Background Detection of inflammation in minor salivary gland biopsy (MSGB) is an important diagnostic method for primary Sjogren's syndrome (pSS) in both the American-European Consensus Group (AECG) and American College of Rheumatology (ACR) criteria. Thus, the diagnostic accuracy of MSGB has been studied in the context of pSS. However, the published results are controversial. This may be due to the small sample sizes, low statistical power, and/or the presence of clinical heterogeneity.

Objectives The purpose of this study is to evaluate the diagnostic performance of MSGB for patients with pSS.

Methods We searched the 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.

Conclusions Our meta-analysis of published studies demonstrates that MSGB has a high diagnostic accuracy and plays an important role in the diagnosis of pSS.

Disclosure of Interest None declared