Weight of salivary gland ultrasonography compared to other items of the 2016 ACR/EULAR classification criteria for Primary Sjögren's syndrome.,Journal of Internal Medicine

当前位置： X-MOL 学术 › J. Intern. Med. › 论文详情

Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)

Weight of salivary gland ultrasonography compared to other items of the 2016 ACR/EULAR classification criteria for Primary Sjögren's syndrome.
Journal of Internal Medicine ( IF 9.0 ) Pub Date : 2019-11-12 , DOI: 10.1111/joim.12992
S Jousse-Joulin ₁ , F Gatineau ₂ , C Baldini ₃ , A Baer ₄ , F Barone ₅ , H Bootsma ₆ , S Bowman ₇ , P Brito-Zerón ₈ , D Cornec ₁ , T Dorner ₉ , S de Vita ₁₀ , B Fisher ₅ , D Hammenfors _{11,

12} , M Jonsson ₁₃ , X Mariette _{14,

15} , V Milic ₁₆ , H Nakamura ₁₇ , W-F Ng ₁₈ , E Nowak ₂ , M Ramos-Casals ₈ , A Rasmussen ₁₉ , R Seror _{14,

15} , C H Shiboski ₂₀ , T Nakamura ₂₁ , A Vissink ₂₂ , A Saraux ₁ , V Devauchelle-Pensec ₁

Affiliation

From the, Rheumatology Department, INSERM UMR 1227, Cavale Blanche Hospital and Brest Occidentale University, Brest, France.
INSERM CIC 1412, Brest Medical University Hospital, Brest, France.
Rheumatology Unit, University of Pisa, Pisa, Italy.
Department of Medicine (Rheumatology), Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Rheumatology Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK.
Department of Rheumatology and Clinical Immunology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.
Department of Rheumatology, University Hospitals, Birmingham NHS Trust, Birmingham, UK.
Autoimmune Diseases Unit, Department of Medicine, Hospital CIMA- Sanitas, Barcelona, Spain.
Department of Medicine, Rheumatology and Clinical Immunology, Charite Universitätsmedizin Berlin and DRFZ Berlin, Berlin, Germany.
Clinic of Rheumatology, Department of Medical and Biological Sciences, University Hospital "Santa Maria della Misericordia", Udine, Italy.
Department of Rheumatology, Haukeland University Hospital, Bergen, Norway.
Section for Rheumatology, Department of Clinical Science, University of Bergen, Bergen, Norway.
Section for Oral and Maxillofacial Radiology, Department of Clinical Dentistry, University of Bergen, Bergen, Norway.
Center for Immunology of Viral Infections and Autoimmune Diseases, Assistance Publique, Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Le Kremlin-Bicêtre, France.
INSERM, Université Paris Sud, Paris, France.
Institute of Rheumatology, School of Medicine, University of Belgrade, Belgrade, Serbia.
Department of Immunology and Rheumatology, Unit of Advanced Medical Sciences, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Institute of Cellular Medicine, Newcastle University & NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne, UK.
Arthritis and Clinical Immunology Research Program, Oklahoma Medical Research Foundation, Oklahoma City, OK, USA.
Department of Orofacial Sciences, School of Dentistry, University of California, San Francisco, CA, USA.
Department of Radiology and Cancer Biology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.

OBJECTIVE Major salivary gland ultrasonography (SGUS) is widely used for the diagnosis of primary Sjögren's syndrome (pSS). Our objective was to assess the contribution of SGUS compared to other items of the 2016 ACR/EULAR pSS classification criteria, based on expert opinion. METHODS A secure web-based relational database was used by 24 experts from 14 countries to assess 512 realistic vignettes developed from data of patients with suspected pSS. Each vignette provided classification criteria items and information on history, clinical symptoms and SGUS findings. Each expert assessed 64 vignettes, and each vignette was assessed by 3 experts. A diagnosis of pSS was defined according to at least 2 of 3 experts. Validation was performed in the independent French DiapSS cohort of patients with suspected pSS. RESULTS A criteria-based pSS diagnosis and SGUS findings were independently associated with an expert diagnosis of pSS (P < 0.001). The derived diagnostic weights of individual items in the 2016 ACR/EULAR criteria including SGUS were as follows: anti-SSA, 3; focus score ≥ 1, 3; SGUS score ≥ 2, 1; positive Schirmer's test, 1; dry mouth, 1; and salivary flow rate < 0.1 mL/min, 1. The corrected C statistic area under the curve for the new weighted score was 0.96. Adding SGUS improves the sensitivity from 90.2 % to 95.6% with a quite similar specificity 84.1% versus 82.6%. Results were similar in the DiapSS cohort: adding SGUS improves the sensitivity from 87% to 93%. CONCLUSION SGUS had similar weight compared to minor items, and its addition improves the performance of the 2016 ACR/EULAR classification criteria.

中文翻译：

与2016年ACR / EULAR原发性干燥综合征综合征分类标准中其他项目相比，唾液腺超声检查的重量。

目的主要涎腺超声检查（SGUS）被广泛用于诊断原发性干燥综合征（pSS）。我们的目标是根据专家的意见，评估SGUS与2016 ACR / EULAR pSS分类标准的其他项目相比所做出的贡献。方法来自14个国家/地区的24位专家使用了一个基于Web的安全关系数据库，评估了512个真实的晕影，这些晕影是根据可疑pSS患者的数据开发而成的。每个小插图均提供分类标准项目以及有关病史，临床症状和SGUS发现的信息。每个专家评估了64个小插图，每个小插图由3个专家评估。根据3名专家中的至少2名定义了pSS的诊断。在独立的法国DiapSS队列中对怀疑患有pSS的患者进行了验证。结果基于标准的pSS诊断和SGUS结果与pSS的专家诊断独立相关（P <0.001）。根据2016年ACR / EULAR标准（包括SGUS）得出的单个项目的诊断权重如下：anti-SSA，3；焦点得分≥1、3；SGUS评分≥2，1; Schirmer检验阳性，1；口干1; 唾液流速<0.1 mL / min，1。对于新的加权评分，曲线下的校正C统计面积为0.96。添加SGUS可以将敏感性从90.2％提高到95.6％，其特异性非常相似，分别为84.1％和82.6％。DiapSS队列的结果相似：添加SGUS可使敏感性从87％提高到93％。结论SGUS的重量与次要物品相似，并且增加了2016 ACR / EULAR分类标准的性能。

更新日期：2019-11-13

点击分享查看原文

点击收藏

阅读更多本刊最新论文本刊介绍/投稿指南11