University of Pennsylvania School of Veterinary Medicine Philadelphia, Philadelphia, Pennsylvania, USA.
Friendship Hospital for Animals, Washington, District of Columbia, USA.
Vet Comp Oncol. 2021 Sep;19(3):578-586. doi: 10.1111/vco.12696. Epub 2021 Apr 13.
Canine gastrointestinal sarcomas, a group of tumours that includes leiomyosarcomas (LMSAs), gastrointestinal stromal tumours (GISTs) and other rarer sarcomas, comprise about 10-30% of all gastrointestinal tumours. This study aims to characterize the histologic characteristics and clinical behaviour in order to identify prognostic factors predictive of outcome. A single institution database search for surgically treated gastrointestinal sarcomas yielded 47 cases with adequate tissue remaining for histologic analysis and 42 cases available for analysis of clinical outcome. Tumours were then prospectively evaluated for mitotic count, necrosis, haemorrhage and inflammation, as well as categorized via immunohistochemical (IHC) staining for smooth muscle actin, c-KIT and DOG-1. IHC analysis defined 32 tumours as GISTs, 14 as LMSAs and one as a sarcoma not otherwise specified. For both GISTs and LMSAs, the overall median survival time (MST) is 1024 days (range 31-1456), which did not differ statistically between tumour types (p = .92). The overall metastatic rate of GISTs in this study was 32.1% (n = 9) which was not significantly different to that of LMSAs at 15.3% (n = 2, p = .45). In multivariate analysis, mitotic count under 9 in GIST patients and complete surgical excision in all tumour types correlated with improved MST. For patients with GISTs, the intensity of c-KIT staining also correlated positively with survival, with an MST of 250 days in cases with weak staining and an MST of 1418 days in cases with moderate or strong c-KIT staining (p = .005).
犬胃肠道肉瘤是一组肿瘤，包括平滑肌肉瘤 (LMSA)、胃肠道间质瘤 (GIST) 和其他罕见的肉瘤，约占所有胃肠道肿瘤的 10-30%。本研究旨在描述组织学特征和临床行为，以确定预测预后的预后因素。对一家机构接受手术治疗的胃肠道肉瘤数据库进行搜索，得到了 47 例有足够组织进行组织学分析的病例，以及 42 例可用于分析临床结果的病例。然后对肿瘤的有丝分裂计数、坏死、出血和炎症进行前瞻性评估，并通过免疫组织化学 (IHC) 染色对平滑肌肌动蛋白、c-KIT 和 DOG-1 进行分类。IHC 分析将 32 例肿瘤定义为 GISTs，14 例为 LMSAs，1 例为未另作说明的肉瘤。对于 GISTs 和 LMSAs，总中位生存时间 (MST) 为 1024 天 (范围 31-1456)，两种肿瘤类型之间无统计学差异 (p =.92)。本研究中 GIST 的总体转移率为 32.1% (n = 9)，与 LMSAs 的 15.3% (n = 2，p =.45) 无显著差异。多变量分析显示，GIST 患者的有丝分裂计数低于 9 和所有肿瘤类型的完全手术切除与 MST 改善相关。对于 GIST 患者，c-KIT 染色强度与生存也呈正相关，弱染色的 MST 为 250 天，中度或强染色的 MST 为 1418 天 (p =.005)。
