A Meta-analysis of the Diagnostic Value of Minor Salivary Gland Biopsy for Primary Sjogren's Syndrome

ABSTRACT

OBJECTIVE: The purpose of this study is to evaluate the diagnostic performance of minor salivary gland biopsy (MSGB) for patients with primary Sjogren's syndrome (pSS). METHODS: We have conducted a search from Medline, Embase, and Cochrane Library databases, and performed a meta-analysis on the diagnostic accuracy of MSGB in pSS patients. RESULTS: A total of eight studies, including 583 pSS and 627 non-pSS patients, were available for the meta-analysis. The pooled sensitivity and specificity of MSGB were 75.7% (95% confidence interval [CI], 72.0~79.1) and 90.7% (88.1~92.9), respectively. The positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio were 9.475 (4.051~22.16), 0.266 (0.208~0.340), and 38.92 (19.12~72.21), respectively. The area under the curve was 0.901 and the Q*; index was 0.902, indicating a high diagnostic accuracy. Some between-study heterogeneity was found in the meta-analyses; however, there was no evidence of a threshold effect (Spearman correlation coefficient= 0.419; p=0.301). Meta-regression showed that the study quality, sample size, study design, and diagnostic criteria were not sources of heterogeneity, and subgroup meta-analyses did not change the overall diagnostic accuracy. CONCLUSION: Our meta-analysis of published studies demonstrates that MSGB has a high diagnostic accuracy and may play an important role in the diagnosis of pSS.