ASSOCIATION BETWEEN HISTOPATHOLOGICAL FINDINGS OF SALIVARY GLAND AND CLINICAL FEATURES IN PATIENTS WITH DRYNESS

Background: In the setting of focal lymphocytic sialadenitis (FLS), focus scoring is important in the diagnosis of Sjögren’s syndrome (SS) [1]. The degree of non-specific findings in the minor salivary gland, such as atrophy, fibrosis, and duct dilatation, should also be observed [2]. However, it is not clearly known whether these histopathological findings are related to the clinical features of SS [3]. Objectives: We aim to investigate the association between minor salivary gland histopathological findings and the clinical features in patients with dryness. Methods: This was a retrospective study on patients who underwent minor salivary gland biopsies in the process of diagnosing Sjögren’s syndrome (SS) between January 2012 and September 2020. Data were collected through reviews of medical records and pathology slides. In addition to the focus score, the extent (absent, mild, moderate, severe) of atrophy, fibrosis, and duct dilatation were also evaluated. Results: In total, 189 patients were enrolled in this study. The mean age at the time of biopsy was 52.8 ± 10.4 years, and the majority were female (97.9%). Mean follow-up period from the time of biopsy was 51.0 ± 36.5 months. The diagnosis was primary SS in 112 (59.3%), secondary SS in 35 (18.5%), and sicca symptom due to other causes in 42 (22.2%). FLS was present in 73.0%, and the focus score was 1 or more in 49.7%. Atrophy was present in 24.3%, fibrosis was present in 64.0%, and duct dilatation was present in 50.3%. Germinal center-like structures were present in 3.7%, and lymphoepithelial lesions were present in 8.5%. Histopathological difference between patients diagnosed with SS and those without were the presence of FLS (83.0% vs. 38.1%, p <0.001) and Focus score (1.9 vs. 0.3, p <0.001). The Focus score of primary SS was higher than those of secondary SS (2.0 vs. 1.3, p =0.023). In SS patients, focus score were associated with atrphy, fibrosis, and lymphoepithelial lesions, but not with clinial features. In SS patients with atrophy, although the duration of dry mouth was statistically shorter, the unstimulated whole salivary flow rate at the time of biopsy was lower than those without (0.05 vs. 0.15 ml/min, p = 0 .011). The presence of atrophy were also associated with inflammatory markers and autoantibodies. In SS patients with fibrosis, there were more patients with an ANA ≥ 1:640 than those without. The number of patients who underwent cataract surgery during the follow-up period was greater in SS patients with duct dilatation than those without, but there was no statistical difference ( p =0.060). Conclusion: The presence and extent of non-specific histopathologic findings in salivary gland in patients with SS were not different from those in patients with dryness due to other causes. However, in patients with SS, the extent of these findings may associate with autoantibodies, inflammatory levels, as well as glandular function. REFERENCES: [1] 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. Arthritis Rheumatol 2017;69:35-45. [2] Fisher BA, Jonsson R, Daniels T, et al. Standardisation of labial salivary gland histopathology in clinical trials in primary Sjögren’s syndrome. Ann Rheum Dis 2017;76:1161-1168. [3] Bautista-Vargas M, Vivas AJ, Tobón GJ. Minor salivary gland biopsy: Its role in the classification and prognosis of Sjögren’s syndrome. Autoimmun Rev 2020;19:102690. Figure 1. Histopathologic findings in minor salivary gland biopsy (a) Analyzed surface area using digital pathology program, (b) Dense lymphocytic infiltration in periductular area (H&E-stained, X10), (c) Effacement of periductal area by lymphocyte and presence of lymphoepithelial lesions (H&E-stained, X20) Acknowledgements: NIL. Disclosure of Interests: Han Joo Baek H.J.B. received speaker fees from Janssen, Astellas, Novartis, AbbVie, JW Pharm, and Meranini., H.J.B. received consulting fees from Janssen, Astellas, Novartis, AbbVie, JW Pharm, and Meranini., H.J.B. received unrestricted grants from Celltrion., Mi Ryoung Seo M.R.S. received speaker fees from Lilly and AbbVie., M.R.S. received unrestricted grants from Hanlim Pharm., Myunghee Kang: None declared, Jae Deok Seo: None declared, Ji Na Yeo: None declared, Hyo-Jin Choi: None declared. DOI: 10.1136/annrheumdis-2024-eular.4735 Keywords: Descriptive Studies, Autoantibodies, Biomarkers Citation: , volume 83, supplement 1, year 2024, page 1712Session: Sjön`s syndrome (Publication Only)

Descriptive Studies, Autoantibodies, Biomarkers