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犬黑素细胞肿瘤的诊断与预后

Diagnosis and Prognosis of Canine Melanocytic Neoplasms.

作者信息

Smedley Rebecca C, Sebastian Kimberley, Kiupel Matti

机构信息

Veterinary Diagnostic Laboratory, Michigan State University, Lansing, MI 48910, USA.

Department of Pathobiology and Diagnostic Investigation, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48910, USA.

出版信息

Vet Sci. 2022 Apr 6;9(4):175. doi: 10.3390/vetsci9040175.

Abstract

Canine melanocytic neoplasms have a highly variable biological behavior ranging from benign cutaneous melanocytomas to malignant oral melanomas that readily metastasize to lymph nodes and internal organs. This review focuses on the diagnosis and prognosis of canine melanocytic neoplasms. While pigmented melanocytic neoplasms can be diagnosed with fine-needle aspirates, an accurate prognosis requires surgical biopsy. However, differentiating amelanotic spindloid melanomas from soft tissue sarcomas is challenging and often requires immunohistochemical labeling with a diagnostic cocktail that contains antibodies against Melan-A, PNL-2, TRP-1, and TRP-2 as the current gold standard. For questionable cases, RNA expression analysis for TYR, CD34, and CALD can further differentiate these two entities. The diagnosis of amelanotic melanomas will be aided by submitting overlying and/or lateral flanking epithelium to identify junctional activity. Wide excision of lateral flanking epithelium is essential, as lentiginous spread is common for malignant mucosal melanomas. Combining histologic features (nuclear atypia, mitotic count, degree of pigmentation, level of infiltration, vascular invasion; tumor thickness and ulceration) with the Ki67 index provides the most detailed prognostic assessment. Sentinel lymph nodes should be evaluated in cases of suspected malignant melanomas using serial sectioning of the node combined with immunohistochemical labeling for Melan-A and PNL-2.

摘要

犬黑素细胞肿瘤具有高度可变的生物学行为,范围从良性皮肤黑素细胞瘤到恶性口腔黑素瘤,后者很容易转移至淋巴结和内部器官。本综述聚焦于犬黑素细胞肿瘤的诊断和预后。虽然色素性黑素细胞肿瘤可通过细针穿刺抽吸进行诊断,但准确的预后评估需要手术活检。然而,将无色素性梭形黑素瘤与软组织肉瘤区分开来具有挑战性,通常需要使用包含抗黑素A、PNL-2、酪氨酸酶相关蛋白1和酪氨酸酶相关蛋白2抗体的诊断组合进行免疫组织化学标记,这是目前的金标准。对于可疑病例,对酪氨酸酶、CD34和钙结合蛋白进行RNA表达分析可进一步区分这两种实体。提交覆盖和/或侧翼上皮组织以识别交界活性将有助于无色素性黑素瘤的诊断。广泛切除侧翼上皮组织至关重要,因为恶性黏膜黑素瘤常见雀斑样蔓延。将组织学特征(核异型性、有丝分裂计数、色素沉着程度、浸润水平、血管侵袭;肿瘤厚度和溃疡)与Ki67指数相结合可提供最详细的预后评估。对于疑似恶性黑素瘤病例,应使用淋巴结连续切片结合抗黑素A和PNL-2免疫组织化学标记来评估前哨淋巴结。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2356/9030435/b67e71eeca82/vetsci-09-00175-g001.jpg

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