The aim of this study is to explore the role of labial minor salivary gland (LMSG) focus score (FS) in stratifying Sjögren's Syndrome (SS) patients, lymphoma development prediction and to facilitate early lymphoma diagnosis. Ιn an integrated cohort of 1997 patients, 618 patients with FS ≥ 1 and at least one-year elapsing time interval from SS diagnosis to lymphoma diagnosis or last follow up were identified. Clinical, laboratory and serological features were recorded. A data driven logistic regression model was applied to identify independent lymphoma associated risk factors. Furthermore, a FS threshold maximizing the difference of time interval from SS until lymphoma diagnosis between high and low FS lymphoma subgroups was investigated, to develop a follow up strategy for early lymphoma diagnosis. Of the 618 patients, 560 were non-lymphoma SS patients while the other 58 had SS and lymphoma. FS, cryoglobulinemia and salivary gland enlargement (SGE) were proven to be independent lymphoma associated risk factors. Lymphoma patients with FS ≥ 4 had a statistically significant shorter time interval from SS to lymphoma diagnosis, compared to those with FS < 4 (4 vs 9 years, respectively, p = 0,008). SS patients with FS ≥ 4 had more frequently B cell originated manifestations and lymphoma, while in patients with FS < 4, autoimmune thyroiditis was more prevalent. In the latter group SGE was the only lymphoma independent risk factor. A second LMSG biopsy is patients with a FS ≥ 4, 4 years after SS diagnosis and in those with FS < 4 and a history of SGE, at 9-years, may contribute to an early lymphoma diagnosis. Based on our results we conclude that LMSG FS, evaluated at the time of SS diagnosis, is an independent lymphoma associated risk factor and may serve as a predictive biomarker for the early diagnosis of SS-associated lymphomas.

本研究的目的是探讨唇小唾液腺 (LMSG) 焦点评分 (FS) 在干燥综合征 (SS) 患者分层、淋巴瘤发展预测和促进淋巴瘤早期诊断中的作用。在 1997 名患者的综合队列中，确定了 618 名 FS ≥ 1 且从 SS 诊断到淋巴瘤诊断或最后一次随访至少经过一年时间的患者。记录临床、实验室和血清学特征。应用数据驱动的逻辑回归模型来识别独立的淋巴瘤相关危险因素。此外，研究了一个 FS 阈值，该阈值最大化了高和低 FS 淋巴瘤亚组之间从 SS 到淋巴瘤诊断的时间间隔差异，以制定早期淋巴瘤诊断的后续策略。在 618 名患者中，560 名是非淋巴瘤 SS 患者，而另外 58 名患有 SS 和淋巴瘤。FS、冷球蛋白血症和唾液腺肿大（SGE）被证明是独立的淋巴瘤相关危险因素。与 FS < 4 的患者相比，FS ≥ 4 的淋巴瘤患者从 SS 到淋巴瘤诊断的时间间隔在统计学上显着缩短（分别为 4 和 9 年，p = 0,008）。FS ≥ 4 的 SS 患者更常见 B 细胞起源表现和淋巴瘤，而 FS < 4 的患者，自身免疫性甲状腺炎更常见。在后一组中，SGE 是唯一的淋巴瘤独立危险因素。第二次 LMSG 活检是 SS 诊断后 4 年 FS ≥ 4 的患者，以及 FS < 4 和 9 年时有 SGE 病史的患者，可能有助于早期淋巴瘤诊断。根据我们的结果，我们得出结论，LMSG FS，