Clinical Accessment Of Two Different Classification Criteria For Diagnosis Of Primary Sj(?)gren Syndrome

Objective:To compare the performace of the American–European Consensus Group(AECG) and the newly proposed American College of Rheumatology(ACR) classification criteria for Sj?gren's Syndrome(SS) and evaluate the sensitivity and specificity of all diagnostic items in criteria,and to test the accuracy of salivary gland ultrasonography(SGUS) for the detection of pSS. Methods:100 patients with suspected SS were questioned the symptoms of dry eyes and dry mouth and examined sialography, salivary flow(unstimulated),lip biopsy, Schirmer's test, ocular surface staining(OSS), tear break-up time(BUT), anti-SSA, anti-SSB and ANA with RF.Salivary gland ultrasonography(SGUS) were also tested.All patients were assessed by 2012 ACR criteria and 2002 AECG criteria.The sensitivity and specificity of all those items and SGUS were calculated using AECG critera as “golden standard”. Results:49 patients fulfilled AECG and 42 patients fulfilled ACR criteria. There was a concordance rate of 0.58 based on the ? statistic. The sensitivity and specificity of sialography, salivary flow(unstimulated), lip biopsy, Schirmer's test, BUT, OSS, anti-SSA/SSB,anti-SSA/SSB or ANA with positive RF was 81.6%?65.3%?85.7%?79.6%?77.6%?63.3%?53.1%?61.2% and 68.6%?74.5%?78.4%?76.5%?62.7%?60.8%?88.2%?84.3%. The SGUS(score? 2) showed a sensitivity(SE) of 81%, a specificity(SP) of 74% for pSS diagnosis. Conclusion:The level of agreement between two criteria was only moderate, but our study shows three diagnostic items in 2012 ACR criteria have higher sensitivity and specificity than others, which supports 2012 ACR criteria. The sensitivity and specificity of SGUS were 81% and 74%,which demonstrates that this new tool could be used for the diagnosis.