Use of histologic margin evaluation to predict recurrence of cutaneous malignant tumors in dogs and cats after surgical excision
Use of histologic margin evaluation to predict recurrence of cutaneous malignant tumors in dogs and cats after surgical excision
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DOI：
10.2460/javma.240.10.1181
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发表时间：
2012-05-15
影响因子：
1.9
通讯作者：
Bettini, Giuliano
中科院分区：
文献类型：
--
作者：
Scarpa, Filippo;Sabattini, Silvia;Bettini, Giuliano
目的 评估手术切缘的组织学评估对于预测手术切除治疗的狗和猫皮肤恶性肿瘤局部复发的有用性。设计前瞻性病例系列。动物 - 40 只狗和 20 只猫。程序 - 对 60 个手术切除的肿瘤（20 个软组织肉瘤 [STS]、20 个肥大细胞肿瘤 [MCT] 和 20 个癌）进行组织学检查。边缘分为干净边缘、紧密边缘或渗透边缘；在 STS 和 MCT 中评估组织学分级。记录 24 个月随访期间的复发率和无复发间隔 (RFI)，并计算方法准确性。结果 - 60 个肿瘤中，29 个 (48%) 的手术切缘干净，11 个 (18%) 接近，20 个 (33%) 浸润。 60 只动物中有 27 只 (45%) 肿瘤复发，平均 +/- SD RFI 为 229 +/- 173 天。肿瘤边缘浸润（16/20）或紧密（8/11）的动物的复发率显着高于肿瘤边缘干净的动物（3/29）。保证金分类是 RFI 的重要预测因素。该方法预测癌症复发的准确度为 94%，STS 为 87%，MCT 为 76%。 结论和临床相关性 - 边缘状态的组织学评估可用于预测仅通过切除治疗的狗和猫皮肤恶性肿瘤的局部复发。方法的准确性因肿瘤类型和级别而异。复发时间建议术后随访应持续 2 年。对于具有浸润性和紧密肿瘤边缘的动物，结果相似，建议对两者进行仔细的术后管理。 （美国兽医医学协会杂志，2012 年；240：1181-1187）
Objective To assess the usefulness of histologic evaluation of surgical margins to predict local recurrence of cutaneous malignant tumors in dogs and cats treated by means of surgical excision.Design Prospective case series.Animals-40 dogs and 20 cats.Procedures-60 surgically excised tumors (20 soft tissue sarcomas [STSs], 20 mast cell tumors [MCTs], and 20 carcinomas) were examined histologically. Margins were classified as clean, close, or infiltrated; histologic grade was assessed in STSs and MCTs. Recurrence rates and recurrence-free intervals (RFIs) during a 24-month follow-up period were recorded, and method accuracy was calculated.Results-Surgical margins were clean in 29 of 60 (48%) tumors, close in 11 (18%), and infiltrated in 20 (33%). Tumors recurred in 27 of 60 (45%) animals, with a mean +/- SD RFI of 229 +/- 173 days. Recurrence rates for animals that had tumors with infiltrated (16/20) or close (8/11) margins were significantly higher than recurrence rate for animals that had tumors with clean margins (3/29). Margin classification was a significant predictor of RFI. Accuracy of the method to predict recurrence was 94% for carcinomas, 87% for STSs, and 76% for MCTs.Conclusions and Clinical Relevance-Histologic assessment of margin status was useful for predicting local recurrence of cutaneous malignant tumors in dogs and cats treated by means of excision alone. Method accuracy varied among tumor types and grades. Recurrence times suggested postsurgical follow-up should continue for 2 years. Results were similar for animals with infiltrated and close tumor margins, and careful postsurgical management is recommended for both. (J Am Vet Med Assoc 2012;240:1181-1187)