Williams Laurel E, Broussard Maia Tcheng, Johnson Jeffrey L, Neel Jennifer
Veterinary Teaching Hospital, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606, USA.
J Am Vet Med Assoc. 2005 Feb 15;226(4):562-6. doi: 10.2460/javma.2005.226.562.
To determine interclinician agreement when assessing remission of lymphoma in dogs and the association among results of clinicians' assessments via lymph node palpation, cytologic examination of fine-needle lymph node aspirates, and flow cytometry as determinants of remission.
Prospective study.
23 dogs with untreated lymphoma. PROCEDURE; Two clinicians independently measured large lymph nodes and cytologic examination and flow cytometry of cells from a mandibular or popliteal lymph node were performed 1 week prior to initiating treatment. Lymph node measurements with clinicians' remission assessments and cytologic examination were repeated at weeks 2, 3, and 5; flow cytometry was repeated at week 5.
Significant correlation was identified between clinicians' remission assessments. Significant correlation between lymph node palpation and cytologic examination was identified at week 5, but not at weeks 2 and 3. Lymphoma was diagnosed in 16 of 23 (70%) dogs at initial evaluation by use of flow cytometry, although it was of limited use at subsequent evaluations and results were not diagnostic of lymphoma in any dog at week 5, including 1 dog in which lymphoma was diagnosed cytologically.
Results suggested that physical examination and measurement of lymph node volume may not be sufficient for accurately determining remission, that flow cytometry alone should not be relied on as a means for diagnosis, and that cytologic examination of fine-needle lymph node aspirates should be considered as the most accurate means of determining remission status at times in which treatment modifications are considered.
确定评估犬淋巴瘤缓解情况时临床医生之间的一致性,以及通过淋巴结触诊、细针穿刺淋巴结抽吸物的细胞学检查和流式细胞术作为缓解决定因素时临床医生评估结果之间的关联。
前瞻性研究。
23只未经治疗的淋巴瘤犬。程序:两名临床医生独立测量大的淋巴结,并在开始治疗前1周对来自下颌或腘窝淋巴结的细胞进行细胞学检查和流式细胞术。在第2、3和5周重复进行临床医生缓解评估和细胞学检查的淋巴结测量;在第5周重复进行流式细胞术。
临床医生缓解评估之间存在显著相关性。在第5周时,淋巴结触诊与细胞学检查之间存在显著相关性,但在第2周和第3周时不存在。在初始评估时,通过流式细胞术在23只犬中的16只(70%)诊断出淋巴瘤,尽管在后续评估中其用途有限,且在第5周时任何犬的结果均不能诊断淋巴瘤,包括1只通过细胞学诊断出淋巴瘤的犬。
结果表明,体格检查和淋巴结体积测量可能不足以准确确定缓解情况,不应仅依靠流式细胞术作为诊断手段,并且在考虑调整治疗时,细针穿刺淋巴结抽吸物的细胞学检查应被视为确定缓解状态的最准确方法。