Anti-SS-A/Ro antibody (anti-SSA), the diagnostic marker of Sjögren’s syndrome (SS), is often detected in systemic sclerosis (SSc). Some patients are diagnosed with SSc/SS overlap syndromes, while there are anti-SSA-positive SSc cases without SS. In this study, we investigated the clinical characteristics of SSc with anti-SSA and clarified the clinical impact of this antibody in SSc. A retrospective chart review was conducted of 156 patients with SSc at Yokohama City University Hospital from 2018 to 2021. Clinical data, laboratory data, imaging, and autoantibody positivity status were collected and analysed to assess the association between these variables and anti-SSA using multivariable logistic regression analysis. This cohort included 18 men and 138 women with SSc (median age, 69.0 years). Thirty-nine patients had diffuse cutaneous SSc (dcSSc) (25%), and 117 patients had limited cutaneous SSc (75%). Forty-four patients were anti-SSA-positive. Among them, 24 fulfilled the SS criteria. Multivariable logistic regression revealed that anti-SSA was statistically associated with interstitial lung disease (ILD; odds ratio [OR] = 2.67; 95% confidence interval [CI], 1.14–6.3; P = 0.024). Meanwhile, anti-SSA positivity tended to increase the development of digital ulcer (OR = 2.18; 95% CI, 0.99–4.82, P = 0.054). In the comparative analysis of the autoantibody single-positive and anti-SSA/SSc-specific autoantibody double-positive groups, the anti-SSA single-positive group showed a significantly increased risk of ILD (OR = 12.1; 95% CI, 2.13-140.57; P = 0.003). Furthermore, patients with SSc and anti-SSA indicated that anti-SSA-positive SSc without SS was strongly associated with dcSSc when compared to that in patients with SS (OR = 6.45; 95% CI, 1.23–32.60; P = 0.024). Anti-SSA positivity increases the risk of organ involvement, such as ILD, in patients with SSc. Additionally, the anti-SSA-positive SSc without SS population may have more severe skin fibrosis than others. Anti-SSA may be a potential marker of ILD and skin severity in SSc.

中文翻译：

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抗 SS-A 抗体阳性系统性硬化症患者的临床特征：156 例患者的队列研究

抗 SS-A/Ro 抗体（抗 SSA）是干燥综合征（SS）的诊断标志物，经常在系统性硬化症（SSc）中检测到。一些患者被诊断为 SSc/SS 重叠综合征，而也有抗 SSA 阳性的 SSc 病例，但没有 SS。在本研究中，我们用抗 SSA 来研究 SSc 的临床特征，并阐明该抗体对 SSc 的临床影响。对 2018 年至 2021 年横滨市立大学医院的 156 名 SSc 患者进行了回顾性图表审查。收集并分析了临床数据、实验室数据、影像学和自身抗体阳性状态，以使用多变量评估这些变量与抗 SSA 之间的关联。逻辑回归分析。该队列包括 18 名男性和 138 名女性 SSc（中位年龄 69.0 岁）。 39 名患者患有弥漫性皮肤 SSc (dcSSc) (25%)，117 名患者患有局限性皮肤 SSc (75%)。 44 名患者抗 SSA 呈阳性。其中，24个符合SS标准。多变量逻辑回归显示，抗 SSA 与间质性肺疾病有统计学相关性（ILD；比值比 [OR] = 2.67；95% 置信区间 [CI]，1.14–6.3；P = 0.024）。同时，抗 SSA 阳性往往会增加指溃疡的发生（OR = 2.18；95% CI，0.99–4.82，P = 0.054）。在自身抗体单阳性和抗SSA/SSc特异性自身抗体双阳性组的比较分析中，抗SSA单阳性组显示ILD风险显着增加（OR=12.1；95%CI，2.13- 140.57；P = 0.003)。此外，SSc 和抗 SSA 患者表明，与 SS 患者相比，不伴 SS 的抗 SSA 阳性 SSc 与 dcSSc 密切相关（OR = 6.45；95% CI，1.23-32.60；P = 0.024）。抗 SSA 阳性会增加 SSc 患者器官受累的风险，例如 ILD。此外，抗 SSA 阳性的 SSc 人群（不含 SS）可能比其他人群有更严重的皮肤纤维化。抗 SSA 可能是 ILD 和 SSc 皮肤严重程度的潜在标志。