Milovancev Milan, Townsend Kaitlin L, Gorman Elena, Bracha Shay, Curran Katie, Russell Duncan S
Department of Clinical Sciences, College of Veterinary Medicine, Oregon State University, Corvallis, Oregon.
Department of Biomedical Sciences, College of Veterinary Medicine, Oregon State University, Corvallis, Oregon.
Vet Surg. 2017 Aug;46(6):879-885. doi: 10.1111/vsu.12668. Epub 2017 Apr 29.
To determine the feasibility and agreement of margin assessment by imprint cytology, shaved margin histopathology, and radial section histopathology in canine cutaneous and subcutaneous mast cell tumors (MCT) and soft tissue sarcomas (STS).
Prospective clinical study.
Three hundred and forty margins from 72 excised tumors (52 MCT and 20 STS) in 54 client-owned dogs.
Imprint cytology samples were acquired by pressing glass slides to the cut surgical margin of the freshly excised surgical specimen. Shaved margin samples were obtained from the patient wound bed using a scalpel immediately prior to closure. Radial section histopathology was performed as part of routine histopathologic processing. All margins were assessed as either positive or negative for presence of tumor cells at the surgical margin. Agreement among methods was calculated using Fleiss Kappa coefficients and an association of method, margin direction, and tumor type with positive margin status was evaluated using a general linear mixed model.
Positive margin detection rates differed for MCT (imprint cytology 21%, radial section histopathology 9%, and shaved margin histopathology 3%; P < .0001) but not for STS. Intermethod agreement was poor (Fleiss Kappa = 0.051 and 0.176 for MCT and STS, respectively). Margin direction did not influence margin status for either tumor type.
Imprint cytology and shaved margin histopathology are feasible, but their results are frequently disparate from routine radial section histopathology. Future studies are needed to evaluate the correlation of each method with local recurrence rates.
确定印片细胞学、削除缘组织病理学和放射状切片组织病理学在犬皮肤和皮下肥大细胞瘤(MCT)及软组织肉瘤(STS)切缘评估中的可行性和一致性。
前瞻性临床研究。
54只客户拥有犬的72个切除肿瘤(52个MCT和20个STS)的340个切缘。
通过将载玻片按压在新鲜切除手术标本的手术切缘获取印片细胞学样本。削除缘样本在伤口闭合前立即用手术刀从患者伤口床获取。放射状切片组织病理学作为常规组织病理学处理的一部分进行。所有切缘根据手术切缘处肿瘤细胞的存在情况评估为阳性或阴性。使用Fleiss Kappa系数计算方法间的一致性,并使用广义线性混合模型评估方法、切缘方向和肿瘤类型与阳性切缘状态的相关性。
MCT的阳性切缘检出率不同(印片细胞学21%,放射状切片组织病理学9%,削除缘组织病理学3%;P < 0.0001),但STS的阳性切缘检出率无差异。方法间一致性较差(MCT和STS的Fleiss Kappa分别为0.051和0.176)。切缘方向对两种肿瘤类型的切缘状态均无影响。
印片细胞学和削除缘组织病理学是可行的,但它们的结果与常规放射状切片组织病理学经常不同。需要进一步研究评估每种方法与局部复发率的相关性。