Royal (Dick) School of Veterinary Studies & Roslin Institute, University of Edinburgh, Roslin, UK.
Vet Comp Oncol. 2020 Sep;18(3):389-401. doi: 10.1111/vco.12563. Epub 2020 Jan 7.
Conflicting evidence exists regarding the importance of routine abdominal ultrasound (US) with hepatic and splenic fine needle aspiration (FNA) cytology during staging of canine mast cell tumours (MCT). The objective of this study was to correlate ultrasonographic and cytologic findings in dogs with strictly defined high-risk MCTs and to determine the influence on outcome. Our hypothesis was that US poorly predicts visceral metastasis in high-risk MCTs and that early metastasis is associated with improved outcome when compared to overt metastasis. US of liver and spleen correlated to cytologic results, categorized as no metastasis, early metastasis or overt metastasis. Of 82 dogs prospectively enrolled, 18% had early visceral metastasis and 7% had overt metastasis on cytology; 67% with visceral metastasis had regional LN metastasis. US was a poor predictor of metastasis with sensitivity, specificity, positive predictive value and negative predictive value for the spleen of 67%, 68%, 21% and 94%, respectively and for the liver of 29%, 93%, 56% and 82%, respectively. Median time to progression (TTP) for dogs with no metastasis, early metastasis and overt metastasis was not reached, 305 and 69 days, respectively (P < .001). Median survival time (MST) for the 3 groups were not reached, 322 and 81 days, respectively (P < .001). High Patnaik or Kiupel grade, early metastasis, overt metastasis and adequate local control were significantly associated with outcome. Early visceral metastasis was associated with poorer outcome compared to dogs without metastasis, however, a subset of dogs experienced long-term control.
关于在犬肥大细胞瘤（MCT）分期时进行常规腹部超声（US）联合肝脾细针抽吸（FNA）细胞学检查的重要性，目前存在相互矛盾的证据。本研究的目的是分析超声和细胞学检查在严格定义的高危 MCT 犬中的相关性，并确定其对预后的影响。我们的假设是，US 对高危 MCT 内脏转移的预测能力较差，与明显转移相比，早期转移与更好的预后相关。肝脾 US 与细胞学结果相关，分为无转移、早期转移或明显转移。在 82 只前瞻性纳入的犬中，18%的犬在细胞学检查中出现早期内脏转移，7%的犬出现明显转移；67%有内脏转移的犬有区域性淋巴结转移。US 对转移的预测能力较差，脾脏的灵敏度、特异性、阳性预测值和阴性预测值分别为 67%、68%、21%和 94%，肝脏的灵敏度、特异性、阳性预测值和阴性预测值分别为 29%、93%、56%和 82%。无转移、早期转移和明显转移的犬的无进展时间（TTP）分别为未达到、305 和 69 天（P<0.001）。3 组犬的中位生存时间（MST）分别为未达到、322 和 81 天（P<0.001）。高 Patnaik 或 Kiupel 分级、早期转移、明显转移和充分的局部控制与预后显著相关。早期内脏转移与无转移的犬相比预后较差，但有一部分犬长期控制。
