STIMULATED WHOLE SALIVA IN THE DIAGNOSIS OF PRIMARY SJÖGREN'S DISEASE.

Aim: The aim of this cross-sectional study was to determine the accuracy of minor labial salivary gland (MLSG) biopsy in the diagnosis of primary Sjögren's disease (pSB). The specific objectives of the study were: to determine if there is a correlation between the focus score (FS) and anti-SSA/Ro, anti-SSB/La, anti-SSA and -SSB antibodies, total unstimulated (UWS) and stimulated (SWS) saliva; to determine and compare the values of UWS and SWS in both groups of subjects; and to compare the utility of UWS and SWS in patients diagnosed with pSB. Materials and Methods: A total of 37 subjects participated in the study, divided into two groups. The test group consisted of 15 patients diagnosed with pSB. The control group consisted of 22 patients who had sicca symptoms but did not meet the 2016 American College of Rheumatology (ACR) and European League Against Rheumatism (EULAR) diagnostic criteria. Results: The median of FS is 1.0 (IQR=1.0-1.5) in the test group, while it is 0.0 (IQR=0.0-0.0) in the control group (p <0.001, Mann-Whitney U test). The sensitivity, specificity, and accuracy of MLSG biopsy were 86.7%, 100.0%, and 94.6%, respectively. The results showed a statistically significant correlation between FS and antinuclear antibodies (ANA) (p=0.002). Pearson's correlation also showed a weak negative correlation without statistical significance between UWS (r= -0.058, p=0.731) and SWS (r= -0.022, p=0.899) and FS. In the test group, 11 patients (73.3%) had abnormal UWS values, while 13 patients (86.7%) had abnormal SWS values. Conclusion: Although MLSG biopsy has great diagnostic value and accuracy in diagnosing pSB, it is not always accurate. Moreover, this study demonstrates the association of anti-SSA autoantibodies with the diagnosis of pSB, the statistically significant association of FS and ANA, and the greater utility of SWS in the diagnosis of pSB. [ABSTRACT FROM AUTHOR]