Faut-il encore effectuer des biopsies des glandes salivaires accessoires ?

Abstract

Labial salivary gland biopsy (LSGB) is a very useful technique that is often performed in our specialty. A lot of these LSGB yield normal results and the interest of this technique may be discussed. This study was made to answer two questions: one on the diagnostic interest of LSGB for the suspected pathology, secondly to verify if there was a correlation between the results of LSGB assessment and the patient's final diagnosis. Ninety-six LSGB were performed in 2004 for Sjögren syndrome, sarcoidosis, amyloidosis and other auto-immune diseases. The histological study assessed the Chisholm-Mason score and screened for amyloidosis and sarcoidosic granuloma. The prescribing unit gave the final diagnosis. The LSGB was very specific (100% of specificity) and there were no false positive results; conversely, its sensitivity was lower, that is 75% for Sjögren syndrome, 67% for amyloidosis, 60% for sarcoidosis and 14% for other auto-immune disease (not defined). LSGB can be recommended for Sjögren syndrome; it is also useful for amyloidosis. In sarcoidosis it gives poor results and presents no interest for other auto-immune diseases. The LSGB prescribed for patients with a suspected initial single diagnosis (Sjögren syndrome only, or amyloidosis only, or sarcoidosis only, or an other auto-immune disease only) significantly increases the specificity and the sensitivity of the technique and suggests that specificity and sensitivity are linked to patient selection and not to LSGB itself.