15 years of the histopathological synovitis score, further development and review: A diagnostic score for rheumatology and orthopaedics

被引：51

作者：

Krenn, V. ^{[1
]}

Perino, G. ^{[2
]}

Ruether, W. ^{[3
]}

Krenn, V. T. ^{[1
]}

Huber, M. ^{[4
]}

Hugle, T. ^{[5
]}

Najm, A. ^{[6
]}

Mueller, S. ^{[1
]}

Boettner, F. ^{[2
]}

Pessler, F. ^{[7
,8
]}

Waldstein, W. ^{[9
]}

Kriegsmann, J. ^{[1
,10
]}

Casadonte, R. ^{[10
]}

Haeupl, T. ^{[11
]}

Wienert, S. ^{[12
]}

Krukemeyer, M. G. ^{[13
]}

Sesselmann, S. ^{[14
]}

Sunitsch, S. ^{[15
]}

Tikhilov, R. ^{[16
]}

Morawietz, L. ^{[17
]}

机构：

[1] MVZ Zentrum Histol Zytol & Mol Diagnost, Max Planck Str, Trier, Germany

[2] Hosp Special Surg, Dept Pathol & Lab Med, 535 E 70th St, New York, NY 10021 USA

[3] Univ Klinikum Hamburg Eppendorf, Klin & Poliklin Orthopadie, Hamburg, Germany

[4] Otto Wagner Spital, Pathol Bakteriol Inst, Vienna, Austria

[5] Hop Orthoped, Lausanne, Switzerland

[6] CHU Nantes, Rhumatol, Nantes, France

[7] Zentrum Expt & Klin Infekt Forsch GmbH, TWINCORE, Hannover, Germany

[8] Helmholtz Zentrum Infekt Forsch, Braunschweig, Germany

[9] Med Univ Wien, AKH Wien, Univ Klin Orthopadie, Vienna, Austria

[10] Proteopath GmbH, Trier, Germany

[11] Med Klin Rheumatol & Klin Immunol Charite, Berlin, Germany

[12] VMscope Berlin, Berlin, Germany

[13] Paracelsus Kliniken Deutschland, Osnabruck, Germany

[14] Orthopad Univ Klin Erlangen, Erlangen, Germany

[15] Med Univ Graz, Inst Pathol, Graz, Austria

[16] Vreden Russian Sci Res Inst Traumatol & Orthoped, St Petersburg, Russia

[17] MVZ Furstenberg Karree, Berlin, Germany

来源：

PATHOLOGY RESEARCH AND PRACTICE | 2017年 / 213卷 / 08期

关键词：

Synovitis score; Synovitis; Rheumatoid arthritis; Arthrosis; Semiquantitative evaluation; Immunohistochemistry; Risk stratification; ARTHRITIS; BIOPSIES; OSTEOARTHRITIS; ARTHROPATHIES; INFLAMMATION; PATHOLOGY;

D O I：

10.1016/j.prp.2017.05.005

中图分类号：

R36 [病理学];

学科分类号：

100103 [病原生物学];

摘要：

The histopathological synovitis score evaluates the immunological and inflammatory changes of synovitis in a graduated manner generally customary for diagnostic histopathological scores. The score results from semiquantitative evaluation of the width of the synovial surface cell layer, the cell density of the stroma and the density of the inflammatory infiltration into 4 semiquantitative levels (normal 0, mild 1, moderate 2, severe 3). The addition of these values results in a final score of 0-9 out of 9. On the basis of this summation the condition is divided into low-grade synovitis and high-grade synovitis: A synovitis score of 1 to <= 4 is called low-grade synovitis (arthrosis-associated/OA synovitis, posttraumatic synovitis, meniscopathy-associated synovitis and synovitis with haemochromatosis). A synovitis score of >= 5 to 9 is called high-grade synovitis (rheumatoid arthritis, psoriatic arthritis, Lyme arthritis, postin-fection/reactive arthritis and peripheral arthritis with Bechterew's disease). By means of the synovitis score it is therefore possible to distinguish between degenerative/posttraumatic diseases (low-grade synovitis) and inflammatory rheumatic diseases (high-grade synovitis) with a sensitivity of 61.7% and a specificity of 96.1%. The diagnostic accuracy according to ROC analysis (AUC: 0.8-0.9) is good. Since the first publication (2002) and an associated subsequent publication (2006), the synovitis score has nationally and internationally been accepted for histopathological assessment of the synovitis. In a PubMed data analysis (status: 14.02.2017), the following citation rates according to Cited by PubMed Central articles resulted for the two synovitis score publications: For DOI: 10.1078/0344-0338-5710261 there were 29 Cited by PubMed Central articles and for the second extended publication DOI:10.1111613652559.2006.02508 there were 44 Cited by PubMed Central articles. Therefore a total of 73 PubMed citations are observed over a period of 15 years, which demonstrates an international acceptance of the score. This synovitis score provides for the first time a diagnostic, standardised and reproducible histopathological evaluation method enabling a contribution to the differential diagnosis of chronic inflammatory general joint diseases. This is particularly the case by incorporation into the joint pathology algorithm. To specify the synovitis score an immunohistochemical determination of various inflammation-relevant CD antigens is proposed to enable a risk stratification of high-grade synovitis (e.g.: progression risk and sensitivity for biologicals). (C) 2017 Elsevier GmbH. All rights reserved.

引用

页码：874 / 881

页数：8

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