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

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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.

Key Points

• Salivary gland biopsy in patients with primary Sjogren’s syndrome (pSS) showed a significant correlation with several markers of both the parotid and submandibular glands in salivary gland scintigraphy, and with clinical features such as cytopenia, and lower unstimulated whole saliva and stimulated whole saliva flow rates.

• Salivary gland scintigraphy might be a good alternative to minor salivary gland biopsy, and the two methods could be complementary to the clinical features in the diagnosis of pSS.

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Data availability

All available data are reported in the manuscript and supplementary file.

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Funding

This work was supported by a grant from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute, funded by the Ministry of Health & Welfare, Republic of Korea [HI16C0992].

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Author notes

  1. These authors, Ji-Won Kim and Roh Jin, contributed equally to this study.

Authors and Affiliations

  1. Department of Rheumatology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, Republic of Korea

    Ji-Won Kim, Ju-Yang Jung, Chang-Hee Suh & Hyoun-Ah Kim

  2. Department of Pathology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, Republic of Korea

    Roh Jin & Jae Ho Han

  3. Clinic of Oral Medicine and Orofacial Pain, Institute of Oral Health Science, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, Republic of Korea

    Jeong-Hyun Kang

  4. Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, Republic of Korea

    Young-Sil An

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  1. Ji-Won Kim
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Contributions

JWK, RJ, JHH, JHK, JYJ, CHS, YSA, and HAK contributed to the study design and data collection, analysis, and interpretation. JWK, RJ, JHH, YSA, and HAK contributed to the data collection and/or data interpretation. All authors revised the manuscript and gave final approval for submission.

Corresponding authors

Correspondence to Young-Sil An or Hyoun-Ah Kim.

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The study was approved by the institutional review board of Ajou University Hospital (AJIRB-BMR-MDB-22–031).

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The consent to participate was waived due to the study of retrospective nature.

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Kim, JW., Jin, R., Han, J.H. et al. Correlations between salivary gland scintigraphy and histopathologic data of salivary glands in patients with primary Sjogren’s syndrome. Clin Rheumatol 41, 3083–3093 (2022). https://doi.org/10.1007/s10067-022-06269-x

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  • DOI: https://doi.org/10.1007/s10067-022-06269-x

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