A Meta-analysis of the Diagnostic Value of Minor Salivary Gland Biopsy for Primary Sjogren's Syndrome

Abstract

Objective. The purpose of this study is to evaluate the diagnostic performance of minor salivary gland biopsy (MSGB) for patients with primary Sjogren’s syndrome (pSS). Methods. We have conducted a search from Medline, Embase, and Cochrane Library databases, and performed a meta-analysis on the diagnostic accuracy of MSGB in pSS patients. Results. A total of eight studies, including 583 pSS and 627 non-pSS patients, were available for the meta-analysis. The pooled sensitivity and specificity of MSGB were 75.7% (95% confidence interval [CI], 72.0∼79.1) and 90.7% (88.1∼92.9), respectively. The positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio were 9.475 (4.051∼22.16), 0.266 (0.208∼0.340), and 38.92 (19.12∼72.21), respectively. The area under the curve was 0.901 and the Q* index was 0.902, indicating a high diagnostic accuracy. Some between-study heterogeneity was found in the meta-analyses; however, there was no evidence of a threshold effect (Spearman correlation coefficient=0.419; p=0.301). Meta-regression showed that the study quality, sample size, study design, and diagnostic criteria were not sources of heterogeneity, and subgroup meta-analyses did not change the overall diagnostic accuracy. Conclusion. Our meta-analysis of published studies demonstrates that MSGB has a high diagnostic accuracy and may play an important role in the diagnosis of pSS.