Description of the clinical, histopathological and immunohistochemical characteristics of patients with sicca syndrome with Minor Salivary Gland biopsy and Focus Score ≥1

Abstract

Introduction. Sjögren's Syndrome (SS) is a systemic autoimmune disease. The usefulness of immunohistochemistry in minor salivary gland biopsy (MSGB) has been described, which could indirectly characterize the lymphocyte phenotype in scenarios of difficult diagnosis.
Objective. To describe the sociodemographic, clinical, serological, histopathological and immunohistochemical variables in patients with sicca syndrome in whom MSGB was performed, with a finding of focus score (FS) greater than or equal to 1.
Materials and methods. Retrospective cohort. Patients with sicca syndrome under study with availability of BGSM, with FS greater than or equal to 1, were included. Immunohistochemistry was performed on the BGSM, with chromogen red staining (CD8 T lymphocytes) and brown (CD4 T lymphocytes). Markers CD20:CD3 and CD4:CD8 are described with Easy Scan Pro 6 –MOTIC® and QuPath® software. Qualitative variables (Chi2 or Fischer's exact test), and quantitative variables (according to normality) were analyzed.
Results. 28 patients were analyzed. 16 patients had SS (8 with polyautoimmunity). An association was found between the presence of glandular atrophy in the BGSM and the presence of polyautoimmunity (OR 11.1 95% CI 1.12 to 112; p value = 0.033). The CD20:CD3 and CD4:CD8 ratios were normal with no statistical differences between patients with and without SS. In the subgroup of patients with SS, predominance of CD4 T lymphocytes was found, with 15 cases (93.7%) with CD4:CD8 ratios equal to or greater than 2:1.
Conclusions. An association was found between glandular atrophy and the presence of polyautoimmunity as well as a predominance of CD4-T lymphocytes in patients with SS, highlighting the possible value of immunohistochemistry of BGSM in this group.