Faculty of Veterinary Medicine, Tehran University, Tehran, Iran.
Department of Pathology, Faculty of Veterinary Medicine, Tehran University, Tehran, Iran.
Cancer Cell Int. 2013 Aug 9;13:79. doi: 10.1186/1475-2867-13-79. eCollection 2013.
The human "Elston and Ellis grading method" was utilized in dogs with mammary tumor to examine its relation to prognosis in this species, based on a 2-year follow-up period. Although cytopathology is widely used for early diagnosis of human neoplasms, it is not commonly performed in veterinary medicine. Our objectives in this study were to identify cytopathology criteria of malignancy for canine mammary tumors and the frequency of different types of mammary lesions and their relationship with histologic grade was investigated. Another aim of this study was to differentiate the simple and adenocarcinoma tumors from the complex or mixed tumor described by Elston and Ellis grading method.
The study was performed in 15 pure or mixed-breed female dogs submitted to surgical resections of mammary tumours. The mammary tumours were excised by simple mastectomy or regional mastectomy, with or without the superficial inguinal lymph nodes. Female dogs were mainly terriers (9 dogs) or mixed (3 dogs), the 3 other animals were a German shepherd, Dachshund and Pekingese. Before surgical excision of the tumour, FNAC was performed using a 0.6 mm diameter needle attached to a 10 ml syringe held in a standard metal syringe holder. The cytological sample was smeared onto a glass slide and either air-dried for May-Grünwald-stain, or ethanol-fixed for Papanicolaou stain and masses were surgically removed, the tumours were grossly examined and tissue samples were fixed in 10%-buffered-formalin and embedded in paraffin. Sections 4 μm thick were obtained from each sample and H&E stained.
We obtained a correct cytohistological correlation in 14/15 cases (93.3%) when all cytopathological examinations were considered. Of the 15 cases examined, 2(13.3%) had well-differentiated (grade I), 6(40%) had moderately differentiated (grade II) and 7(46.7%) had poorly differentiated (grade III) tumours. Classification of all canine mammary gland lesions revealed 13(86.7%) malignant and 2(13.3%) benign tumors. The histological examination showed that the most common tumor types of mammary glands in bitches were: complex carcinoma, adenocarcinoma, malignant mixed tumour, benign mixed tumour, simple carcinoma- (5/15; 33.3%), (3/15; 20%), (3/15; 20%) and (2/15;13.3%), respectively. Simple carcinoma and cystic hyperplasia were less common - (1/15; 6.7%), and (1/15; 6.7%), respectively. Moreover, the most often tumors occur in inguinal mammary (60%) and abdominal (27%) glands.
Our results demonstrate that, because of the similarity of the cytohistopathological findings in the human and canine mammary gland tumours, it is possible to use the same cytopathological criteria applied in human pathology for the diagnosis of canine mammary gland tumours. Furthemoer, routine use of this human grading method would help the clinician to make a more accurate prognosis in the interests of post-surgical management in dogs with mammary carcinomas. Furthermore, this research will allow a more discriminating classification of mammary tumors and probably has a bearing on cytohistopathology, epidemiology, pathogenesis and prognosis. The most often tumors occur in inguinal mammary (60%) and abdominal (27%) glands. This interesting regional difference may be due to a) the duration of the growth before the diagnosis; b) the age of the dogs; and c) high prevelance of unspayed animals. Moreover, the most common type of tumor was complex carcinoma - 33.3% (5 cases).
本研究利用人类“Elston 和 Ellis 分级法”对犬乳腺肿瘤进行研究,以 2 年随访期为基础,观察其与预后的关系。虽然细胞学广泛应用于人类肿瘤的早期诊断,但在兽医领域并不常用。我们的目的是确定犬乳腺肿瘤的恶性细胞学标准,并研究不同类型的乳腺病变的频率及其与组织学分级的关系。本研究的另一个目的是区分 Elston 和 Ellis 分级方法中描述的单纯癌和腺癌与复杂或混合肿瘤。
本研究共纳入 15 只纯种或混种雌性犬,均接受乳腺肿瘤切除术。乳腺肿瘤通过单纯乳房切除术或区域性乳房切除术切除,伴或不伴浅表腹股沟淋巴结切除术。雌性犬主要为梗犬(9 只)或混种犬(3 只),另外 3 只动物为德国牧羊犬、腊肠犬和北京犬。在肿瘤切除前,使用直径 0.6 毫米的针连接到标准金属注射器支架上的 10 毫升注射器进行细针穿刺细胞学检查。细胞学样本涂在载玻片上,风干后行迈-格努染色,或乙醇固定行巴氏染色。然后手术切除肿瘤,大体检查肿瘤,组织样本用 10%缓冲福尔马林固定,石蜡包埋。从每个样本中获得 4μm 厚的切片,并进行 H&E 染色。
当考虑所有细胞学检查时,我们在 15 例中有 14 例(93.3%)获得了正确的细胞组织学相关性。在 15 例检查中,2 例(13.3%)为高分化(I 级),6 例(40%)为中分化(II 级),7 例(46.7%)为低分化(III 级)。所有犬乳腺腺病变的分类显示 13 例(86.7%)为恶性,2 例(13.3%)为良性肿瘤。组织学检查显示,母犬乳腺最常见的肿瘤类型为:复杂癌、腺癌、恶性混合瘤、良性混合瘤、单纯癌(5/15;33.3%)、(3/15;20%)、(3/15;20%)和(2/15;13.3%)。单纯癌和囊性增生较少见(1/15;6.7%)和(1/15;6.7%)。此外,最常见的肿瘤发生在腹股沟乳腺(60%)和腹部乳腺(27%)。
我们的结果表明,由于人类和犬乳腺肿瘤的细胞组织病理学发现相似,因此可以使用相同的细胞学标准应用于人类病理学,用于诊断犬乳腺肿瘤。此外,常规使用这种人类分级方法将有助于临床医生对犬乳腺癌进行更准确的预后,以利于术后管理。此外,这项研究将允许对乳腺肿瘤进行更具鉴别力的分类,可能对细胞组织病理学、流行病学、发病机制和预后有影响。最常见的肿瘤发生在腹股沟乳腺(60%)和腹部乳腺(27%)。这种有趣的区域性差异可能是由于 a)在诊断前的生长时间;b)犬的年龄;c)未绝育动物的高流行率。此外,最常见的肿瘤类型是复杂癌——33.3%(5 例)。