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波兰单中心回顾性研究中雌性犬乳腺肿瘤的风险因素分析及临床病理特征。

Risk factor analysis and clinicopathological characteristics of female dogs with mammary tumours from a single-center retrospective study in Poland.

机构信息

Department of Pathology and Veterinary Diagnostics, Institute of Veterinary Medicine, Warsaw University of Life Sciences (SGGW), Nowoursynowska 159C, 02-776, Warsaw, Poland.

Division of Veterinary Epidemiology and Economics, Institute of Veterinary Medicine, Warsaw University of Life Sciences (SGGW), Nowoursynowska 159C, 02-776, Warsaw, Poland.

出版信息

Sci Rep. 2024 Mar 6;14(1):5569. doi: 10.1038/s41598-024-56194-z.

Abstract

This is a comprehensive retrospective study to characterize female dogs with canine mammary tumors (CMTs) using a dataset retrieved from the archives of the Division of Animal Pathology, Institute of Veterinary Medicine in Warsaw, and to identify prognostic factors. Clinical and histopathological data of 1447 dogs with CMTs were included. Malignant tumours were found in 83.3% (n = 1206), benign tumours in 11.7% (n = 169), and non-neoplastic lesions in 5.0% (n = 72) of dogs. Dogs most often had grade II carcinomas (38.2%, 215/562) of a single histological subtype (88.5%, 1281/1447), mostly simple carcinoma (35.3%, 510/1447). Dogs with a median age of 10 years significantly often had larger (≥ 3 cm) and malignant CMTs, whereas intact females had smaller tumours (median size 2.0 cm). However, the threshold value for the age of the dog in the differentiation of malignant and non-neoplastic/benign masses could not be determined. Most females were hormonally active (76.4%, 372/487). Hormonally active dogs significantly more often had multiple tumours. Multiple tumours were significantly smaller (median 2.5 cm) than single ones. Among pedigree dogs, small-breed dogs were mostly recorded (43%, 428/1006). Twelve breeds had an increased risk of CMTs, regardless of tumour behaviour, compared with the theoretical distribution of pedigree dogs in Poland. Four breeds were often affected only by malignant and other four breeds only by non-neoplastic/benign CMT. Large-breed dogs were significantly younger and affected by larger CMT (median 4 cm) compared with small- and medium-breed dogs. Ninety dogs with a malignant CMT and complete records were included in the full analysis of CMT-specific survival (CMT-SS) with a median follow-up time of 20.0 months. We showed that the timing of ovariohysterectomy in relation to mastectomy was significantly associated with grade, CMT-SS, and CMT-related death. We indicated the low diagnostic accuracy of palpation of regional lymph nodes (RLN) in the prediction of their metastatic involvement. By multivariable analysis, dogs with neoplastic emboli, tumour ulceration, and simple or complex carcinoma had a significantly higher risk of local recurrence. Tumour size > 3 cm was as a strong independent predictor of lung metastases. Compared with dogs with an easily separated localized tumour, dogs with a multiple/diffuse malignant CMT pattern had a fivefold higher risk of death. The risk of death was significantly higher in the presence of neoplastic emboli (~ fivefold) and tumour ulceration (~ fourfold). Furthermore, the presence of neoplastic emboli and large tumour size were independent predictors of CMT-related death.

摘要

这是一项使用华沙兽医科学院动物病理学系档案中检索到的数据对患有犬乳腺肿瘤 (CMT) 的雌性犬进行特征描述的全面回顾性研究,并确定预后因素。共纳入 1447 例患有 CMT 的犬的临床和组织病理学数据。恶性肿瘤占 83.3%(n=1206),良性肿瘤占 11.7%(n=169),非肿瘤性病变占 5.0%(n=72)。犬最常患有单一组织学亚型的 II 级癌(38.2%,215/562)(88.5%,1447/1447),主要为单纯癌(35.3%,510/1447)。中位年龄为 10 岁的犬更常患有较大(≥3cm)和恶性 CMT,而未绝育的雌性犬的肿瘤较小(中位大小为 2.0cm)。然而,犬年龄的阈值值不能用于区分恶性和非肿瘤/良性肿块。大多数雌性犬处于激素活跃状态(76.4%,372/487)。处于激素活跃状态的犬更常患有多个肿瘤。多个肿瘤明显更小(中位大小 2.5cm)。在纯种犬中,主要记录到小型犬(43%,428/1006)。12 个品种的 CMT 发病风险增加,与波兰理论上的纯种犬分布无关。有四个品种仅受恶性肿瘤影响,另外四个品种仅受非肿瘤/良性 CMT 影响。与小型和中型犬相比,大型犬的年龄明显较小,且患有较大的 CMT(中位大小为 4cm)。90 例患有恶性 CMT 且记录完整的犬被纳入 CMT 特异性生存(CMT-SS)的全分析中,中位随访时间为 20.0 个月。我们表明,卵巢切除术与乳房切除术的时间与分级、CMT-SS 和 CMT 相关死亡显著相关。我们指出了触诊区域淋巴结(RLN)在预测其转移受累方面的诊断准确性较低。通过多变量分析,具有肿瘤栓子、肿瘤溃疡以及单纯或复杂癌的犬具有更高的局部复发风险。肿瘤大小>3cm 是肺转移的独立强预测因子。与具有易于分离的局限性肿瘤的犬相比,具有多发性/弥漫性恶性 CMT 模式的犬的死亡风险高五倍。存在肿瘤栓子时,死亡风险显著增加(约五倍),肿瘤溃疡时(约四倍)。此外,肿瘤栓子的存在和肿瘤的大尺寸是 CMT 相关死亡的独立预测因子。

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