{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T07:21:11Z","timestamp":1770276071293,"version":"3.49.0"},"reference-count":14,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2009,1,2]],"date-time":"2009-01-02T00:00:00Z","timestamp":1230854400000},"content-version":"vor","delay-in-days":581,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2007,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold>Objective<\/jats:bold>: Sjogren's syndrome (SS) is an autoimmune disease involving primarily the salivary and lacrimal glands (\u201csicca\u201d symptoms) with extraglandular features including joint and nervous system involvement. In patients with a questionable diagnosis of SS but severe extraglandular symptoms, a lip biopsy is often performed to firmly establish the diagnosis of SS. This study was undertaken to identify areas of uncertainty regarding the accuracy of biopsy interpretation and the diagnostic benefits of the procedure.<\/jats:p><jats:p><jats:bold>Study Design<\/jats:bold>: Retrospective review of clinical and pathologic data.<\/jats:p><jats:p><jats:bold>Methods<\/jats:bold>: Clinical data from 47 patients referred to the otolaryngology\u2013head and neck surgery service for lip biopsy were reviewed. Archival pathologic specimens were scored using the currently accepted grading system.<\/jats:p><jats:p><jats:bold>Results<\/jats:bold>: The grading system was incorrectly applied during initial interpretation of 45% (n = 21) of specimens. This resulted in five (10%) pathologic misdiagnoses and 16 (34%) nondiagnoses. On re\u2010interpreting the specimens with consistent application of the grading system, 62% (n = 29) of the biopsies were definitely positive, and 36% (n = 17) were negative. Neither positive serology nor the presence of sicca symptoms predicted a positive biopsy (likelihood ratio = 0.95 and 0.96, respectively). Lip biopsy guided treatment in at least 65% (n = 31) of patients but was ignored in the presence of other clinical findings in 17% (n = 8) of patients.<\/jats:p><jats:p><jats:bold>Conclusions<\/jats:bold>: Consistent application of the grading system is essential in avoiding incorrect diagnosis and aiding clinical decisions. However, not all patients undergoing lip biopsy will derive diagnostic benefit from the procedure. In this series, clinical symptoms and serology did not predict positive lip biopsy.<\/jats:p>","DOI":"10.1097\/mlg.0b013e31804654f7","type":"journal-article","created":{"date-parts":[[2007,4,5]],"date-time":"2007-04-05T08:05:12Z","timestamp":1175760312000},"page":"1004-1008","source":"Crossref","is-referenced-by-count":36,"title":["Utility of Lip Biopsy in the Diagnosis and Treatment of Sjogren's Syndrome"],"prefix":"10.1002","volume":"117","author":[{"given":"Alexander J.","family":"Langerman","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth A.","family":"Blair","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nadera J.","family":"Sweiss","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jerome B.","family":"Taxy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2009,1,2]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/ard.61.6.554"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0714.2001.300705.x"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/ard.61.6.482"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.21.5.656"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-87-5-535"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/0030-4220(74)90160-1"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/0030-4220(74)90417-4"},{"key":"e_1_2_6_9_2","first-page":"732","volume-title":"Surgical Pathology of the Head Neck","author":"Barnes L","year":"2001"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.3109\/s10165-004-0338-x"},{"key":"e_1_2_6_11_2","first-page":"938","article-title":"Change in final diagnosis on second evaluation of labial minor salivary gland biopsies.","volume":"29","author":"Vivino FB","year":"2002","journal-title":"J Rheumatol"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780270205"},{"key":"e_1_2_6_13_2","first-page":"247","article-title":"Establishing guidelines for the role of minor salivary gland biopsy in clinical practice for Sjogren's syndrome.","volume":"25","author":"Lee M","year":"1998","journal-title":"J Rheumatol"},{"key":"e_1_2_6_14_2","first-page":"1515","article-title":"Minor salivary gland biopsies in patients investigated for primary Sjogren's syndrome: a review of 187 patients.","volume":"20","author":"Wise CM","year":"1993","journal-title":"J Rheumatol"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-005-0984-4"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1097%2FMLG.0b013e31804654f7","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1097\/MLG.0b013e31804654f7","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,10]],"date-time":"2023-10-10T02:41:39Z","timestamp":1696905699000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1097\/MLG.0b013e31804654f7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2007,6]]},"references-count":14,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2007,6]]}},"alternative-id":["10.1097\/MLG.0b013e31804654f7"],"URL":"https:\/\/doi.org\/10.1097\/mlg.0b013e31804654f7","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2007,6]]}}}