The diagnostic utility of labial salivary gland biopsy in IgG4-related disease

Masafumi Moriyama, Miho Ohta, Sachiko Furukawa, Yurie Mikami, Akihiko Tanaka, takashi maehara, Masaki Yamauchi, Noriko Ishiguro, Jun Nosuke Hayashida, Shintarou Kawano, Yukiko Ohyama, Tamotsu Kiyoshima, Seiji Nakamura

研究成果: ジャーナルへの寄稿記事

9 引用 (Scopus)

抄録

Objective: For the definitive diagnosis of IgG4-related disease (IgG4-RD), biopsies of local lesions are recommended so as to exclude other diseases, including lymphoma and cancer. However, performing biopsies of underlying organs is technically difficult. In this study, we examined the diagnostic utility of labial salivary gland (LSG) biopsy as a less invasive procedure. Methods: Sixty-six patients with suspected IgG4-RD by clinical findings or high serum IgG4 underwent LSG biopsy. We examined the relationship between the number of IgG4-positive plasma cells in LSG and clinical findings. Results: The final diagnosis was 45 patients with IgG4-RD, 12 with Sjögren’s syndrome, four with suspected Sjögren’s syndrome, three with malignant lymphoma, one with systemic lupus erythematosus, and one with Warthin’s tumor. The sensitivity, specificity, and accuracy of LSG biopsy were 55.6%, 100.0%, and 70.0%, respectively. Forty-five IgG4-RD patients were divided into two groups: 1) 25 with lesions of salivary glands (IgG4-RD S+) and 2) 20 without these lesions (IgG4-RD S−). Seventeen of 25 (68.0%) IgG4-RD S + and 8 of 20 (40.0%) IgG4-RD S − patients were positive for LSG biopsy. In the IgG4-RD S − patients, the mean number of affected organs and serum IgG4 in the positive cases for LSG biopsy were significantly higher than in the negative cases. Conclusion: A solo LSG biopsy is insufficient for the diagnosis of IgG4-RD because of its low sensitivity. However, LSG biopsy combined with clinical findings, including serum IgG4 and number of affected organs, may contribute towards a diagnosis of IgG4-RD patients with affected underlying organs.

元の言語英語
ページ(範囲)725-729
ページ数5
ジャーナルModern Rheumatology
26
発行部数5
DOI
出版物ステータス出版済み - 9 2 2016

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Lip
Salivary Glands
Immunoglobulin G
Biopsy
Lymphoma
Serum
Adenolymphoma
Plasma Cells
Systemic Lupus Erythematosus

All Science Journal Classification (ASJC) codes

  • Rheumatology

これを引用

The diagnostic utility of labial salivary gland biopsy in IgG4-related disease. / Moriyama, Masafumi; Ohta, Miho; Furukawa, Sachiko; Mikami, Yurie; Tanaka, Akihiko; maehara, takashi; Yamauchi, Masaki; Ishiguro, Noriko; Hayashida, Jun Nosuke; Kawano, Shintarou; Ohyama, Yukiko; Kiyoshima, Tamotsu; Nakamura, Seiji.

:: Modern Rheumatology, 巻 26, 番号 5, 02.09.2016, p. 725-729.

研究成果: ジャーナルへの寄稿記事

Moriyama, Masafumi ; Ohta, Miho ; Furukawa, Sachiko ; Mikami, Yurie ; Tanaka, Akihiko ; maehara, takashi ; Yamauchi, Masaki ; Ishiguro, Noriko ; Hayashida, Jun Nosuke ; Kawano, Shintarou ; Ohyama, Yukiko ; Kiyoshima, Tamotsu ; Nakamura, Seiji. / The diagnostic utility of labial salivary gland biopsy in IgG4-related disease. :: Modern Rheumatology. 2016 ; 巻 26, 番号 5. pp. 725-729.
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title = "The diagnostic utility of labial salivary gland biopsy in IgG4-related disease",
abstract = "Objective: For the definitive diagnosis of IgG4-related disease (IgG4-RD), biopsies of local lesions are recommended so as to exclude other diseases, including lymphoma and cancer. However, performing biopsies of underlying organs is technically difficult. In this study, we examined the diagnostic utility of labial salivary gland (LSG) biopsy as a less invasive procedure. Methods: Sixty-six patients with suspected IgG4-RD by clinical findings or high serum IgG4 underwent LSG biopsy. We examined the relationship between the number of IgG4-positive plasma cells in LSG and clinical findings. Results: The final diagnosis was 45 patients with IgG4-RD, 12 with Sj{\"o}gren’s syndrome, four with suspected Sj{\"o}gren’s syndrome, three with malignant lymphoma, one with systemic lupus erythematosus, and one with Warthin’s tumor. The sensitivity, specificity, and accuracy of LSG biopsy were 55.6{\%}, 100.0{\%}, and 70.0{\%}, respectively. Forty-five IgG4-RD patients were divided into two groups: 1) 25 with lesions of salivary glands (IgG4-RD S+) and 2) 20 without these lesions (IgG4-RD S−). Seventeen of 25 (68.0{\%}) IgG4-RD S + and 8 of 20 (40.0{\%}) IgG4-RD S − patients were positive for LSG biopsy. In the IgG4-RD S − patients, the mean number of affected organs and serum IgG4 in the positive cases for LSG biopsy were significantly higher than in the negative cases. Conclusion: A solo LSG biopsy is insufficient for the diagnosis of IgG4-RD because of its low sensitivity. However, LSG biopsy combined with clinical findings, including serum IgG4 and number of affected organs, may contribute towards a diagnosis of IgG4-RD patients with affected underlying organs.",
author = "Masafumi Moriyama and Miho Ohta and Sachiko Furukawa and Yurie Mikami and Akihiko Tanaka and takashi maehara and Masaki Yamauchi and Noriko Ishiguro and Hayashida, {Jun Nosuke} and Shintarou Kawano and Yukiko Ohyama and Tamotsu Kiyoshima and Seiji Nakamura",
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T1 - The diagnostic utility of labial salivary gland biopsy in IgG4-related disease

AU - Moriyama, Masafumi

AU - Ohta, Miho

AU - Furukawa, Sachiko

AU - Mikami, Yurie

AU - Tanaka, Akihiko

AU - maehara, takashi

AU - Yamauchi, Masaki

AU - Ishiguro, Noriko

AU - Hayashida, Jun Nosuke

AU - Kawano, Shintarou

AU - Ohyama, Yukiko

AU - Kiyoshima, Tamotsu

AU - Nakamura, Seiji

PY - 2016/9/2

Y1 - 2016/9/2

N2 - Objective: For the definitive diagnosis of IgG4-related disease (IgG4-RD), biopsies of local lesions are recommended so as to exclude other diseases, including lymphoma and cancer. However, performing biopsies of underlying organs is technically difficult. In this study, we examined the diagnostic utility of labial salivary gland (LSG) biopsy as a less invasive procedure. Methods: Sixty-six patients with suspected IgG4-RD by clinical findings or high serum IgG4 underwent LSG biopsy. We examined the relationship between the number of IgG4-positive plasma cells in LSG and clinical findings. Results: The final diagnosis was 45 patients with IgG4-RD, 12 with Sjögren’s syndrome, four with suspected Sjögren’s syndrome, three with malignant lymphoma, one with systemic lupus erythematosus, and one with Warthin’s tumor. The sensitivity, specificity, and accuracy of LSG biopsy were 55.6%, 100.0%, and 70.0%, respectively. Forty-five IgG4-RD patients were divided into two groups: 1) 25 with lesions of salivary glands (IgG4-RD S+) and 2) 20 without these lesions (IgG4-RD S−). Seventeen of 25 (68.0%) IgG4-RD S + and 8 of 20 (40.0%) IgG4-RD S − patients were positive for LSG biopsy. In the IgG4-RD S − patients, the mean number of affected organs and serum IgG4 in the positive cases for LSG biopsy were significantly higher than in the negative cases. Conclusion: A solo LSG biopsy is insufficient for the diagnosis of IgG4-RD because of its low sensitivity. However, LSG biopsy combined with clinical findings, including serum IgG4 and number of affected organs, may contribute towards a diagnosis of IgG4-RD patients with affected underlying organs.

AB - Objective: For the definitive diagnosis of IgG4-related disease (IgG4-RD), biopsies of local lesions are recommended so as to exclude other diseases, including lymphoma and cancer. However, performing biopsies of underlying organs is technically difficult. In this study, we examined the diagnostic utility of labial salivary gland (LSG) biopsy as a less invasive procedure. Methods: Sixty-six patients with suspected IgG4-RD by clinical findings or high serum IgG4 underwent LSG biopsy. We examined the relationship between the number of IgG4-positive plasma cells in LSG and clinical findings. Results: The final diagnosis was 45 patients with IgG4-RD, 12 with Sjögren’s syndrome, four with suspected Sjögren’s syndrome, three with malignant lymphoma, one with systemic lupus erythematosus, and one with Warthin’s tumor. The sensitivity, specificity, and accuracy of LSG biopsy were 55.6%, 100.0%, and 70.0%, respectively. Forty-five IgG4-RD patients were divided into two groups: 1) 25 with lesions of salivary glands (IgG4-RD S+) and 2) 20 without these lesions (IgG4-RD S−). Seventeen of 25 (68.0%) IgG4-RD S + and 8 of 20 (40.0%) IgG4-RD S − patients were positive for LSG biopsy. In the IgG4-RD S − patients, the mean number of affected organs and serum IgG4 in the positive cases for LSG biopsy were significantly higher than in the negative cases. Conclusion: A solo LSG biopsy is insufficient for the diagnosis of IgG4-RD because of its low sensitivity. However, LSG biopsy combined with clinical findings, including serum IgG4 and number of affected organs, may contribute towards a diagnosis of IgG4-RD patients with affected underlying organs.

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U2 - 10.3109/14397595.2016.1148225

DO - 10.3109/14397595.2016.1148225

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EP - 729

JO - Modern Rheumatology

JF - Modern Rheumatology

SN - 1439-7595

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