH terms

  • Female
  • Humans
  • Leukocyte Common Antigens
  • Male
  • Middle Aged
  • Radionuclide Imaging
  • Retrospective Studies
  • Rheumatoid Factor
  • Salivary Glands / diagnostic imaging
  • Salivary Glands / pathology
  • Salivary Glands, Minor / diagnostic imaging
  • Salivary Glands, Minor / pathology
  • Sjogren's Syndrome* / diagnosis

Substances

  • Rheumatoid Factor
  • Leukocyte Common Antigens