Amsellem Pierre M, Cavanaugh Ryan P, Chou Po-Yen, Bacon Nicholas J, Schallberger Sandra P, Farese James P, Kuntz Charles A, Liptak Julius M, Culp William T N, Robat Cecilia S, Powers Barbara E
J Am Vet Med Assoc. 2019 Mar 15;254(6):716-722. doi: 10.2460/javma.254.6.716.
OBJECTIVE To describe the signalment, clinical signs, biological behavior, and outcome for cats with apocrine gland anal sac adenocarcinoma (AGASACA) that underwent surgical excision. DESIGN Retrospective case series. ANIMALS 30 client-owned cats. PROCEDURES Databases of 13 Veterinary Society of Surgical Oncology member-affiliated institutions were searched for records of cats with a histologic diagnosis of AGASACA that underwent tumor excision. For each cat, information regarding signalment, clinical signs, diagnostic test results, treatment, and outcome was extracted from the medical record. The Kaplan-Meier method was used to determine median time to local recurrence (TLR), disease-free interval (DFI), and survival time. Cox regression was used to identify factors associated with TLR, DFI, and survival time. RESULTS Perineal ulceration or discharge was the most common clinical sign in affected cats. Eleven cats developed local recurrence at a median of 96 days after AGASACA excision. Incomplete tumor margins and a high nuclear pleomorphic score were risk factors for local recurrence. Nuclear pleomorphic score was negatively associated with DFI. Local recurrence and a high nuclear pleomorphic score were risk factors for death. Median DFI and survival time were 234 and 260 days, respectively. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that, in cats, perineal ulceration or discharge should raise suspicion of AGASACA and prompt rectal and anal sac examinations. Local recurrence was the most common life-limiting event in cats that underwent surgery for treatment of AGASACA, suggesting that wide margins should be obtained whenever possible during AGASACA excision. Efficacy of chemotherapy and radiation therapy for treatment of cats with AGASACA requires further investigation. (J Am Vet Med Assoc 2019;254:716-722).
目的 描述接受手术切除的猫顶泌汗腺肛门囊腺癌（AGASACA）的特征、临床症状、生物学行为及预后。 设计 回顾性病例系列研究。 动物 30 只客户拥有的猫。 方法 检索 13 个外科肿瘤学兽医协会成员附属机构的数据库，查找经组织学诊断为 AGASACA 并接受肿瘤切除的猫的记录。 从病历中提取每只猫的特征、临床症状、诊断检查结果、治疗及预后信息。 采用 Kaplan-Meier 方法确定局部复发中位时间（TLR）、无病生存期（DFI）和生存时间。 采用 Cox 回归分析确定与 TLR、DFI 和生存时间相关的因素。 结果 会阴溃疡或排液是患病猫最常见的临床症状。11 只猫在 AGASACA 切除后中位 96 天出现局部复发。肿瘤切缘不完整和高核多形性评分是局部复发的危险因素。核多形性评分与 DFI 呈负相关。局部复发和高核多形性评分是死亡的危险因素。中位 DFI 和生存时间分别为 234 天和 260 天。 结论及临床意义 结果表明，猫出现会阴溃疡或排液应怀疑 AGASACA，并应及时进行直肠和肛门囊检查。局部复发是接受手术治疗 AGASACA 的猫最常见的限制生命的事件，提示在切除 AGASACA 时应尽可能获得足够的切缘。化疗和放疗对治疗猫 AGASACA 的疗效需要进一步研究。（《美国兽医医学协会杂志》2019 年；254:716 - 722）
