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患有脾脏边缘区淋巴瘤的犬的临床特征和预后。

Clinical characteristics and outcome in dogs with splenic marginal zone lymphoma.

机构信息

Department of Surgical and Radiological Sciences, Davis, CA, USA.

出版信息

J Vet Intern Med. 2013 Jul-Aug;27(4):949-54. doi: 10.1111/jvim.12116. Epub 2013 Jun 4.

Abstract

BACKGROUND

Splenic marginal zone lymphoma (MZL) is a form of indolent B-cell lymphoma that is not well characterized in dogs.

HYPOTHESIS/OBJECTIVES: The purpose of this study was to describe clinical characteristics and outcome in dogs with splenic MZL confirmed by histopathology, immunophenotyping, and molecular clonality assessment. We hypothesized that affected dogs would have prolonged survival time with splenectomy alone.

ANIMALS

Thirty-four dogs were included. Twenty-nine dogs were diagnosed after splenectomy, and 5 dogs were diagnosed at necropsy.

METHODS

Pathology records were searched for dogs with histologically confirmed splenic MZL. Clinical and outcome data were retrospectively collected by medical record review, and prognostic factors were evaluated. Histopathology was reviewed by a board-certified pathologist, and tissue sections were subjected to immunophenotyping and molecular clonality assessment by PCR.

RESULTS

Immunohistochemistry confirmed a B-cell phenotype for all dogs. Molecular clonality assessment was performed in 33 of 34 dogs, of which 24 had clonal rearrangement of immunoglobulin (Ig) loci, 3 had pseudoclonal rearrangement, and 6 had polyclonal rearrangement. The overall median survival time (MST) for the 29 dogs that underwent splenectomy was 383 days. The MST for 14 of 29 asymptomatic dogs that underwent splenectomy for MZL was 1,153 days as compared to 309 days for 15/29 dogs with clinical signs referable to splenic MZL (P = .018). Lymph node involvement, hemoabdomen, anemia, chemotherapy, and concurrent malignancy did not affect survival outcome.

CONCLUSIONS AND CLINICAL IMPORTANCE

Dogs diagnosed with splenic MZL can have prolonged survival with splenectomy alone, without the use of adjuvant chemotherapy. Asymptomatic dogs may have a better survival outcome.

摘要

背景

脾边缘区淋巴瘤(MZL)是一种惰性 B 细胞淋巴瘤,在犬中特征不明显。

假设/目的:本研究的目的是描述通过组织病理学、免疫表型和分子克隆性评估确诊为脾 MZL 的犬的临床特征和预后。我们假设单独进行脾切除术可延长受影响犬的生存时间。

动物

共纳入 34 只犬。29 只犬在脾切除术后被诊断,5 只犬在尸检时被诊断。

方法

通过检索组织学上确诊为脾 MZL 的犬的病理学记录来确定病例。通过病历回顾收集临床和预后数据,并评估预后因素。由一名经过委员会认证的病理学家对组织病理学进行回顾,通过聚合酶链反应对组织切片进行免疫表型和分子克隆性评估。

结果

所有犬的免疫组织化学均证实为 B 细胞表型。对 34 只犬中的 33 只进行了分子克隆性评估,其中 24 只存在免疫球蛋白(Ig)基因座的克隆性重排,3 只有假性克隆性重排,6 只有多克隆性重排。29 只接受脾切除术的犬的总中位生存时间(MST)为 383 天。14 只无症状犬因脾 MZL 接受脾切除术的 MST 为 1153 天,而 29 只犬中有 15 只因脾 MZL 出现临床症状的 MST 为 309 天(P =.018)。淋巴结受累、腹腔积血、贫血、化疗和同时发生的恶性肿瘤不影响生存结果。

结论和临床意义

单独进行脾切除术可使诊断为脾 MZL 的犬延长生存时间,无需辅助化疗。无症状犬可能有更好的生存结果。

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