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犬乳腺肿瘤组织学亚型的预后意义:一项对229例病例的观察性队列研究

Prognostic Significance of Canine Mammary Tumor Histologic Subtypes: An Observational Cohort Study of 229 Cases.

作者信息

Rasotto Roberta, Berlato Davide, Goldschmidt Michael H, Zappulli Valentina

机构信息

1 Dick White Referrals, Six Mile Bottom, Cambridge, UK.

2 Centre for Small Animal Studies, Animal Health Trust, New Market, Suffolk, UK.

出版信息

Vet Pathol. 2017 Jul;54(4):571-578. doi: 10.1177/0300985817698208. Epub 2017 Mar 29.

Abstract

Histopathology is considered the gold standard diagnostic method for canine mammary tumors. In 2011, a new histologic classification for canine mammary tumors was proposed. The present study was a 2-year prospective study that validated the 2011 classification as an independent prognostic indicator with multivariate analysis in a population of 229 female dogs, identifying subtype-specific median survival times (MST) and local recurrence/distant metastasis rates. Dogs with benign tumors and carcinoma arising in benign mixed tumors all had an excellent prognosis. Dogs with complex carcinoma and simple tubular carcinoma also experienced prolonged survival. Those with simple tubulopapillary carcinoma, intraductal papillary carcinoma, and carcinoma and malignant myoepithelioma had a more than 10-fold higher risk of tumor-related death. The prognosis was even worse for adenosquamous carcinoma (MST = 18 months), comedocarcinoma (MST = 14 months), and solid carcinoma (MST = 8 months). The most unfavorable outcome was for anaplastic carcinoma (MST = 3 months) and carcinosarcoma (MST = 3 months), which also had the highest metastatic rates (89% and 100%, respectively). Adenosquamous carcinoma exhibited the highest local recurrence rate (50%). In the same canine population, the tumor diameter was recognized as a strong predictor of local recurrence/distant metastasis and an independent prognosticator of survival in the multivariate analysis. Excision margins were predictive only of local recurrence, whereas lymphatic invasion and histologic grade were predictive of local recurrence/distant metastasis and survival, although only in univariate analyses. In conclusion, this study validated the 2011 classification scheme and provided information to be used in the clinical setting and as the basis for future prognostic studies.

摘要

组织病理学被认为是犬乳腺肿瘤的金标准诊断方法。2011年,提出了一种新的犬乳腺肿瘤组织学分类。本研究是一项为期2年的前瞻性研究,通过多变量分析在229只雌性犬的群体中验证了2011年分类作为独立预后指标的有效性,确定了亚型特异性中位生存时间(MST)以及局部复发/远处转移率。患有良性肿瘤和良性混合瘤中发生的癌的犬均预后良好。患有复杂癌和单纯管状癌的犬也生存期延长。患有单纯微乳头状癌、导管内乳头状癌、癌和恶性肌上皮瘤的犬肿瘤相关死亡风险高出10倍以上。腺鳞癌(MST = 18个月)、粉刺癌(MST = 14个月)和实体癌(MST = 8个月)的预后更差。最不利的结果是间变性癌(MST = 3个月)和癌肉瘤(MST = 3个月),它们也具有最高的转移率(分别为89%和100%)。腺鳞癌表现出最高的局部复发率(50%)。在同一犬群体中,肿瘤直径在多变量分析中被认为是局部复发/远处转移的有力预测指标和生存的独立预后指标。切缘仅可预测局部复发,而淋巴管浸润和组织学分级可预测局部复发/远处转移和生存,尽管仅在单变量分析中如此。总之,本研究验证了2011年分类方案,并提供了可用于临床环境并作为未来预后研究基础的信息。

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