Clinical evaluation of the modified open wound sutureless labial gland biopsy technique for patient with Sjögren syndrome

doi:10.16138/j.1673-6087.2025.04.09

Abstract

Abstract:

Objective To explore the clinical value of modified open-wound sutureless labial gland biopsy for patients with Sjögren syndrome. Methods A total of 24 patients who underwent labial gland biopsy in our department from March 2023 to April 2025 were divided into the sutureless labial gland biopsy (SLSGB) group and the traditional labial salivary gland biopsy (TLSGB) group. The numerical rating scale (NRS) 0-10 was used to evaluate the postoperative recovery time and incision pain at 2 h, 1 d, and 7 d after surgery in both groups. Results The postoperative recovery time score was (6.67±0.82) points in the TLSGB group and (2.00±0.00) points in the SLSGB group (P< 0.001). The NRS scores at 2 h, 1 d, and 7 d after surgery were (5.83±0.98), (2.67±0.52), and (2.00±0.63) points in the TLSGB group, and (1.72±0.46), 0, and 0 points in the SLSGB group, respectively. There were significant differences between the two groups at 2 h and 1 d after surgery (both P<0.05), but there was no statistical difference at 7 d after surgery (P>0.05). Conclusions Open incision labial gland biopsy is less invasive, less prone to secondary injury, does not require suture removal, is easy to operate, and rarely causes complications. It can reduce significantly the economic and time costs and it’s more easily accepted by patients.

Key words: Sjögren syndrome, Sutureless labial gland biopsy, Postoperative recovery

CLC Number:

R593

CHEN Yabing, GAO Jie, XU Xia, ZHAO Dongbao. Clinical evaluation of the modified open wound sutureless labial gland biopsy technique for patient with Sjögren syndrome[J]. Journal of Internal Medicine Concepts & Practice, 2025, 20(04): 312-315.

Figures/Tables 1

References 32

[1]	Qin B, Wang J, Yang Z, et al. Epidemiology of primary Sjögren’s syndrome: a systematic review and meta-analysis[J]. Ann Rheum Dis, 2015, 74(11):1983-1989.
[2]	Shiboski CH, Shiboski SC, Seror R, et al. 2016 American college of rheumatology/European league against rheumatism classification criteria for primary Sjögren’s syndrome: a consensus and data-driven methodology involving three international patient cohorts[J]. Ann Rheum Dis, 2017, 76(1):9-16.
[3]	Shiboski SC, Shiboski CH, Criswell L, et al. American college of rheumatology classification criteria for Sjögren’s syndrome: a data-driven, expert consensus approach in the Sjögren’s international collaborative clinical alliance cohort[J]. Arthritis Care Res (Hoboken), 2012, 64(4):475-487. pmid: 22563590
[4]	Vitali C, Bombardieri S, Jonsson R, et al. Classification criteria for Sjögren’s syndrome: a revised version of the European criteria proposed by the American-European Consensus Group[J]. Ann Rheum Dis, 2002, 61(6):554-558. doi: 10.1136/ard.61.6.554 pmid: 12006334
[5]	Guellec D, Cornec D, Jousse-Joulin S, et al. Diagnostic value of labial minor salivary gland biopsy for Sjögren’s syndrome: a systematic review[J]. Autoimmun Rev, 2013, 12(3):416-420. doi: 10.1016/j.autrev.2012.08.001 pmid: 22889617
[6]	Daniels TE, Cox D, Shiboski CH, et al. Associations between salivary gland histopathologic diagnoses and phenotypic features of Sjögren’s syndrome among 1,726 registry participants[J]. Arthritis Rheum, 2011, 63(7):2021-2030.
[7]	Franceschini F, Cavazzana I, Andreoli L, et al. The 2016 classification criteria for primary Sjogren’s syndrome: what’s new?[J]. BMC Med, 2017, 15(1):69.
[8]	Brito-Zerón P, Acar-Denizli N, Ng WF, et al. How immunological profile drives clinical phenotype of primary Sjögren’s syndrome at diagnosis: analysis of 10,500 patients (Sjögren Big Data Project)[J]. Clin Exp Rheumatol, 2018, 36 Suppl 112(3):102-112. pmid: 30156539
[9]	Baldini C, Berardicurti O, Giacomelli R, et al. Is minor salivary gland biopsy still mandatory in Sjogren’s syndrome?[J]. Autoimmun Rev, 2024, 23(1):103425.
[10]	Caporali R, Bonacci E, Epis O, et al. Safety and usefulness of minor salivary gland biopsy: retrospective analysis of 502 procedures performed at a single center[J]. Arthritis Rheum, 2008, 59(5):714-720.
[11]	Quartuccio L, Baldini C, Bartoloni E, et al. Anti-SSA/SSB-negative Sjögren’s syndrome shows a lower prevalence of lymphoproliferative manifestations, and a lower risk of lymphoma evolution[J]. Autoimmun Rev, 2015, 14(11):1019-1022. doi: 10.1016/j.autrev.2015.07.002 pmid: 26162302
[12]	Greenspan JS, Daniels TE, Talal N, et al. The histopathology of Sjögren’s syndrome in labial salivary gland biopsies[J]. Oral Surg Oral Med Oral Pathol, 1974, 37(2):217-229.
[13]	Fisher BA, Jonsson R, Daniels T, et al. Standardisation of labial salivary gland histopathology in clinical trials in primary Sjögren’s syndrome[J]. Ann Rheum Dis, 2017, 76(7):1161-1168.
[14]	Vitali C, Moutsopoulos HM, Bombardieri S. The European Community Study Group on diagnostic criteria for Sjögren’s syndrome. Sensitivity and specificity of tests for ocular and oral involvement in Sjögren’s syndrome[J]. Ann Rheum Dis, 1994, 53(10):637-647. doi: 10.1136/ard.53.10.637 pmid: 7979575
[15]	Chen YC, Chen HY, Hsu CH. Recent advances in salivary scintigraphic evaluation of salivary gland function[J]. Diagnostics (Basel), 2021, 11(7):1173.
[16]	Farrar JT, Young JP Jr, LaMoreaux L, et al. Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale[J]. Pain, 2001, 94(2):149-158. doi: 10.1016/S0304-3959(01)00349-9 pmid: 11690728
[17]	Adamson TC 3rd, Fox RI, Frisman DM, et al. Immunohistologic analysis of lymphoid infiltrates in primary Sjogren’s syndrome using monoclonal antibodies[J]. J Immunol, 1983, 130(1):203-208. pmid: 6600176
[18]	Christodoulou MI, Kapsogeorgou EK, Moutsopoulos HM. Characteristics of the minor salivary gland infiltrates in Sjögren’s syndrome[J]. J Autoimmun, 2010, 34(4):400-407. doi: 10.1016/j.jaut.2009.10.004 pmid: 19889514
[19]	Jonsson MV, Delaleu N, Brokstad KA, et al. Impaired salivary gland function in NOD mice: association with changes in cytokine profile but not with histopathologic changes in the salivary gland[J]. Arthritis Rheum, 2006, 54(7):2300-2305.
[20]	Brito-Zerón P, Retamozo S, Ramos-Casals M. Sjögren syndrome[J]. Med Clin (Barc), 2023, 160(4):163-171.
[21]	Lida Santiago M, Seisdedos MR, García Salinas RN, et al. Frequency of complications and usefulness of the minor salivary gland biopsy[J]. Reumatol Clin, 2012, 8(5):255-258. pmid: 22771273
[22]	Varela Centelles P, Sánchez-Sánchez M, Costa-Bouzas J, et al. Neurological adverse events related to lip biopsy in patients suspicious for Sjögren’s syndrome: a systematic review and prevalence meta-analysis[J]. Rheumatology (Oxford), 2014, 53(7):1208-1214. doi: 10.1093/rheumatology/ket485 pmid: 24599912
[23]	程昉, 赵福涛, 沈雪敏, 等. 原发性干燥综合征多学科诊疗专家共识(2024版)[J]. 内科理论与实践, 2024, 19(6): 357-362.
	Cheng F, Zhao FT, Shen XM, et al. Expert consensus on multidisciplinary diagnosis and treatment of primary Sjögren syndrome (2024 ed)[J]. J Intern Med Concepts Pract, 2024, 19(6): 357-362.
[24]	Bud M, Jitaru S, Lucaciu O, et al. The advantages of the dental operative microscope in restorative dentistry[J]. Med Pharm Rep, 2021, 94(1):22-27. doi: 10.15386/mpr-1662 pmid: 33629044
[25]	Li C, Zheng W, Tian Y, et al. Surgical advantage of modified labial salivary gland biopsy using chalazion forceps: a prospective randomized controlled study[J]. Clin Exp Med, 2024, 24(1):175. doi: 10.1007/s10238-024-01428-7 pmid: 39105891
[26]	Liao R, Yang HT, Li H, et al. Recent advances of salivary gland biopsy in Sjögren’s syndrome[J]. Front Med (Lausanne), 2022,8:792593.
[27]	Cho A, Lee YR, Jeon YT, et al. Correlations of MR sialographic gradings with the clinical measures of Sjögren’s syndrome[J]. Laryngoscope, 2023, 133(2):307-316.
[28]	Parker M, Zheng Z, Lasarev MR, et al. Novel autoantibodies help diagnose anti-SSA antibody negative Sjögren disease and predict abnormal labial salivary gland pathology[J]. Ann Rheum Dis, 2024, 83(9):1169-1180. doi: 10.1136/ard-2023-224936 pmid: 38702176
[29]	Park HS, Martínez-Martínez L, Magallares López B, et al. Prognostic significance of lymphocytic foci composition in minor salivary gland biopsies for severe disease flare and severity in Sjögren’s syndrome: a 3-year follow-up cohort study[J]. Front Immunol, 2024,15:1332924.
[30]	Kroese FGM, Haacke EA, Bombardieri M. The role of salivary gland histopathology in primary Sjögren’s syndrome: promises and pitfalls[J]. Clin Exp Rheumatol, 2018, 36 Suppl 112(3):222-233. pmid: 30156550
[31]	Carubbi F, Alunno A, Cipriani P, et al. A retrospective, multicenter study evaluating the prognostic value of minor salivary gland histology in a large cohort of patients with primary Sjögren’s syndrome[J]. Lupus, 2015, 24(3):315-320. doi: 10.1177/0961203314554251 pmid: 25297554
[32]	Haacke EA, van der Vegt B, Vissink A, et al. Germinal centers in diagnostic biopsies of patients with primary Sjögren’s syndrome are not a risk factor for non-Hodgkin’s lymphoma but a reflection of high disease activity: comment on the article by Sène et al[J]. Arthritis Rheumatol, 2019, 71(1):170-171. doi: 10.1002/art.40715

项目	TLSGB组(n=6)	SLSGB组(n=18)	P
术后恢复时间（d）	6.67±0.82	2.00±0.00	<0.001
NRS（分）
术后2 h	5.83±0.98	1.72±0.46	0.001
术后第1天	2.67±0.52	0.00±0.00	<0.010
术后第7天	2.00±0.63	0.00±0.00	0.090
红细胞沉降率(mm/h)	25.00±26.52	22.67±17.79	0.204
C反应蛋白(mg/L)	4.29±4.15	3.35±1.93	0.122
RF(U/mL)	32.25±39.79	29.79±46.19	0.938