Proposal of a 2-tier histologic grading system for canine cutaneous mast cell tumors to more accurately predict biological behavior.
Proposal of a 2-tier histologic grading system for canine cutaneous mast cell tumors to more accurately predict biological behavior.
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针对犬皮肤肥大细胞肿瘤的2层组织学分级系统的建议，以更准确地预测生物学行为。
DOI：
10.1177/0300985810386469
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发表时间：
2011-01
影响因子：
2.4
通讯作者：
Miller R
中科院分区：
文献类型：
--
作者：
Kiupel M;Webster JD;Bailey KL;Best S;DeLay J;Detrisac CJ;Fitzgerald SD;Gamble D;Ginn PE;Goldschmidt MH;Hendrick MJ;Howerth EW;Janovitz EB;Langohr I;Lenz SD;Lipscomb TP;Miller MA;Misdorp W;Moroff S;Mullaney TP;Neyens I;O'Toole D;Ramos-Vara J;Scase TJ;Schulman FY;Sledge D;Smedley RC;Smith K;W Snyder P;Southorn E;Stedman NL;Steficek BA;Stromberg PC;Valli VE;Weisbrode SE;Yager J;Heller J;Miller R
目前，犬皮肤肥大细胞瘤（mct）的预后和治疗决定主要基于组织学分级。然而，兽医病理学家使用不同的分级系统和制度修改使得组织学分级的预后价值非常值得怀疑。为了评估兽医病理学家显微分级的一致性和Patnaik分级系统的预后意义，来自16家机构的28名兽医病理学家对95只狗的95个皮肤mct进行了盲法研究。兽医病理学家诊断3级mct的一致性为75%，诊断1级和2级mct的一致性低于64%。为了提高病理学家之间的一致性并提供更好的预后意义，设计了2级组织学分级系统。高级别mct的诊断是基于以下任何一个标准的存在：在10个高倍视场（hpf）中至少有7个有丝分裂象；至少3个多核（3个或更多核）细胞在10 hpf；在10 hpf中至少有3个奇异核；核增大（即至少10%的肿瘤细胞的核直径变化至少2倍）。选择有丝分裂活性最高或异核分裂程度最高的田地来评估不同的参数。根据新的分级系统，高级别mct与较短的转移时间或新肿瘤发展时间以及较短的生存时间显著相关。高级别mct的中位生存时间少于4个月，而低级别mct的中位生存时间超过2年。
Currently, prognostic and therapeutic determinations for canine cutaneous mast cell tumors (MCTs) are primarily based on histologic grade. However, the use of different grading systems by veterinary pathologists and institutional modifications make the prognostic value of histologic grading highly questionable. To evaluate the consistency of microscopic grading among veterinary pathologists and the prognostic significance of the Patnaik grading system, 95 cutaneous MCTs from 95 dogs were graded in a blinded study by 28 veterinary pathologists from 16 institutions. Concordance among veterinary pathologists was 75% for the diagnosis of grade 3 MCTs and less than 64% for the diagnosis of grade 1 and 2 MCTs. To improve concordance among pathologists and to provide better prognostic significance, a 2-tier histologic grading system was devised. The diagnosis of high-grade MCTs is based on the presence of any one of the following criteria: at least 7 mitotic figures in 10 high-power fields (hpf); at least 3 multinucleated (3 or more nuclei) cells in 10 hpf; at least 3 bizarre nuclei in 10 hpf; karyomegaly (ie, nuclear diameters of at least 10% of neoplastic cells vary by at least two-fold). Fields with the highest mitotic activity or with the highest degree of anisokaryosis were selected to assess the different parameters. According to the novel grading system, high-grade MCTs were significantly associated with shorter time to metastasis or new tumor development, and with shorter survival time. The median survival time was less than 4 months for high-grade MCTs but more than 2 years for low-grade MCTs.
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影响因子：
1.5
作者：
Northrup, NC;Harmon, BG;Howerth, EW
通讯作者：
Howerth, EW
影响因子：
2.2
作者：
Preziosi, R.;Sarli, G.;Paltrinieri, M.
通讯作者：
Paltrinieri, M.
影响因子：
2.4
作者：
Strefezzi, RD;Xavier, JG;Catao-Dias, TL
通讯作者：
Catao-Dias, TL
影响因子：
2.4
作者：
PATNAIK, AK;EHLER, WJ;MACEWEN, EG
通讯作者：
MACEWEN, EG
影响因子：
4.8
作者：
Webster, Joshua D.;Yuzbasiyan-Gurkan, Vilma;Kiupel, Matti
通讯作者：
Kiupel, Matti