Frequency of Sjögren’s syndrome in patients with dry symptoms using two histopathological methods

• Published in: Revista Colombiana de Reumatología (English Edition) 2024-01, Vol.31 (1), p.29-37
• Main Authors: Cajamarca-Barón, Jairo, Guavita-Navarro, Diana, Gutiérrez Cura, Ana María, Castro Quiroga, Paula Cristina, Cubides, Héctor, Arredondo, Ana María, Escobar, Alejandro, Polo Nieto, José Fernando, Ibáñez, Claudia, Rojas-Villarraga, Adriana
• Format: Article
• Language: English
• Subjects: Biopsia de glándula salival menor; Chisolm Mason; Focus Score; Minor salivary gland biopsy; Sjögren’s syndrome; Síndrome de Sjögren
• ISSN: 2444-4405; 2444-4405
• DOI: 10.1016/j.rcreue.2022.03.009

The criteria for Sjögren’s syndrome (SS) classification (ACR/EULAR 2016), include labial salivary gland (LSG) biopsy using the focus score (FS). But, in some cases it continues to be based on Chisholm and Mason (CM). Our objective was to evaluate the frequency of SS in patients with dry symptoms using FS and CM and to evaluate the degree of inter and intra-observer concordance of the histopathological reading by both methods. Cross-sectional study design. All patients with dry symptoms and studies to perform the SS classification criteria (2016) were included. The samples were independently evaluated by two readers. Descriptive statistics was used for the calculation of SS frequency. Agreement (Cohen’s Kappa coefficient) was analysed (STATA) for each test (CM and FS). Ethics approval was obtained. 92 patients were included. According to the 2016 criteria, SS was reported in 26.1% patients in whom FS was used and in 34.8% patients in whom CM was used. The degree of intra-observer concordance for the diagnosis of FLS was perfect and moderate-high for observers. Inter-observer agreement was substantial, with kappa values ​​of .77 FS and .75 CM. FS method is a more detailed and specific score that facilitates correct classification. The use of CM as a histopathological classificatory method for SS includes more patients when compared with FS. These results are of relevance to standardise the reading of LSG biopsy in specialized services attending SS patients. Los criterios de clasificación del síndrome de Sjögren (SS) (ACR/EULAR-2016) incluyen la biopsia de glándula salival menor (BGSM), la cual utiliza el puntaje de focos (Focus Score/FS), pero en algunos casos sigue basándose en Chisholm y Mason (CM). Nuestro objetivo fue evaluar la frecuencia de SS en pacientes con síntomas secos, mediante el uso de FS y CM y el grado de concordancia inter e intraobservador de la lectura por ambos métodos. Estudio transversal. Se incluyeron todos los pacientes con síntomas secos y estudios para realizar los criterios de clasificación SS (2016). Dos lectores hicieron la evaluación independiente. Se utilizó estadística descriptiva para el cálculo de la frecuencia de SS. Se analizó la concordancia interobservadores e intraobservadores (Kappa de Cohen) (STATA) para cada prueba (CM y FS). Se obtuvo aprobación ética. Se incluyeron 92 pacientes. Se clasificó SS en el 26,1% de los pacientes en quienes se empleó FS y en el 34,8% en quienes se empleó CM. El grado de concordancia intr