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Non-invasive imaging for predicting labial salivary gland biopsy outcomes in patients with suspected primary Sjögren syndrome

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Abstract

To identify the value of salivary gland ultrasound (SGUS) combined with magnetic resonance imaging (MRI) and magnetic resonance sialography (MRS) in predicting the results of labial salivary gland biopsy (LSGB) in patients with suspected primary Sjögren syndrome (pSS), and construct a nomogram model to predict LSGB results. A total of 181 patients who were admitted with suspected pSS from December 2018 to April 2023 were examined and divided into a training set (n = 120) and a validation set (n = 61). Baseline data of the two groups were examined, and the value of SGUS, MRI, and MRS in predicting LSGB was analyzed. Multivariate logistic analysis was used to screen for risk factors, and nomogram prediction models were constructed using these results. In the training set, the SGUS, MRI, and MRS scores of patients in the LSGB + group were higher than those in the LSGB − group (all P < 0.001). The positive prediction value (PPV) was 91% for an SGUS score of 3, and 82% for MRI and MRS scores of 2 or more. We developed a nomogram prediction model based on SGUS, MRI, and MRS data, and it had a concordance index (C-index) of 0.94. The Hosmer–Lemeshow test (χ2 = 3.17, P = 0.92) also indicated the nomogram prediction model had good accuracy and calibration for prediction of LSGB results. A nomogram model based on SGUS, MRI, and MRS results can help rheumatologists decide whether LSGB should be performed in patients with suspected pSS.

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Acknowledgements

We are grateful to Professor Wei Wang and Dr. Lian Cheng from the Imaging Department of Yangzhou University Affiliated Hospital for providing technical guidance and support for the successful completion of this study. We thank Medjaden Inc. for assistance in the preparation of this manuscript.

Funding

This study was supported by grants from National Natural Science Foundation of China (No. 82071821), Jiangsu Provincial Natural Science Foundation of China (No. BK20201222), The Fifth Phase of "333 Project" Scientific Research Project of Jiangsu Province in 2020 (No. BRA2020175), Yangzhou University "High-end Talent Plan" Top Talent Growth Plan (2019), and special fund for medical innovation and transformation of Yangzhou University (AHYZUCXTD 202105).

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  1. Nan Xu, Xuanhan Wang and Tiandian Dai contributed equally to this work.

Authors and Affiliations

  1. Department of Rheumatology and Immunology, Affiliated Hospital of Yangzhou University, Yangzhou University, No. 368, Hangjiang RoadJiangsu Province, Yangzhou, 225000, People’s Republic of China

    Nan Xu, Xuanhan Wang, Tiantian Dai, Nianxing Liu, Yimin Ding, Jinqiong Chen, Yuxuan Fang, Yongbin Zhang & Guoqing Li

  2. Department of Rheumatology and Immunology, Qingdao West Coast New District People’s Hospital, Qingdao, 266000, People’s Republic of China

    Longlong Tian

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  1. Nan Xu
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Contributions

Guoqing Li and Nan Xu designed the study. Xuanhan Wang, Nan Xu, Tiantian Dai, Yimin Ding, Yongbin Zhang, Yuxuan Fang collated the data, carried out data analyses and produced the initial draft of the manuscript. Nan Xu, Tiantian Dai, Nianxing Liu, Longlong Tian and Jinqiong Chen contributed to drafting the manuscript. All authors have read and approved the final submitted manuscript.

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Correspondence to Guoqing Li.

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Xu, N., Wang, X., Dai, T. et al. Non-invasive imaging for predicting labial salivary gland biopsy outcomes in patients with suspected primary Sjögren syndrome. Clin Rheumatol 43, 1683–1692 (2024). https://doi.org/10.1007/s10067-024-06949-w

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