アブストラクト（49巻2号：神奈川歯学）

神奈川歯学

Japanese

Title　： シェーグレン症候群の診断における口唇腺生検の意義についての研究
Subtitle　： 原著
Authors　： 河野伸二郎, 久保田英朗, 石田孝文, 小澤重幸, 鈴木健司, 土肥雅彦, 岩渕博史, 本間義郎, 藤林孝司, 窪田展久*
Authors（kana）　：
Organization　： 神奈川歯科大学大学院顎顔面外科学講座, *神奈川歯科大学附属病院病理診断科
Journal　： 神奈川歯学
Volume　： 49
Number　： 2
Page　： 119-126
Year/Month　： 2014 / 12
Article　： 原著
Publisher　： 神奈川歯科大学学会
Abstract　： 「緒言」最近, Sjogren's International Collaborative Clinical Alliance (SICCA) から新しいシェーグレン症候群 (SS) の診断基準が提示された. これは, 米国, アルゼンチン, デンマーク, 中国, 日本, 英国の6か国の機関で採取された血液, 唾液, 臨床検査データをカリフォルニア大学サンフランシスコ校 (UCSF) に集め解析した結果が, 米国リウマチ学会 (ACR) で承認されACR基準として発表されたものである. 一方本邦では, 1999年日本厚生省シェーグレン症候群改訂診断基準 (JPN基準) が広く用いられている. JPN基準では, 生検病理検査, 口腔検査, 眼科検査, 血清検査の4項目の他覚的検査からなり, 4項目中いずれか2項目以上が該当すればSSと確定診断することになっている. 一方, ACR基準では, 血清自己抗体検査, 口唇腺生検病理検査, keratoconjunctivitis-sicca (KCS) 検査所見の3項目からなり, これら3項目のうち2項目以上陽性で診断するとしている.
Practice　： 歯科学
Keywords　： シェーグレン症候群, 口唇腺生検, 診断基準

English

Title　： A Study for Evaluating Significance of Labial Salivary Gland Biopsy in Diagnosis of Sjogren's Syndrome
Subtitle　：
Authors　： Shinjiro KAWANO, Eiro KUBOTA, Takafumi ISHIDA, Shigeyuki OZAWA, Kenji SUZUKI, Masahiko DOHI, Hiroshi IWABUCHI, Yoshiro HONMA, Takashi FUJIBAYASHI, Nobuhisa KUBOTA*
Authors（kana）　：
Organization　： Department of Oral and Maxillofacial Surgery, Kanagawa Dental University, Graduate School of Dentistry, Department of Diagnostic Pathology, Kanagawa Dental University Hospital
Journal　： Kanagawa Shigaku
Volume　： 49
Number　： 2
Page　： 119-126
Year/Month　： 2014 / 12
Article　： Original article
Publisher　： Kanagawa Odontological Society
Abstract　： [Abstract] A new classification criteria for Sjogren's syndrome (SS) was recently released from the Sjogren's International Collaborative Clinical Alliance (SICCA), and it was approved by American College of Rheumatology (ACR). Whereas criteria from American-European Consensus Group (AECG) involved subjective symptoms for the criterion, the new classification was based solely on objective clinical tests. Among them, labial salivary gland biopsy (LSGB) is utmost important for the SS diagnosis. At the time point of April 2010, we have positively introduced LSGB to diagnose SS among patients who visited our clinic with chief complaint of dry mouth. We retrospectively examined the diagnostic rate of SS between patients from April 2007 to March 2010 (group I) and those from April 2010 to September 2011 (group II). Both of the patients' groups were age and sex matched, and the former consisted of 233 patients and 122 in the latter. The patients were diagnosed according to the Revised Japanese Criteria for SS (1999). The positive rate of diagnosis in LSGB was 54.8% in the former group, and 68.0% in the latter, respectively. The diagnostic performance of SS was increased from 8.2% in the former group to 17.9% in the latter, respectively. We also examined differences of pathological evaluation of LSGB between JPN and ACR criteria. The ACR criterion distinguishes focal lymphocytic sialadenitis (FLS) from nonspecific or sclerosing chronic sialadenitis (NS/SCS) in assessing LSGB, and FLS is considered characteristic for SS. We found that several cases of SS associated with high titer of anti-SS-A antibody displayed pathological specimen which was not typical for SS, i.e., NS/SCS. From these results, it is considered that differences in the pathological assessment of the LSGB may affect the diagnostic accuracy of SS.
Practice　： Dentistry
Keywords　：