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影响犬脾切除术后生存的病理因素。

Pathologic factors affecting postsplenectomy survival in dogs.

作者信息

Spangler W L, Kass P H

机构信息

IDEXX Veterinary Services, Inc., Broderick, CA, USA.

出版信息

J Vet Intern Med. 1997 May-Jun;11(3):166-71. doi: 10.1111/j.1939-1676.1997.tb00085.x.

Abstract

The apparently high prevalence of splenomegaly in dogs, along with the surgical accessibility of the spleen, results in a relatively large number of splenectomies in dogs in clinical veterinary practice. Splenic nodular lesions are widely considered to be indicative of hemangiosarcoma and thus a disease that is ultimately fatal. This study correlates the results of complete pathologic evaluation and classification of 500 spleens obtained by splenectomy with survival information for each dog. Among the spleens examined, 257 of 500 (51.4%) were classified nonneoplastic and 241 (48.2%) were neoplastic; 2 (0.4%) were unclassified. Miscellaneous non-nodular splenomegaly accounted for 46 of 257 (18%) of the nonneoplastic lesions; nodular splenomegaly accounted for 206 of 257 (79%) of nonneoplastic splenic lesions and was composed of lymphoid hyperplastic nodules and associated hematomas, hyperplastic lymphoid nodules alone, or hematomas with no apparent underlying cause. Nodular neoplastic diseases of the spleen were divided among benign tumors (11.5%) and a variety of primary sarcomas. Hemangiosarcoma made up 51% of splenic malignancies but accounted for less than 25% of the spleens evaluated. Survival of dogs with hematomas associated with nonneoplastic conditions of the spleen was markedly different from that in dogs with hemangiosarcoma-associated hematomas, even though most could not be effectively differentiated on gross inspection. Two month postoperative survival was 83% for dogs with nonneoplastic-related hematomas, whereas only 31% of dogs with hemangiosarcoma, with or without associated hematomas, were alive after 2 months. Twelve-month survival times were 64% and 7%, respectively. An overall postsplenectomy survival rate of 52% was based on the number of dogs surviving for a minimum of 6 months postoperatively.

摘要

犬类脾脏肿大的明显高发病率,以及脾脏在手术上的可及性,导致临床兽医实践中犬类脾切除术的数量相对较多。脾脏结节性病变被广泛认为是血管肉瘤的指征,因此是一种最终致命的疾病。本研究将通过脾切除术获得的500个脾脏的完整病理评估和分类结果与每只犬的生存信息相关联。在所检查的脾脏中,500个中有257个(51.4%)被分类为非肿瘤性,241个(48.2%)为肿瘤性;2个(0.4%)未分类。杂项非结节性脾肿大占非肿瘤性病变的257个中的46个(18%);结节性脾肿大占非肿瘤性脾脏病变的257个中的206个(79%),由淋巴样增生性结节及相关血肿、单纯增生性淋巴样结节或无明显潜在病因的血肿组成。脾脏的结节性肿瘤性疾病分为良性肿瘤(11.5%)和多种原发性肉瘤。血管肉瘤占脾脏恶性肿瘤的51%,但占评估脾脏的比例不到25%。与脾脏非肿瘤性疾病相关的血肿的犬的生存率与血管肉瘤相关血肿的犬的生存率明显不同,尽管大多数在大体检查中无法有效区分。非肿瘤性相关血肿的犬术后两个月生存率为83%,而有或无相关血肿的血管肉瘤犬术后两个月只有31%存活。十二个月生存率分别为64%和7%。基于术后至少存活6个月的犬的数量,脾切除术后总体生存率为52%。

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