Anti-SSA/Ro60kd Antibodies Are Associated With Positive Salivary Gland Biopsy in Sjögren’s Syndrome: A Retrospective Exploratory Study

Introduction/objectives: Sjögren’s syndrome (SS) is a systemic autoimmune disease with heterogeneous clinical, laboratory, and histopathological manifestations, which complicate timely diagnosis. Minor salivary gland biopsy (MSGB) is a key component of SS classification, although its relationship with clinical and serological features remains incompletely characterized. This study aimed to evaluate the association between MSGB findings and clinical-laboratory variables in patients with SS and to identify variables associated with a positive biopsy. Methods: We conducted a retrospective observational study at Braga Local Health Unit, including 37 patients diagnosed with SS between 1995 and 2024 who underwent MSGB. Patients were categorized into group A (positive biopsy, n = 17) or group B (negative biopsy, n = 20). Clinical, serological, and histopathological variables were analyzed using Fisher’s exact test and multivariate logistic regression. Results: Thirty-seven patients were included (17 biopsy-positive, 20 biopsy-negative). The most frequent manifestations were ocular dryness (91.9%), oral dryness (78.4%), anti-SSA antibodies (Ro52: 51.4%; Ro60 kDa: 54.1%), antinuclear antibodies (ANA) titers >1:160 (64.9%), rheumatoid factor (RF) positivity (40.5%), elevated erythrocyte sedimentation rate (ESR) (67.6%), and arthralgia (56.8%). Fisher’s exact test identified several statistically significant associations between clinical and serological variables. In multivariate logistic regression, anti-SSA Ro60 kDa positivity was independently associated with a positive biopsy result (OR: 12.94; 95% CI: 1.39-120.13; p = 0.024), while myalgias were associated with a lower likelihood of biopsy positivity. Conclusion: This exploratory study identified associations between serological markers and salivary gland biopsy findings in SS. Anti-SSA Ro60 kDa positivity may be associated with histopathological involvement; however, given the small sample size and wide confidence intervals, these findings should be interpreted cautiously and require validation in larger prospective studies.