Maeda S, Tsuboi M, Sakai K, Ohno K, Fukushima K, Kanemoto H, Hiyoshi-Kanemoto S, Goto-Koshino Y, Chambers J K, Yonezawa T, Uchida K, Matsuki N
1 Department of Veterinary Clinical Pathobiology, Graduate School of Agricultural and Life Sciences, University of Tokyo, Tokyo, Japan.
2 Department of Veterinary Pathology, Graduate School of Agricultural and Life Sciences, University of Tokyo, Tokyo, Japan.
Vet Pathol. 2017 Jul;54(4):595-604. doi: 10.1177/0300985817705175. Epub 2017 May 11.
Although cytology is a rapid diagnostic procedure in dogs, the cytologic criteria of endoscopic biopsies for chronic enteritis and intestinal lymphoma are not well defined. An immediate diagnosis using cytology would benefit patients by enabling prompt initiation of therapy. The objective of this study was to investigate the correlation between the results of endoscopic cytology and histopathology. In this study, 167 dogs with clinical signs of chronic gastrointestinal disease were included. On the basis of histopathology, the following diagnoses were determined: lymphocytic-plasmacytic enteritis in 93 dogs; eosinophilic enteritis in 5 dogs; small cell intestinal lymphoma in 45 dogs; and large cell intestinal lymphoma in 24 dogs. Two clinical pathologists retrospectively evaluated the endoscopic cytology of squash-smear preparations. The cytologic diagnoses of inflammation, small cell lymphoma, and large cell lymphoma were based on the severity of lymphocyte infiltration, the size of infiltrated lymphocytes, and eosinophil/mast cell infiltration. The clinical severity score was significantly increased along with the degree of lymphocyte infiltration evaluated by cytology. The cytologic diagnosis was in complete agreement with the histopathologic diagnosis in 136 of 167 (81.4%) cases. For the differentiation between enteritis and lymphoma, endoscopic cytology had a sensitivity of 98.6%, a specificity of 73.5%, a positive predictive value of 72.3%, and a negative predictive value of 98.6%. The log-rank test and Cox regression analysis showed that the results of cytology predicted the prognosis. These results suggest that endoscopic cytology is a useful technique to aid diagnosis of intestinal inflammation and lymphoma in dogs.
尽管细胞学检查在犬类中是一种快速的诊断方法,但慢性肠炎和肠道淋巴瘤的内镜活检的细胞学标准尚未明确界定。通过细胞学检查立即做出诊断可使患者受益,从而能够迅速开始治疗。本研究的目的是探讨内镜细胞学检查结果与组织病理学之间的相关性。在本研究中,纳入了167只患有慢性胃肠疾病临床症状的犬。根据组织病理学,确定了以下诊断结果:93只犬为淋巴细胞性浆细胞性肠炎;5只犬为嗜酸性肠炎;45只犬为小细胞肠道淋巴瘤;24只犬为大细胞肠道淋巴瘤。两名临床病理学家回顾性评估了压片涂片制剂的内镜细胞学检查结果。炎症、小细胞淋巴瘤和大细胞淋巴瘤的细胞学诊断基于淋巴细胞浸润的严重程度、浸润淋巴细胞的大小以及嗜酸性粒细胞/肥大细胞浸润情况。临床严重程度评分随着通过细胞学评估的淋巴细胞浸润程度显著增加。在167例病例中的136例(81.4%)中,细胞学诊断与组织病理学诊断完全一致。对于肠炎和淋巴瘤的鉴别,内镜细胞学检查的敏感性为98.6%,特异性为73.5%,阳性预测值为72.3%,阴性预测值为98.6%。对数秩检验和Cox回归分析表明,细胞学检查结果可预测预后。这些结果表明,内镜细胞学检查是辅助诊断犬肠道炎症和淋巴瘤的一种有用技术。