Labial salivary gland specimens were obtained from 470 patients with sicca syndrome, collagen diseases and other diseases, and were analyzed according to the histological criteria reported by Chisholm and Mason. Abnormal findings were observed the labial salivary gland in 133(55.0%) of 242 patient with xerostomia that were significantly higher(P<0.001) as compared with 64(28.1%) of 228 patients without xerostomia. The histological findings correlated well with the findings of parotid sialography(p<0.001). In patients without xerostomia, abnormal histological findings were frequently observed in collagen disease; 8(13.1%) of 61 patients with rheumatoid arthritis; 17(22.7%) of 75 patients with systemic lupus erythematosus; and 9(30.0%) of 30 patients with mixed connective tissue disease. In 193 patients with abnormal findings in the salivary gland, the average age of the patient with xerostomia at biopsy was higher than that of the patients without symptoms(p<0.001). Since it remains nuclear whether the patients who show abnormal findings of labial salivary gland without xerostomia have Sjogren's syndrome, or whether these histological abnormalities represent part of the basic disease process, these patients should be oberved under the term of "subclinical" Sjogren's syndrome.
Labial salivary gland biopsy