Περίληψη:
Labial salivary gland (LSG) biopsy is used in the classification of primary Sjögren's syndrome (PSS) and in patient stratification in clinical trials. It may also function as a biomarker. The acquisition of tissue and histological interpretation is variable and needs to be standardised for use in clinical trials. A modified European League Against Rheumatism consensus guideline development strategy was used. The steering committee of the ad hoc working group identified key outstanding points of variability in LSG acquisition and analysis. A 2-day workshop was held to develop consensus where possible and identify points where further discussion/data was needed. These points were reviewed by a subgroup of experts on PSS histopathology and then circulated via an online survey to 50 stakeholder experts consisting of rheumatologists, histopathologists and oral medicine specialists, to assess level of agreement (0-10 scale) and comments. Criteria for agreement were a mean score ≥6/10 and 75% of respondents scoring ≥6/10. Thirty-nine (78%) experts responded and 16 points met criteria for agreement. These points are focused on tissue requirements, identification of the characteristic focal lymphocytic sialadenitis, calculation of the focus score, identification of germinal centres, assessment of the area of leucocyte infiltration, reporting standards and use of prestudy samples for clinical trials. We provide standardised consensus guidance for the use of labial salivary gland histopathology in the classification of PSS and in clinical trials and identify areas where further research is required to achieve evidence-based consensus. © 2016 BMJ Publishing Group Limited.
Συγγραφείς:
Fisher, B.A.
Jonsson, R.
Daniels, T.
Bombardieri, M.
Brown, R.M.
Morgan, P.
Bombardieri, S.
Ng, W.-F.
Tzioufas, A.G.
Vitali, C.
Shirlaw, P.
Haacke, E.
Costa, S.
Bootsma, H.
Devauchelle-Pensec, V.
Radstake, T.R.
Mariette, X.
Richards, A.
Stack, R.
Bowman, S.J.
Barone, F.
De Albuquerque, R.P.P.
Allen, R.
Astorri, E.
Baldini, C.
Bhabra, R.
Brito-Zerón, P.
Chengot, P.
Fedele, S.
Kruize, A.A.
Omdal, R.
Porter, S.
Potts, J.
Poveda-Gallego, A.
Price, E.
Priori, R.
Ramos-Casals, M.
Retamozo, S.
Suchak, K.
Sutcliffe, N.
Syed, Z.
Tappuni, A.R.
Theander, E.
Wahren-Herlenius, M.
Triantafyllou, A.
Vissink, A.
De Vita, S.
Yap, C.
Osayi, K.
Sjogren's histopathology workshop group (appendix) from ESSENTIAL (EULAR Sjogren's syndrome study group)
Λέξεις-κλειδιά:
Article; consensus development; disease classification; germinal center; histopathology; human; medical specialist; neutrophil chemotaxis; patient attitude; practice guideline; priority journal; rheumatologist; salivary gland biopsy; sialoadenitis; Sjoegren syndrome; standard; standardization; biopsy; consensus development; Delphi study; leukocyte; lip; lymphocyte; minor saliva gland; pathology; practice guideline; Sjoegren syndrome, Biopsy; Delphi Technique; Germinal Center; Humans; Leukocytes; Lip; Lymphocytes; Reference Standards; Salivary Glands, Minor; Sialadenitis; Sjogren's Syndrome
