Primer Sjögren Sendromlu Hastalarda Tanı Anında Yapılan Minör Tükürük Bezi Biyopsisindeki Patolojik Bulgular ile Schirmer Testi ve Serolojik Testler Arasındaki İlişki

Abstract

Giriş ve Amaç Primer Sjögren sendromlu (pSS) hastalarda tanı anında yapılan minör tükrük bezi patolojisi ile schirmer testi ve serolojik test sonuçları arasındaki ilişkiyi değerlendirmeyi amaçladık. Gereç ve Yöntemler Haziran 2018-Temmuz 2023 tarihleri arasında tanı anında kurumumuzda serolojik testleri, minör tükürük bezi biyopsisi ve schirmer testi yapılıp pSS tanısı alan toplam 41 hasta çalışmaya dahil edildi. Biyopsi örneklerinde odak skoru, atrofi ve fibrozis değerleri skorlandı. Histopatolojik bulgular ile demografik, klinik, schirmer testi ve serolojik testler arasındaki ilişki değerlendirildi. Bulgular 41 hastanın 38'i (%92,7) kadın, 3'ü (%7) erkek olup yaş ortalaması 55,54±14,06 idi. Fokus skoru≥1 olan hastalarda; antinükleer antikor değeri≥1/320 (%42,9), romatoid faktör pozitifliği (%28,6), anti Sjögren sendromu (SS) A/SSB pozitifliği (%76,2, %38,1) daha yüksek oranda saptandı. Ayrıca, fokus skoru≥1 olan hastalarda asiner atrofi ve fibrozis daha yüksek olmakla fibrozisle arasında anlamlı ilişki vardı (p<0.008). Yaş ile asiner atrofi ve fibrozis skoru1≥ arasında (p=0,030, p=0,006) ve ağız kuruluğu ile fibrozis arasında (p=0,008) anlamlı korelasyon saptandı. Çok değişkenli analizde fokus skorunda schimer testi pozitifliği bağımsız bir risk faktörü olarak gözlendi (OR = 22,531, %95CI 1,369–370,174). Sonuç Çalışmamızda yüksek fokus skorunun serolojik testlerin pozitifliği ve ekzokrin fonksiyonların bozulmasıyla ilişkili olduğu, Schirmer testinin pozitif olmasının fokus skorunu artırıcı etkisi olduğu belirlendi.

Keywords

• Minör tükürük bezi biyopsisi
• Serolojik Testler
• Schirmer testi
• Sjögren sendromu

The Relationship Between Pathological Findings of Minor Salivary Gland Biopsy Performed at the Time of Diagnosis and Schirmer Test and Serological Tests in Patients with primary Sjögren's Syndrome

Abstract

Aim Our aim was to assess the correlation between minor salivary gland pathology and the results of Schirmer and serological tests conducted during the diagnosis of primary Sjögren's syndrome (pSS). Method A total of 41 patients who were diagnosed with pSS after having serological tests, minor salivary gland biopsy and Schirmer test performed at our institution at the time of diagnosis between June 2018 and July 2023 were included in the study. Focus score, atrophy and fibrosis values were scored in biopsy samples. The relationship between histopathological findings and clinical, Schirmer test and serological tests was evaluated. Results Of the 41 patients, 38 were female (92.7%), 3 (7%) were male, and the average age was 55.54 ± 14.06. In patients with focal score≥1, antinuclear antibody value≥1/320 (42.9%), rheumatoid factor positivity (28.6%), anti Sjögren's syndrome (SS) A/SSB positivity (76.2%, 38.1%) ) was detected at a higher rate. Additionally, acinar atrophy and fibrosis were higher in patients with focus score≥1, and there was a significant relationship between fibrosis (p<0.008). A significant correlation was detected between age with acinar atrophy and fibrosis score1≥ (p=0.030, p=0.006) and between dry mouth with fibrosis (p=0.008). In multivariate analysis, schimer test positivity in focal score was observed as an independent risk factor (OR = 22.531, 95%CI 1.369–370.174). Conclusion In our study, a high focus score was found to be correlated with positive serological tests and impaired exocrine functions, and a positive Schirmer test was found to have an increasing effect on the focus score.

Keywords

• Minör tükürük bezi biyopsisi
• Serolojik Testler
• Schirmer testi
• Sjögren sendromu

Ethical Statement

T.C. RECEP TAYYİP ERDOĞAN ÜNİVERSİTESİ Girişimsel Olmayan Klinik Araştırmalar Etik Kurul Başkanlığı Sayı : E-40465587-050.01.04-1030 24.04.2024 Konu : Etik Kurul Sayın Dr. Öğr. Üyesi Osman CÜRE Üniversitemiz Girişimsel Olmayan Klinik Araştırmalar Etik Kuruluna yapmış olduğunuz “Romatoloji polikliniğinde sjögren sendromu tanısı almış hastalarının klinik ve otoantikor pozitifliği ile minör tükrük bezi biopsisinde bakılan inflamasyon skorlarının karşılaştırılması ” isimli başvurunuz etik kurulumuz yönergesine göre 18.04.2024 tarihinde yapmış olduğu toplantıda incelenmiş olup, 2024/84 karar numarası ile bilimsel ve etik yönden uygun bulunmuştur. Bilgilerinizi ve gereğini saygılarımla rica ederim. Doç. Dr. Tahsin Gökhan TELATAR Başkan

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