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15 Jahre histopathologischer Synovialitis-Score

Rückblick und Weiterentwicklung eines diagnostischen Scores

Fifteen years of the histopathological synovitis score

Review and further developments of a diagnostic score

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Zusammenfassung

Der histopathologische Synovialitis-Score bewertet die immunologischen und inflammatorischen Veränderungen der Synovialitis in einer für diagnostische histopathologische Scores generell üblichen, abgestuften Weise. Ein Synovialitis-Score-Wert von 1 bis ≤ 4 wird als Low-Grade-Synovialitis bezeichnet (Arthrose-assoziierte/OA-Synovialitis, posttraumatische Synovialitis, Meniskopathie-assoziierte Synovialitis und Synovialitis bei Hämochromatose) gewertet. Ein Synovialitis-Score-Wert von ≥ 5 bis 9 wird als High-Grade-Synovialitis (rheumatoide Arthritis, Psoriasisarthritis, Lyme-Arthritis, postinfektiöse/reaktive Arthritis und periphere Arthritis bei Morbus Bechterew) bezeichnet, die Sensitivität beträgt 61,7 % die Spezifität 96,1 %. Die diagnostische Wertigkeit gemäß der Receiver Operating Characteristic(ROC)-Analyse (FUK: 0,8–0,9) ist gut. Seit der Erstpublikation (2002) und einer hiermit verbundenen Folgepublikation (2006) entwickelte sich eine nationale und internationale Akzeptanz des Synovialitis-Scores. In einer Datenanalyse der PubMed (Stand: 11.01.2017) ergaben sich gemäß „cited by PubMed Central articles“ für die 2 Synovialitis-Score-Publikationen folgende Zitierungswerte: Für DOI: 10.1078/0344-0338-5710261 lagen 29 in PubMed Central zitierte Artikel und für die zweite erweiterte Publikation, DOI: 10.1111/j.1365-2559.2006.02508, 44 in PubMed Central zitierte Artikel vor. Somit besteht eine Gesamtsumme von 73 PubMed-Zitationen in einem Zeitraum von 15 Jahren, die eine internationale Akzeptanz des Scores belegen. Zur Spezifizierung des Synovialitis-Scores wird eine immunhistochemische Bestimmung verschiedener inflammationsrelevanter CD-Antigene vorgeschlagen, um eine Risikostratifizierung von High-Grade-Synovialitiden (z. B. Progressionsrisiko und Biologika-Sensitivität) zu ermöglichen.

Abstract

The histopathological synovitis score evaluates in a graded approach, as is largely usual for diagnostic histopathological scores, the immunological and inflammatory changes caused by synovitis. A synovitis score of between 1 and ≤ 4 is classified as low-grade (osteoarthritis-related synovitis, post-traumatic synovitis, meniscopathy-related synovitis and synovitis in hemochromatosis). Synovitis scores of between ≥ 5 and 9 are classified as high-grade synovitis (rheumatoid arthritis, psoriatic arthritis, Lyme’s arthritis, post-infection/reactive arthritis and peripheral arthritis in Bechterew disease); sensitivity is 61.7% and sensitivity 96.1%. According to receiver operating characteristic (ROC) analysis (AUC: 0.8–0.9), diagnostic value is good. National and international acceptance of the synovitis score has grown since the first publication in 2002 and a related follow-up publication in 2006. PubMed data analysis (as of 11.01.2017) yielded the following citation values according to “cited by PubMed Central articles” for two publications relating to the synovitis score: there were 29 cited-by-PubMed articles for DOI: 10.1078/0344-0338-5710261, and 44 cited-in-PubMed articles for the second publication, DOI: 10.1111/j.1365-2559.2006.02508. This makes a total of 73 PubMed citations over a period of 15 years, thereby evidencing the score’s international acceptance. Immunohistochemical determination of a number of CD antigens relevant to inflammation has been proposed to further specify the synovitis score for the purposes of risk stratification of high-grade synovitis (e.g., risk of progression and sensitivity to biological agents).

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Authors and Affiliations

  1. MVZ-Zentrum für Histologie, Zytologie und Molekulare Diagnostik, Max-Planck-Str. 5, 54296, Trier, Deutschland

    V. Krenn, V. T. Krenn, S. Müller & J. Kriegsmann

  2. Department of Pathology and Laboratory Medicine, Hospital for Special Surgery, New York, USA

    G. Perino & F. Boettner

  3. Klinik und Poliklinik für Orthopädie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland

    W. Rüther

  4. Pathologisch-bakteriologisches Institut, Otto Wagner Spital, Wien, Österreich

    M. Huber

  5. Hôpital Orthopédique, Lausanne, Schweiz

    T. Hügle

  6. Rhumatologie, Centre hospital-universitaire de Nantes, Nantes, Frankreich

    A. Najm

  7. TWINCORE, Zentrum für Experimentelle und Klinische Infektionsforschung GmbH, Hannover, Deutschland

    F. Pessler

  8. AKH-Wien, Universitätsklinik für Orthopädie, Medizinische Universität Wien, Wien, Österreich

    W. Waldstein

  9. Med. Klinik, Rheumatologie und Klinische Immunologie, Charité, Berlin, Deutschland

    T. Häupl

  10. VMscope-Berlin, Berlin, Deutschland

    S. Wienert

  11. Paracelsus-Kliniken Deutschland, Osnabrück, Deutschland

    M. G. Krukemeyer

  12. Orthopädische Universitätsklinik Erlangen, Erlangen, Deutschland

    S. Sesselmann

  13. Vreden Russian Scientific Research Institute of Traumatology and Orthopedics, Saint Petersburg, Russland

    R. Tikhilov

  14. Klinikum Ernst von Bergmann gemeinnützige GmbH, Potsdam, Deutschland

    L. Morawietz

Authors
  1. V. Krenn
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  2. G. Perino
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  3. W. Rüther
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  4. V. T. Krenn
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  5. M. Huber
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  6. T. Hügle
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  7. A. Najm
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  8. S. Müller
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  9. F. Boettner
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  10. F. Pessler
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  11. W. Waldstein
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  12. J. Kriegsmann
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  13. T. Häupl
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  14. S. Wienert
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  15. M. G. Krukemeyer
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  16. S. Sesselmann
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  17. R. Tikhilov
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  18. L. Morawietz
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Corresponding author

Correspondence to V. Krenn.

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Interessenkonflikt

V. Krenn, G. Perino, W. Rüther, V.T. Krenn, M. Huber, T. Hügle, A. Najm, S. Müller, F. Boettner, F. Pessler, W. Waldstein, J.T. Kriegsmann, T. Häupl, S. Wienert, M.G. Krukemeyer, S. Sesselmann, R. Tikhilov und L. Morawietz geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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U. Müller-Ladner, Bad Nauheim

U. Lange, Bad Nauheim

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Krenn, V., Perino, G., Rüther, W. et al. 15 Jahre histopathologischer Synovialitis-Score. Z Rheumatol 76, 539–546 (2017). https://doi.org/10.1007/s00393-017-0308-2

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  • DOI: https://doi.org/10.1007/s00393-017-0308-2

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