Endoscopic Cytology for the Diagnosis of Chronic Enteritis and Intestinal Lymphoma in Dogs
Endoscopic Cytology for the Diagnosis of Chronic Enteritis and Intestinal Lymphoma in Dogs
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DOI：
10.1177/0300985817705175
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发表时间：
2017-07-01
影响因子：
2.4
通讯作者：
Matsuki, N.
中科院分区：
文献类型：
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作者：
Maeda, S.;Tsuboi, M.;Matsuki, N.
虽然细胞学检查是犬的快速诊断方法，但慢性肠炎和肠淋巴瘤内镜活检的细胞学标准尚未明确。使用细胞学的立即诊断将使患者能够迅速开始治疗。本研究的目的是探讨内镜下细胞学检查结果与组织病理学检查结果之间的相关性。在这项研究中，纳入了167只具有慢性胃肠道疾病临床体征的犬。在组织病理学的基础上，确定了以下诊断：93只狗的淋巴细胞-浆细胞性肠炎; 5只狗的嗜酸性肠炎; 45只狗的小细胞肠淋巴瘤; 24只狗的大细胞肠淋巴瘤。两名临床病理学家回顾性评价了内镜下细胞学的挤压涂片准备。炎症、小细胞淋巴瘤和大细胞淋巴瘤的细胞学诊断基于淋巴细胞浸润的严重程度、浸润淋巴细胞的大小和嗜酸性粒细胞/肥大细胞浸润。临床严重程度评分随着细胞学评估的淋巴细胞浸润程度而沿着显著增加。细胞学诊断与组织病理学诊断完全一致者136例（81.4%）。对于肠炎和淋巴瘤的鉴别，内镜细胞学检查的敏感性为98.6%，特异性为73.5%，阳性预测值为72.3%，阴性预测值为98.6%。Log-rank检验和考克斯回归分析显示细胞学检查结果可预测预后。这些结果表明，内镜细胞学是一种有用的技术，以帮助诊断肠道炎症和淋巴瘤的狗。
Although cytology is a rapid diagnostic procedure in dogs, the cytologic criteria of endoscopic biopsies for chronic enteritis and intestinal lymphoma are not well defined. An immediate diagnosis using cytology would benefit patients by enabling prompt initiation of therapy. The objective of this study was to investigate the correlation between the results of endoscopic cytology and histopathology. In this study, 167 dogs with clinical signs of chronic gastrointestinal disease were included. On the basis of histopathology, the following diagnoses were determined: lymphocytic-plasmacytic enteritis in 93 dogs; eosinophilic enteritis in 5 dogs; small cell intestinal lymphoma in 45 dogs; and large cell intestinal lymphoma in 24 dogs. Two clinical pathologists retrospectively evaluated the endoscopic cytology of squash-smear preparations. The cytologic diagnoses of inflammation, small cell lymphoma, and large cell lymphoma were based on the severity of lymphocyte infiltration, the size of infiltrated lymphocytes, and eosinophil/mast cell infiltration. The clinical severity score was significantly increased along with the degree of lymphocyte infiltration evaluated by cytology. The cytologic diagnosis was in complete agreement with the histopathologic diagnosis in 136 of 167 (81.4%) cases. For the differentiation between enteritis and lymphoma, endoscopic cytology had a sensitivity of 98.6%, a specificity of 73.5%, a positive predictive value of 72.3%, and a negative predictive value of 98.6%. The log-rank test and Cox regression analysis showed that the results of cytology predicted the prognosis. These results suggest that endoscopic cytology is a useful technique to aid diagnosis of intestinal inflammation and lymphoma in dogs.