Evidence map›Paper›PMID 35412585›Full record

ArticleRheumatology (Oxford, England)2022

Digital image analysis of intraepithelial B-lymphocytes to assess lymphoepithelial lesions in salivary glands of Sjögren's syndrome patients.

Martha S van Ginkel, Tineke van der Sluis, Marian L C Bulthuis, Henk J Buikema, Erlin A Haacke, Suzanne Arends, Stine Harder, Fred K L Spijkervet, Hendrika Bootsma, Arjan Vissink and 2 more

Open access · bronzeAbstract read
In one paragraph

Article in Rheumatology (Oxford, England), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
1.1field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.

  1. Pooled it
  2. Observational
  3. Article
  4. Article
  5. Review
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 1 institution in 1 country.

Martha S van GinkelDepartment of Rheumatology and Clinical Immunology.ORCID 0000-0002-0867-0282
Tineke van der SluisDepartment of Pathology and Medical Biology, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands.
Marian L C BulthuisDepartment of Pathology and Medical Biology, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands.
Henk J BuikemaDepartment of Pathology and Medical Biology, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands.
Erlin A HaackeDepartment of Rheumatology and Clinical Immunology.
Suzanne ArendsDepartment of Rheumatology and Clinical Immunology.
Stine HarderVisiopharm A/S, Hørsholm, Denmark.
Fred K L SpijkervetDepartment of Oral and Maxillofacial Surgery, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands.
Hendrika BootsmaDepartment of Rheumatology and Clinical Immunology.
Arjan VissinkDepartment of Oral and Maxillofacial Surgery, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands.
Frans G M KroeseDepartment of Rheumatology and Clinical Immunology.
Bert van der VegtDepartment of Pathology and Medical Biology, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands.
University Medical Center Groningen · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveSalivary glands of primary SS (pSS) patients characteristically harbour periductal infiltrates, in which lymphoepithelial lesions (LELs) can develop. LELs are composed of hyperplastic ductal epithelium with infiltrating lymphocytes and may assist in the challenging diagnostic process of pSS. As manual identification of LELs remains difficult, we aimed to identify LELs by using an objective digital image analysis (DIA) algorithm that detects intraepithelial lymphocytes.

methodsA virtual triple-staining technique developed for this study was used to count intraepithelial lymphocytes in consecutive slides stained for CD3 (T-lymphocytes), high-molecular-weight cytokeratin (hmwCK) (striated ducts) and CD20 (B-lymphocytes) in labial and parotid gland biopsies in a diagnostic cohort of 109 sicca patients. Patients were classified as having pSS or non-SS according to the ACR-EULAR classification criteria.

resultsT-lymphocytes were detected in almost all analysed ducts of pSS and non-SS sicca patients, whereas intraepithelial B-lymphocytes were present in 59-68% of labial and parotid gland biopsies of pSS patients, against only 2-3% of patients classified as non-SS. Intraepithelial B-lymphocytes were found in almost all striated ducts with hyperplasia (LELs). Remarkably, ∼25% of analysed striated ducts without hyperplasia of pSS patients also contained B-lymphocytes (precursor-LELs). Furthermore, presence of intraepithelial B-lymphocytes was associated with clinical parameters of pSS (i.e. serology).

conclusionThe presence of intraepithelial B-lymphocytes in salivary gland biopsies of sicca patients is a clear indicator of pSS and can be used as an objective alternative to LEL scoring. Therefore, identification of B-lymphocyte-containing ducts should be added to the diagnostic histopathological work-up of patients suspected of pSS.

Indexed as

Intraepithelial LymphocytesSjogren's SyndromeB-LymphocytesHumansHyperplasiaSalivary Glandshistopathologylabial glandlymphoepithelial lesionsparotid glandsalivary glandSS

Identifiers

PMID35412585
PMCPMC9788820
OpenAlexW4223595336

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.