Patterns of referral and histopathological interpretation of minor salivary gland biopsy in suspected Sjögren’s disease: a single-center experience
摘要
Minor salivary gland biopsy (MSGB) is a cornerstone in the diagnosis and classification of Sjögren's disease (SjD). remain limited, particularly from the Middle East. To describe referral patterns, histopathological findings, and diagnostic yield of MSGB in patients with suspected SjD over 10 years at a tertiary center in Jordan. This retrospective cross-sectional study included 125 MSGB specimens collected between January 2015 and December 2024 at Jordan University Hospital. Clinical, laboratory, imaging, and histopathological data were retrieved and analyzed. Biopsy positivity was defined as a focus score ≥ 1. Univariable and multivariable logistic regression analyses were performed to identify independent predictors of biopsy positivity. Most patients were female (84.8%), with a median age of 55 (range: 11–81 years). Rheumatologists were the predominant referring specialty (70.2%). A progressive increase in biopsy utilization was observed from 2021 onward. Focal lymphocytic sialadenitis (FLS) was the most frequent histopathological diagnosis (36%). On multivariable analysis, positive ANA (aOR 3.04, 95% CI 1.03–8.95) and RF (aOR 3.82, 95% CI 1.26–11.54) were independent predictors of biopsy positivity. No significant associations were found with anti-SSA, anti-SSB, or inflammatory markers. MSGB demonstrates moderate diagnostic yield in a real-world tertiary setting, with ANA and RF positivity as independent predictors of positive histology. These findings add valuable insights into SjD diagnosis from an underrepresented region.