Labial salivary gland biopsies in Sjögren's syndrome: still the gold standard?

  • Stewart C
  • Bhattacharyya I
  • Berg K
 et al. 
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Objectives: 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. Study design: 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. Conclusion: Since the LSG biopsy can be the determining factor in SS diagnoses, these demonstrated inconsistencies merit further consideration. © 2008 Mosby, Inc. All rights reserved.

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  • Carol M. Stewart

  • Indraneel Bhattacharyya

  • Kathleen Berg

  • Donald M. Cohen

  • Christine Orlando

  • Peter Drew

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