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不可触及/正常大小的区域淋巴结切除对犬皮肤肥大细胞瘤分期的影响:一项多中心回顾性研究。

The impact of extirpation of non-palpable/normal-sized regional lymph nodes on staging of canine cutaneous mast cell tumours: A multicentric retrospective study.

作者信息

Ferrari R, Marconato L, Buracco P, Boracchi P, Giudice C, Iussich S, Grieco V, Chiti L E, Favretto E, Stefanello D

机构信息

Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, Milano, Italy.

Centro Oncologico Veterinario, Sasso Marconi, Italy.

出版信息

Vet Comp Oncol. 2018 Dec;16(4):505-510. doi: 10.1111/vco.12408. Epub 2018 Jun 12.

DOI:10.1111/vco.12408
PMID:29893066
Abstract

Metastasis to regional lymph nodes (RLNs) in dogs with cutaneous mast cell tumour (cMCT) has been correlated with shortened survival time and higher risk of spread to distant sites. In the present study, extirpation of non-palpable or normal-sized RLNs was included in the surgical management of cMCT in dogs. Correlations between histological nodal status (HN0-3) and tumour variables were analysed. Ninety-three dogs with single cMCT without distant metastasis that underwent wide surgical excision of the primary tumour and extirpation of non-palpable or normal-sized RLN were included. The association between HN (HN0 vs HN > 0; HN0-1 vs HN2-3) and tumour variables (site, longest diameter, ulceration, 3-tier and 2-tier histological grades) was analysed by a generalized linear model with multinomial error. Then, 33 (35.5%) RLNs were HN0, 14 (15%) were HN1, 26 (28%) were HN2 and 20 (21.5%) were HN3. The presence of positive (HN > 0) RLN was significantly associated with cMCT larger than 3 cm. No other association was statistically significant. Non-palpable/normal-sized RLN in dogs with cMCT can harbour histologically detectable metastatic disease in nearly half of the cases. Extirpation of the RLN should always perfomed to obtain a correct staging of the disease, even in the absence of clinical suspicion of metastasis. Further studies should evaluate the possible therapeutical effect of the tumour burden reduction obtained by exrtipartion of a positive RLN.

摘要

皮肤肥大细胞瘤(cMCT)犬发生区域淋巴结(RLN)转移与生存时间缩短及远处转移风险增加相关。在本研究中,对不可触及或正常大小的RLN进行切除被纳入犬cMCT的手术治疗中。分析了组织学淋巴结状态(HN0 - 3)与肿瘤变量之间的相关性。纳入了93只患有单发cMCT且无远处转移的犬,这些犬接受了原发肿瘤的广泛手术切除以及不可触及或正常大小RLN的切除。通过具有多项误差的广义线性模型分析HN(HN0与HN > 0;HN0 - 1与HN2 - 3)与肿瘤变量(部位、最长直径、溃疡、三级和二级组织学分级)之间的关联。结果显示,33个(35.5%)RLN为HN0,14个(15%)为HN1,26个(28%)为HN2,20个(21.5%)为HN3。阳性(HN > 0)RLN的存在与大于3 cm的cMCT显著相关。无其他关联具有统计学意义。cMCT犬中不可触及/正常大小的RLN在近一半的病例中可存在组织学可检测到的转移性疾病。即使在无临床转移怀疑的情况下,也应始终切除RLN以获得疾病的正确分期。进一步的研究应评估切除阳性RLN所带来的肿瘤负荷降低可能产生的治疗效果。

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