Labial salivary gland biopsies in Sjögren's syndrome: still the gold standard?
OBJECTIVE
The accuracy and diagnostic benefits of the labial salivary gland (LSG) biopsy for Sjögren's syndrome (SS) have received mixed reviews. This study was conducted to assess (1) the inter-rater agreement among 5 pathologists, and (2) the relationship between biopsy findings and clinical disease parameters.


METHODS
Three oral pathologists (OP) and two surgical pathologists (SP) provided independent diagnoses, focus scores, and plasma cell characterizations for 37 LSG biopsies. Inter-rater reliability was assessed using percentage of overall agreement and intraclass correlation coefficients. Relationships between diagnoses and clinical parameters were assessed by nonparametric correlations.


RESULTS
Overall agreement among the pathologists was poor, although the intra-specialty agreement was good. The ratings of OP were most highly correlated with serological measures, while those of SP were correlated with salivary flow rate and disease damage.


CONCLUSIONS
Since the LSG biopsy can be the determining factor in SS diagnoses, these demonstrated inconsistencies merit further consideration.
Stewart
Carol M
CM
Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, University of Florida College of Dentistry, Gainesville, FL 32610, USA. cstewart@dental.ufl.edu
Bhattacharyya
Indraneel
I
Berg
Kathleen
K
Cohen
Donald M
DM
Orlando
Christine
C
Drew
Peter
P
Islam
Nadim M
NM
Ojha
Junu
J
Reeves
Westley
W
D000328:Adult; D000368:Aged; D001706:Biopsy; D005260:Female; D006801:Humans; D008046:Lip; D008214:Lymphocytes; D008875:Middle Aged; D015588:Observer Variation; D010950:Plasma Cells; D011237:Predictive Value of Tests; D012015:Reference Standards; D012463:Saliva / Q000378:metabolism; D012470:Salivary Glands, Minor / Q000473:pathology*; D012636:Secretory Rate; D012859:Sjogren's Syndrome / Q000097:blood* / Q000175:diagnosis*