Spriggs Tyler S, Gedon Natalie K Y, Linder Keith E, Bizikova Petra
College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA.
Vet Dermatol. 2024 Oct;35(5):524-535. doi: 10.1111/vde.13267. Epub 2024 Jun 5.
Cytological detection of acantholytic keratinocytes (acantholytic cells [AC]) helps to identify canine pemphigus foliaceus (cPF) yet AC also occurs in superficial pyoderma (SP), the main differential diagnosis.
HYPOTHESIS/OBJECTIVES: To compare selected cytomorphological features of cPF and SP and to establish cytological diagnostic criteria that could differentiate cPF from SP.
40 and 51 client-owned dogs with PF and SP, respectively.
Impression smears from cPF (64), impetigo (40) and exfoliative superficial pyoderma (ESP) (17) samples were stained with Romanowsky stain, randomised, blinded and evaluated by two investigators independently. The entire sample was screened (×500 or ×1000 magnification) for round (AC1), boat (AC2) and raft AC, eosinophils and bacteria. Interobserver agreements were calculated.
The average number of the 10 highest ×500 fields for AC1 and AC2 was significantly higher in PF than SP (p < 0.0001; Kruskal-Wallis test). Rafts and eosinophils were more common in PF than SP (p < 0.0001; chi-square test), while bacteria were rare in PF (5%; p < 0.0001; chi-square test). Observations between the experienced and novice investigators were highly correlated. An ROC analysis identified five AC1/×500-magnification field as a suitable cut-off value for predicting PF diagnosis. This cut-off value was tested by two additional investigators, who identified sensitivity of 84%-100%, specificity of 95%-97% and accuracy of 95%-96% for the diagnosis of cPF.
Criterion-based impression smear cytological evaluation can provide strong evidence to support the clinical diagnosis. Acantholytic cell morphology varies in cPF and SP, and experience can improve accuracy in cytological differentiation.
棘层松解性角质形成细胞（棘层松解细胞[AC]）的细胞学检测有助于诊断犬落叶型天疱疮（cPF），但AC也可见于主要鉴别诊断疾病浅表脓皮病（SP）中。
假设/目的：比较cPF和SP的某些细胞形态学特征，建立可区分cPF与SP的细胞学诊断标准。
分别为40只和51只患PF和SP的客户拥有的犬。
对cPF（64份）、脓疱病（40份）和剥脱性浅表脓皮病（ESP，17份）样本制作压片涂片，用罗曼诺夫斯基染色法染色，随机分组、设盲，由两名研究者独立评估。对整个样本进行筛查（×500或×1000放大倍数），检查圆形（AC1）、舟形（AC2）和筏状AC、嗜酸性粒细胞及细菌。计算观察者间一致性。
PF中AC1和AC2在10个最高×500视野中的平均数显著高于SP（p < 0.0001；Kruskal-Wallis检验）。筏状AC和嗜酸性粒细胞在PF中比在SP中更常见（p < 0.0001；卡方检验），而细菌在PF中少见（5%；p < 0.0001；卡方检验）。经验丰富和新手研究者之间的观察结果高度相关。ROC分析确定5个AC1/×500放大倍数视野作为预测PF诊断的合适临界值。另外两名研究者对该临界值进行了检验，他们诊断cPF的敏感性为84% - 100%，特异性为95% - 97%，准确性为95% - 96%。
基于标准的压片涂片细胞学评估可为临床诊断提供有力证据。cPF和SP中棘层松解细胞形态不同，经验可提高细胞学鉴别准确性。
