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目的:探讨原发性干燥综合征(primary sjogren’s syndrome,pSS)患者唇腺活检病理诊断中唇腺灶性指数(FS)与免疫组化检测的应用价值。方法:选取2010年1月~2015年12月昆山市第一人民医院临床诊断为干燥综合征患者56例,每4mm~2唇腺病理切片≥1个淋巴灶(FS≥1),且CD3、CD20及Bcl-6结果呈阳性(A组);同期选择临床确诊慢性非特异性唾液腺炎21例、慢性硬化性唾液腺炎11例的唇腺活检组织作为对照(B组)。收集临床资料,比较二组结果对干燥综合征的诊断价值。结果:经统计学处理A组临床与病理符合率明显高于B组,存在显著差异(P<0.05)。A组患者CD3、CD20及Bcl-6阳性水平明显高于对照组,二者之间具有显著差异(P<0.05)。结论:两组方法判断唇腺病理对干燥综合征的临床诊断具有显著差异,唇腺灶性指数(FS)与免疫组化检测能够有效提高干燥综合征阳性率。
Objective: To investigate the value of lip glandular foci (FS) and immunohistochemistry in pathological diagnosis of primary labial primary sjogren’s syndrome (pSS). Methods: From January 2010 to December 2015, 56 cases of Sjogren’s syndrome were diagnosed in First People’s Hospital of Kunshan City, with ≥1 lymph node (FS≥1) in every 4mm ~ 2 labial gland. CD3, CD20 and Bcl-6 were positive (group A). In the same period, 21 cases of chronic non-specific salivary gland inflammation and 11 cases of chronic sclerosing salivary gland were selected as control group (group B). Collect clinical data and compare the diagnostic value of the two groups on Sjogren’s syndrome. Results: The clinical and pathological coincidence rates of group A were significantly higher than those of group B statistically (P <0.05). The positive levels of CD3, CD20 and Bcl-6 in group A were significantly higher than those in control group (P <0.05). Conclusion: There are significant differences between the two groups in judging the pathological changes of the labial glands and the clinical diagnosis of Sjogren ’s syndrome. The labial glandular index (FS) and immunohistochemistry can effectively improve the positive rate of Sjogren’ s syndrome.