唇腺灶性指数与免疫组化在原发性SS病理诊断中的应用价值初探

目的:探讨原发性干燥综合征(primary sjogren’s syndrome,pSS)患者唇腺活检病理诊断中唇腺灶性指数(FS)与免疫组化检测的应用价值。方法:选取2010年1月~2015年12月昆山市第一人民医院临床诊断为干燥综合征患者56例,每4mm~2唇腺病理切片≥1个淋巴灶(FS≥1),且CD3、CD20及Bcl-6结果呈阳性(A组);同期选择临床确诊慢性非特异性唾液腺炎21例、慢性硬化性唾液腺炎11例的唇腺活检组织作为对照(B组)。收集临床资料,比较二组结果对干燥综合征的诊断价值。结果:经统计学处理A组临床与病理符合率明显高于B组,存在显著差异(P0.05)。A组患者CD3、CD20及Bcl-6阳性水平明显高于对照组,二者之间具有显著差异(P0.05)。结论:两组方法判断唇腺病理对干燥综合征的临床诊断具有显著差异,唇腺灶性指数(FS)与免疫组化检测能够有效提高干燥综合征阳性率。

A Study on the Application Value of Salivary Gland Focus Score and Immunohistochemistry in Diagnosing Primary SS.

Objective:To investigate the application value of salivary gland focus score (FS) and immunohistochemistry in diagnosing Primary Sjogren's Syndrome (pSS).Methods:Chose 56 cases of patients in our hospital diagnosed as pSS from January 2010 to December 2015,with 1 or more than 1 lymphatic focus on every 4mm2 pathological section of labial gland(FS 1),and CD3 、CD20、Bcl-6 porved positive (Group A).In addition,32 biopsies of chronic nonspecific sialadenitis (N =21) and chronic sclerosing sialadenitis (N =11) were chosen as the negative control.For all biopsy samples,FS was calculated while expressions of CD3,CD20 and Bcl-6 were evaluated by immunohistochemistry.FS ≥ 1 were considered as positive.Moreover,clinical data were collected.The value of FS and expression of CD3,CD20 and Bcl-6 for diagnosis of pSS were analyzed by SPSS 22.0.Results:The coincidence rate of clinical diagnosis and pathological diagnosis in Group A was significantly higher than that in Group B,with significant difference (P ＜ 0.05).While the levels of CD3,CD20 and Bcl-6 were higher in group A than in Group B with significant difference (P ＜ 0.05).Conlusions:There are significant differences in the two methods of diagnozing pSS with salivary gland pathology.The combined detection of FS and immunohistochemistry of CD3,CD20 and Bcl-6 can improve the positive rate in diagnosing pSS.