类肿瘤型舍格伦综合征诊断问题的初步探讨

目的：探讨类肿瘤型舍格伦综合征的特点和诊断方法。方法对２２例腮腺区类肿瘤型舍格伦综合征、５０例腮腺多形性腺瘤和２５例腮腺淋巴瘤,进行各项临床资料内容的卡方检验及逐步判别分析。结果（１）类肿瘤型舍格伦综合征好于４０－５９岁的女性,局部表现为涎腺区肿块,质中、表面光滑、有酸胀和时大时小现象,还有口干、眼干和关节酸痛等全身症状,抗炎治疗有效。（２）建立了类肿瘤型舍格伦综合征、多形性腺瘤和腺淋巴瘤的判别函     

85例舍格伦综合征腮腺表现的临床分析与探讨

目的　为了明确舍格伦综合征腮腺表现的特点;以及与其它临床表现之间的关系。方法　对85例舍格伦综合征患者的临床资料进行回顾性分析,并结合文献进一步进行探讨。结果　舍格伦综合征的腮腺表现以炎症型最多;肥大型次之;类肿瘤型最少;三者与口干燥之间的关系存在显著差异;部分患者有恶变可能。结论　舍格伦综合征腮腺表现的特点是该病诊断的一个重要依据,临床应引起重视     

类肿瘤型舍格伦综合征46例临床分析

目的：通过临床资料分析,进一步探讨类肿瘤型舍格伦综合征的临床表现和治疗方法。方法：结合文献复习,对46例类肿瘤型舍格伦综合征的临床表现和治疗进行回顾性分析。结果：46例患者的局部表现主要为1个或1个以上肿块,伴有口干症19例（41％）,眼干症11例（23％）,有自身抗体8例（17％）,治疗结果,手术组25例全部有效,但有5例异位复发;药物组21例,有效17例,有8例原位复发,手术组有1例,药物组2例于治疗后随访中出现恶变。结论：类肿瘤型舍格伦综合征局部表现主要为肿块,部分患者有全身表现,少数可发生恶变,治疗应采取局部与全身,药物与手术相结合的方法。治疗前明确诊断,首选药物治疗,若疗效不明显或反复出现肿块,宜及时手术治疗。     

联合免疫抑制疗法治疗类肿瘤型舍格伦综合征的疗效研究

目的：评价联合免疫抑制疗法在治疗类肿瘤型舍格伦综合征中的临床应用。方法：临床表现为类肿瘤型的舍格伦综合征患者共22名。免疫抑制剂选用的是强的松和氯喹。根据临床表现，将治疗效果分为优、良、差3级。结果：强的松和氯喹联合治疗类肿瘤型舍格伦综合征的总有效率可达95．5％。结论：联合免疫抑制疗法是治疗类肿瘤型舍格伦综合征的较为有效的一种方法。     

合格伦综合征磁共振涎腺造影图像分析

目的：分析舍格伦综合征患者的腮腺磁共振涎腺造影表现、特点及应用价值。方法：应用1．5T超导型全身磁共振扫描仪对32例舍格伦综合征患者进行磁共振涎腺造影检查，获得自旋回波磁共振涎腺造影，对其特点进行观察和总结。结果：在舍格伦综合征患者磁共振成像中可看到点状、球状、腔状及破坏性表现，少数有正常的主导管和分支导管表现；无造影检查所见主导管层状或葱皮状。结论：磁共振涎腺造影可客观、清晰地反映舍格伦综合征患者腮腺主分支导管、腺泡病变，可作为诊断舍格伦综合征的依据之一。     

舍格伦综合征合并黏液表皮样癌1例并文献复习

目的：探讨舍格伦综合征患恶性病变的风险性及高危因素。方法：对1例右侧腮腺舍格伦综合征合并黏液表皮样癌病例的临床与病理特征进行分析,结合文献进行讨论。结果：舍格伦综合征患恶性病变的风险性明显升高。结论：临床在诊断舍格伦综合征的同时,若伴有腮腺区的肿块、反复肿胀及疼痛、淋巴结肿大可能是并发恶性肿瘤的高危因素。     

腮腺磁共振造影在舍格伦综合征诊断中的价值

目的：探讨腮腺磁共振造影在舍格伦综合征（SS）诊断中的价值。方法：应用磁共振涎腺成像及磁共振造影（MRS）诊断腮腺表现为主的舍格伦综合征，在选择合理诊断标准的基础上，结合免疫学指标、病理学检查进行诊断。并与腮腺造影结果进行比较。结果：32例最终诊断为SS的25例患者中，23例MRS诊断出现典型的表现，即导管和腺泡不规则的扩张，并能排除腮腺占位性病变。敏感度：92％：特异度：71．4％；准确度：87．5％。伴有自身抗体出现的占68．％：唇腺活检符合SS表现的占72％。18例SS患者MRS与腮腺造影均有阳性表现，15例结果基本相同，占83.3％。结论：MRS能客观地反映舍格伦综合征患者受累腺体的病变情况和程度，是SS诊断和与腮腺肿瘤性疾病鉴别诊断的重要方法之一。     

合格伦综合征磁共振涎腺造影图像分析

目的:分析舍格伦综合征患者的腮腺磁共振涎腺造影表现、特点及应用价值.方法:应用1.5T超导型全身磁共振扫描仪对32例舍格伦综合征患者进行磁共振涎腺造影检查.获得自旋回波磁共振涎腺造影,对其特点进行观察和总结.结果:在舍格伦综合征患者磁共振成像中可看到点状、球状、腔状及破坏性表现,少数有正常的主导管和分支导管表现;无造影检查所见主导管层状或葱皮状.结论:磁共振涎腺造影可客观、清晰地反映舍格伦综合征患者腮腺主分支导管、腺泡病变,可作为诊断舍格伦综合征的依据之一.     

结节型舍格伦综合征与恶性淋巴瘤关系初探

目的 探讨结节型舍格伦综合征(tumor like Sj(o)gren’s syndrome,TLSS)与非TLSS( non-TLSS,NTLSS)患者临床、实验室特征及淋巴瘤的发生情况,以期为临床预测舍格伦综合征尤其是TLSS患者发生恶性淋巴瘤转化提供依据.方法 收集1998年1月至2010年1月就诊于北京大学口腔医学院·口腔医院并诊断为原发性舍格伦综合征或TLSS的患者199例,回顾性研究199例患者临床及实验室资料,根据有无腺体肿块将患者分为TLSS组(25例)及NTLSS组(174例),分析临床及实验室指标的差异并行统计学分析.结果 25例TLSS患者中23例为腮腺肿块,2例为颌下腺肿块；TLSS患者在腮腺造影阳性率(P =0.018)、γ球蛋白异常水平(P =0.014)、类风湿因子异常水平(P=0.001)、唇腺生发中心样结构形成(P=O.O14)、抗SSA抗体及抗SSB抗体双阳性率(P ＜0.001)方面与NTLSS患者差异均有统计学意义；25例TLSS患者中3例发生淋巴瘤,占入选病例总数的1.5％(3/199),占TLSS患者的12％ (3/25),3例淋巴瘤包括腹股沟区弥漫性大B细胞淋巴瘤1例及黏膜相关淋巴组织淋巴瘤2例；NTLSS患者无淋巴瘤发生.结论 TLSS与NTLSS患者在临床及实验室特征方面存在差异,TLSS患者更易出现淋巴瘤.     

腮腺炎性肿块的临床,造影及病理分析

本文报道３２例腮腺性肿块临床，造影及病理分析，术前诊断：良性肿物１５例，肿物性质待查５例，舍格伦综合征结节型９例，腮腺炎性包块３例，本次根据病理并结合临床及造影重新诊断：１８例慢性炎症，１４例舍格伦综合征结节型，在临床上，３２例患者中１６例表现为无任何不适感的腮腺区肿块，９例伴有腮腺肿块史，７例有口干，眼干或疼痛症状。在腮腺造影上，２７例腮腺造影患者中６例全导管扩张，９例末梢导管扩张，１７例腺泡充     

~(99m)锝腮腺动态显像对舍格伦综合征的诊断价值

目的 探讨＾９９ｍ锝腮腺动态显像对诊断舍格伦征的价值。方法 应用＾９９ｍ锝对临床诊断为舍格伦综合征的５２例患者进行腮腺动态显像,将所得的结果应用计算机ＲＯＩ程序进行定量分析和动态曲线分析,结果 腮腺外形较正常大者４６例（８８．４％）肿大腮腺轮廓清晰２８例（５３．８５％）轮廓模糊１８例（３４．６２％）腮腺功能正常７例（１３．４６％）轻度受损１５例（２８．８４％）中８度受损１７例（３２．６９％）,重度     

Sialochemistry in Sj?gren's syndrome.

The value of sialochemistry in the study of Sj?gren's syndrome was explored by comparative examination of a spectrum of parotid components in twelve subjects with a positive diagnosis of the disease and twelve control subjects with normal gland function. The subjects with Sj?gren's syndrome all exhibited a marked reduction in flow rate and phosphate concentration and a marked elevation in sodium and chloride concentration. The concentration of IgA was somewhat elevated (commensurate with reduced flow rate); the levels of IgG, IgM, and albumin were normal. The major functional abnormality in the parotid gland in Sj?gren's syndrome appears to be luminal transport in the ductal region; leakage of serum components is minimal. Sialochemistry can be helpful in differentiating Sj?gren's disease from other diseases of the salivary gland and in assessing degree of pathologic change.     

Histochemical study of labial salivary glands in Sj?gren's syndrome.

Human labial salivary gland biopsies of patients presenting connective tissue diseases associated with Sj?gren's syndrome were submitted to a polysaccharide histochemistry study. The normal acinar secretion is an association of neutral polysaccharides with a sulphosialomucin. In Sj?gren's syndrome, there is a great reduction in the secretory activity of the acinar cells, but no qualitative change was observed. The pathogenesis of this decreased production and its importance regarding the clinical manifestations of Sj?gren's syndrome are discussed.     

Salivary gland involvement in autoimmune thyroiditis, with special reference to the degree of association with Sj?gren's syndrome.

From a total of 63 patients with autoimmune thyroiditis, 19 cases were further investigated to determine the degree of concomitant morphologic and functional salivary gland changes. For comparison, 21 of a total of 28 cases of primary Sj?gren's syndrome were also examined. Of the 19 cases of autoimmune thyroiditis, 11 showed various degrees of salivary gland involvement on the basis of an analysis of lower lip salivary gland biopsy specimens, scintigraphy of the parotid, and unstimulated whole sialometry. Six of these cases fulfilled the criteria of primary Sj?gren's syndrome. A remarkably high proportion of dark-staining acini was observed in the lower lip biopsy specimens of our patients with thyroiditis (8 of 19, 42%) and less among our patients with primary Sj?gren's syndrome (5 of 21, 24%). We conclude that significant involvement of salivary glands may occur in cases of autoimmune thyroiditis, which indicates that common mechanisms may frequently be operative in the development of thyroid and salivary gland immune disease.     

Recurrent parotitis in childhood (report of 102 cases)

This article presents 102 cases of recurrent parotitis in childhood with studies of clinical findings, sialographic manifestations, dynamic functions of the parotid gland examined with radionuclide, laboratory findings and follow-up studies of 28 cases including sialography. The following conclusions are reached: 1. The etiology is retrograde infection induced by mumps virus and upper respiratory infection which lower the resistance of the child. Familial abnormalities are potential factors. Incomplete immune function of the children is also a factor related to pathogenesis of this disease, and following growth and development of the immune system this disease will undergo remission. 2. This disease involves both parotid gland generally. 3. Sialographic manifestations will disappear following subsidence of clinical symptoms, but it may take years. 4. If the disease has not been cured in childhood, it may continue to adult and then healing will take place. Relationship with Sj?gren's syndrome has not been revealed.     

Multiple sialolithiasis in the parotid gland with Sjögren's syndrome and its sonographic findings--report of 3 cases

We present 3 cases of Sj?gren's syndrome in which multiple sialolithiasis were observed in the parenchyma of the parotid gland. The sonographic examinations showed microliths that were observed as hyperechoic spots. Some of the microliths were accompanied with comet sign, however most of them showed no particular posterior echoes. None of them showed acoustic shadows, which are normally observed in cases with sialolithiasis. We were able to prove that some of the hyperechoic spots observed sonographically in patients with severe Sj?gren's syndrome were microliths. Although these multiple microliths are rarely detected, they may exist potentially in higher frequency in patients with severe Sj?gren's syndrome.     

Sjogren syndrome: a review of the literature and a case report

Sj?gren syndrome is one of the most prevalent autoimmune diseases in which the body's immune system mistakenly attacks its own moisture producing glands. Although Sj?gren syndrome occurs in all age groups in both women and men, women in their fourties are the most affected. Sj?gren's syndrome can occur alone or in the presence of another connective tissue disease, respectively called primary and secundary Sj?gren syndrome. When two of the three clinical hallmarks: keratoconjunctivitis sicca, xerostomia or connective tissue disease are present, Sj?gren 's syndrome should be considered. To confirm the diagnosis of Sj?gren's syndrome several tests are required. e.g. blood tests, ophthalmologic tests and oral tests. Rheumatologists have the primary responsibility for managing Sj?gren's syndrome. Other specialists can treat the related symptoms. The incidence of lymphoma is higher in patients with Sj?gren's syndrome than in the general population. Therefore patients must be monitored carefully for the development of related autoimmune diseases, lymphoma and other complications. Sj?gren's syndrome is serious but generally not fatal if complications are diagnosed and treated early.     

Hydrallazine-induced Sj?gren's syndrome

4 years after initiation of therapy with hydrallazine hydrochloride (for treatment of hypertension), a 60-year-old male patient developed clinical features of Sj?gren's syndrome, with immunological features of drug-induced systemic lupus erythematosus. In addition, the patient described rheumatoid arthritis-like symptoms and had reduced lacrimal and parotid salivary flow, but lacked the typical features of Sj?gren's syndrome on labial gland biopsy. 1 year after discontinuation of hydrallazine therapy, the clinical parameters returned to normal.     

Scintigraphic evaluation of the salivary glands in patients with Sj?gren's syndrome

The clinical value of salivary gland scintigraphy (RI-sialography) was studied in 11 cases with definite Sj?gren's syndrome. Time-activity curves which were obtained from computer-assisted analysis of RI-sialography were classified into 4 types (N:normal type, M:median type, F:flat type, S:sloped type), and the efficacy of scintigraphy in evaluating salivary gland function and the relationship between time-activity curves and other diagnostic methods are discussed. Flattened time-activity curves such as F- or S-type were more often seen in submandibular glands than in parotid glands. Flattened curves were not seen in the early stage of the inflammatory process; conversely, when we found a flattened curve, it suggested a wide destruction of the salivary gland tissues. Correlation between time-activity curve and sialography showed 90.9%, and correlation between time-activity curve and histopathological change in the minor salivary gland of the lower lip also showed 90.9%.