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一种用于犬骨肉瘤的新组织学分级系统的预后意义

Prognostic significance of a new histologic grading system for canine osteosarcoma.

作者信息

Kirpensteijn J, Kik M, Rutteman G R, Teske E

机构信息

Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, The Netherlands.

出版信息

Vet Pathol. 2002 Mar;39(2):240-6. doi: 10.1354/vp.39-2-240.

Abstract

Histologic grade is an important determinant in clinical outcome of human osteosarcoma (OS). In this study, the histologic characteristics of primary and metastatic canine OS were evaluated using a new classification system. Histologic characteristics were classified in 166 primary and 34 metastatic canine OS. Prognostic variables for clinical outcome were determined using multivariate analysis. Most OS were histologically characterized by severe to extreme cellular pleomorphism, a variable number of mitoses, small to moderate amounts of matrix, a high percentage of tumor cells, and minimal to moderate amounts of necrosis. Tumor invasion into vessels was present in 117/152 (71%) tumors, and 12/50 (24%) of the regional lymph nodes had evidence of metastasis. Classification of the 166 tumors resulted in seven (4%) grade 1, 34 (21%) grade II, and 125 (75%) grade III OS. In the multivariate analysis, histologic grade III OS and elevated pretreatment plasma alkaline phosphatase (AP) levels were independent predictors of clinical outcome. Dogs with high-grade tumors and elevated AP should be carefully evaluated for the presence of metastatic disease before starting adjunctive therapy protocols.

摘要

组织学分级是人类骨肉瘤(OS)临床预后的一个重要决定因素。在本研究中,使用一种新的分类系统对原发性和转移性犬骨肉瘤的组织学特征进行了评估。对166例原发性和34例转移性犬骨肉瘤的组织学特征进行了分类。使用多变量分析确定临床预后的预后变量。大多数骨肉瘤的组织学特征为严重至极重度细胞多形性、不同数量的有丝分裂、少量至中等量的基质、高比例的肿瘤细胞以及少量至中等量的坏死。117/152(71%)的肿瘤存在肿瘤血管浸润,12/50(24%)的区域淋巴结有转移证据。166例肿瘤的分类结果为7例(4%)1级、34例(21%)2级和125例(75%)3级骨肉瘤。在多变量分析中,组织学3级骨肉瘤和治疗前血浆碱性磷酸酶(AP)水平升高是临床预后的独立预测因素。在开始辅助治疗方案之前,应仔细评估患有高级别肿瘤且AP升高的犬是否存在转移性疾病。

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