University of Veterinary Medicine Vienna, Vienna, Austria.
Schwarzman Animal Medical Center, New York, NY.
Vet Pathol. 2024 Sep;61(5):743-751. doi: 10.1177/03009858241239566. Epub 2024 Mar 27.
Increased proliferation is a driver of tumorigenesis, and quantification of mitotic activity is a standard task for prognostication. This systematic review is an analysis of all available references on mitotic activity in feline tumors to provide an overview of the assessment methods and prognostic value. A systematic literature search in PubMed and Scopus and a nonsystematic search in Google Scholar were conducted. All articles on feline tumors that correlated mitotic activity with patient outcome were identified. Data analysis revealed that of the 42 eligible articles, mitotic count (MC, mitotic figures/tumor area) was evaluated in 39 studies, and mitotic index (MI, mitotic figures/tumor cells) in 3 studies. The risk of bias was considered high for most studies (26/42, 62%) based on small study populations, insufficient details of the MC/MI methods, and lack of statistical measures for diagnostic accuracy or effect on outcome. The MC/MI methods varied between studies. A significant association of MC with survival was determined in 20 of 28 (71%) studies (10 studies evaluated other outcome metrics or provided individual patient data), while 1 study found an inverse effect. Three tumor types had at least 4 studies, and a prognostic association with survival was found in 5 of 6 studies on mast cell tumors, 5 of 5 on mammary tumors, and 3 of 4 on soft-tissue sarcomas. MI was shown to correlate with survival for mammary tumors by 2 research groups; however, comparisons to MC were not conducted. Further studies with standardized mitotic activity methods and appropriate statistical analysis for discriminant ability of patient outcome are needed to infer the prognostic value of MC and MI.
增殖增加是肿瘤发生的驱动因素，有丝分裂活性的定量分析是预测预后的标准任务。本系统综述分析了所有关于猫科肿瘤有丝分裂活性的可用参考文献，以提供评估方法和预后价值的概述。在 PubMed 和 Scopus 中进行了系统的文献检索，并在 Google Scholar 中进行了非系统的检索。确定了所有将有丝分裂活性与患者预后相关联的猫科肿瘤相关文章。数据分析显示，在 42 篇合格文章中，有 39 篇研究评估了有丝分裂计数（MC，有丝分裂数/肿瘤面积），3 篇研究评估了有丝分裂指数（MI，有丝分裂数/肿瘤细胞）。大多数研究（26/42，62%）的偏倚风险较高，这是基于研究人群规模较小、MC/MI 方法的细节不足以及缺乏诊断准确性或对预后影响的统计措施。MC/MI 方法在研究之间存在差异。28 项研究中有 20 项（71%）确定了 MC 与生存之间存在显著相关性（10 项研究评估了其他结局指标或提供了个体患者数据），而 1 项研究发现了相反的效果。有 3 种肿瘤类型至少有 4 项研究，其中 6 项肥大细胞瘤研究、5 项乳腺肿瘤研究和 4 项软组织肉瘤研究均与生存预后相关。2 个研究小组表明 MI 与乳腺肿瘤的生存相关，但未进行与 MC 的比较。需要进一步进行标准化有丝分裂活性方法和适当的统计分析，以评估患者结局的判别能力，从而推断 MC 和 MI 的预后价值。
