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Bertram CA, Donovan TA, Bartel A. Mitotic activity: A systematic literature review of the assessment methodology and prognostic value in canine tumors. Vet Pathol 2024; 61:752-764. [PMID: 38533804 PMCID: PMC11370189 DOI: 10.1177/03009858241239565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
One of the most relevant prognostic indices for tumors is cellular proliferation, which is most commonly measured by the mitotic activity in routine tumor sections. The goal of this systematic review was to analyze the methods and prognostic relevance of histologically measuring mitotic activity that have been reported for canine tumors in the literature. A total of 137 articles that correlated the mitotic activity in canine tumors with patient outcome were identified through a systematic (PubMed and Scopus) and nonsystematic (Google Scholar) literature search and eligibility screening process. Mitotic activity methods encompassed the mitotic count (MC, number of mitotic figures per tumor area) in 126 studies, presumably the MC (method not specified) in 6 studies, and the mitotic index (MI, number of mitotic figures per number of tumor cells) in 5 studies. A particularly high risk of bias was identified based on the available details of the MC methods and statistical analyses, which often did not quantify the prognostic discriminative ability of the MC and only reported P values. A significant association of the MC with survival was found in 72 of 109 (66%) studies. However, survival was evaluated by at least 3 studies in only 7 tumor types/groups, of which a prognostic relevance is apparent for mast cell tumors of the skin, cutaneous melanoma, and soft tissue tumor of the skin and subcutis. None of the studies using the MI found a prognostic relevance. This review highlights the need for more studies with standardized methods and appropriate analysis of the discriminative ability to prove the prognostic value of the MC and MI in various tumor types. Future studies are needed to evaluate the influence of the performance of individual pathologists on the appropriateness of prognostic thresholds and investigate methods to improve interobserver reproducibility.
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2
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Bertram CA, Bartel A, Donovan TA, Kiupel M. Atypical Mitotic Figures Are Prognostically Meaningful for Canine Cutaneous Mast Cell Tumors. Vet Sci 2023; 11:5. [PMID: 38275921 PMCID: PMC10821277 DOI: 10.3390/vetsci11010005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 12/15/2023] [Accepted: 12/18/2023] [Indexed: 01/27/2024] Open
Abstract
Cell division through mitosis (microscopically visible as mitotic figures, MFs) is a highly regulated process. However, neoplastic cells may exhibit errors in chromosome segregation (microscopically visible as atypical mitotic figures, AMFs) resulting in aberrant chromosome structures. AMFs have been shown to be of prognostic relevance for some neoplasms in humans but not in animals. In this study, the prognostic relevance of AMFs was evaluated for canine cutaneous mast cell tumors (ccMCT). Histological examination was conducted by one pathologist in whole slide images of 96 cases of ccMCT with a known survival time. Tumor-related death occurred in 11/18 high-grade and 2/78 low-grade cases (2011 two-tier system). The area under the curve (AUC) was 0.859 for the AMF count and 0.880 for the AMF to MF ratio with regard to tumor-related mortality. In comparison, the AUC for the mitotic count was 0.885. Based on our data, a prognostically meaningful threshold of ≥3 per 2.37 mm2 for the AMF count (sensitivity: 76.9%, specificity: 98.8%) and >7.5% for the AMF:MF ratio (sensitivity: 76.9%, specificity: 100%) is suggested. While the mitotic count of ≥ 6 resulted in six false positive cases, these could be eliminated when combined with the AMF to MF ratio. In conclusion, the results of this study suggests that AMF enumeration is a prognostically valuable test, particularly due to its high specificity with regard to tumor-related mortality. Additional validation and reproducibility studies are needed to further evaluate AMFs as a prognostic criterion for ccMCT and other tumor types.
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Affiliation(s)
- Christof A. Bertram
- Institute of Veterinary Pathology, University of Veterinary Medicine Vienna, 1210 Vienna, Austria
| | - Alexander Bartel
- Institute for Veterinary Epidemiology and Biostatistics, Freie Universität Berlin, 14163 Berlin, Germany;
| | - Taryn A. Donovan
- Department of Anatomic Pathology, The Schwarzman Animal Medical Center, New York, NY 10065, USA;
| | - Matti Kiupel
- Veterinary Diagnostic Laboratory, Michigan State University, Lansing, MI 48910, USA
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3
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Ossowska M, Picornell JA, Finotello R, Amores-Fuster I, Tanis JB. Pre-operative neoadjuvant vinblastine-prednisolone in canine mast cell tumours: A single-centre retrospective cohort study. Vet Comp Oncol 2023; 21:447-459. [PMID: 37183272 DOI: 10.1111/vco.12904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 04/24/2023] [Accepted: 04/26/2023] [Indexed: 05/16/2023]
Abstract
Neoadjuvant chemotherapy can be used in canine mast cell tumours (MCTs) to optimise surgical margins or to enable marginal excision in challenging locations. The objective of this study was to describe the outcome of dogs with cutaneous and subcutaneous MCTs treated with neoadjuvant vinblastine-prednisolone (NA-VP). Records of treatment-naïve dogs with cutaneous/subcutaneous MCT that received NA-VP were reviewed including signalment, indication for NA-VP, staging results, clinical response, surgical data and histopathology reports. For dogs with post-operative follow-up ≥365 days, predictive factors for local recurrence (LR) were evaluated. Forty-four dogs were included. NA-VP was indicated to optimise surgical margins (group MARG) in 19 dogs (43.2%) and to enable surgery (group MORB) in 25 dogs (56.8%). Complete and partial response were documented in 40.9% of dogs and 30 dogs (68.2%) underwent surgery. The indication for NA-VP was significantly associated with undergoing surgery (p < .001) on multivariable analysis. Twelve (48%) and 18 dogs (94.7%) underwent surgery in the group MORB and MARG, respectively. Five dogs (16.7%) experienced wound dehiscence. Complete excision was achieved in 14 dogs (46.7%). In dogs undergoing surgery with ≥365 days of follow-up, LR was documented in five cases (20.8%). None of the factors analysed including mitotic count, completeness of excision and response to NA-VP were associated with LR; notably, LR occurred in 3/11 (27.2%) completely excised MCTs. In a pre-operative setting, NA-VP appears safe and could be beneficial in selected cases. Prognostic factors such as clinical response, mitotic count and completeness of excision should be interpreted with caution following NA-VP.
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Affiliation(s)
- Małgorzata Ossowska
- Department of Small Animal Clinical Sciences, Institute of Veterinary Science, University of Liverpool, Neston, UK
| | - Jose Alvarez Picornell
- Department of Small Animal Clinical Sciences, Institute of Veterinary Science, University of Liverpool, Neston, UK
| | - Riccardo Finotello
- Department of Small Animal Clinical Sciences, Institute of Veterinary Science, University of Liverpool, Neston, UK
- Department of Veterinary Medicine, University of Bari, Valenzano, Italy
| | - Isabel Amores-Fuster
- Department of Small Animal Clinical Sciences, Institute of Veterinary Science, University of Liverpool, Neston, UK
| | - Jean-Benoit Tanis
- Department of Small Animal Clinical Sciences, Institute of Veterinary Science, University of Liverpool, Neston, UK
- Department of Molecular & Clinical Cancer Medicine, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
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4
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Cino M, Gariboldi EM, Stefanello D, Spindler KP, Ferraris EI, Morello EM, Bertola L, Maniscalco L, Martano M. Ki67 Index in Patnaik Grade 2/Kiupel Low-Grade Canine Cutaneous Mast Cell Tumors with Early Lymph Node Metastasis: A Descriptive Study. Vet Sci 2023; 10:436. [PMID: 37505841 PMCID: PMC10384441 DOI: 10.3390/vetsci10070436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 06/29/2023] [Accepted: 07/03/2023] [Indexed: 07/29/2023] Open
Abstract
Several studies evaluating Ki67 in canine cutaneous mast cell tumors (cMCTs) have reported its prognostic value when tumors of all histological grades are included. This study aims to evaluate whether the Ki67 index has a predictive value in a homogeneous cohort of G2/LG cMCTs with HN2 lymph nodes (LNs) and to describe the clinical outcome. The second goal was to explore the correlation between the Ki67 index and MC. The medical databases of three institutions were retrospectively searched for dogs undergoing surgical treatment for cMCT and LN extirpation, with a histological diagnosis of G2/LG with HN2 LNs. Information about histological margins, MC, Ki67 index, local recurrence, nodal relapse, distant metastasis, de novo cMCT occurrence and date and cause of death were included. A total of 39 cases were identified. None of these developed local and nodal relapse or metastatic distant disease. Median MC was 1 (0-2). Median Ki67 index was 3.5 (0.7-14.3). Ki67 and MC were not significantly correlated. At the end of the study, 32 (82%) dogs were alive, 7 (18%) dogs were dead from unrelated causes and 4 (10.2%) dogs were lost to follow-up. The median ST was not reached, and the mean was 893 days (104-2241 days). Considering the strict inclusion criteria, dogs affected by G2/LG with HN2 LNs treated with surgery alone may have a good oncologic outcome; the Ki67 index does not have prognostic impact.
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Affiliation(s)
- Marzia Cino
- Department of Veterinary Medical Sciences, University of Parma, Strada del Taglio 10, 43126 Parma, Italy
| | - Elisa Maria Gariboldi
- Department of Veterinary Medicine and Animal Sciences, University of Milan, Via dell' Università 1, 26900 Lodi, Italy
| | - Damiano Stefanello
- Department of Veterinary Medicine and Animal Sciences, University of Milan, Via dell' Università 1, 26900 Lodi, Italy
| | - Kevin Pascal Spindler
- Department of Veterinary Medical Sciences, University of Parma, Strada del Taglio 10, 43126 Parma, Italy
| | - Erica Ilaria Ferraris
- Department of Veterinary Sciences, University of Torino, Largo Braccini 2, 10095 Grugliasco, Italy
| | - Emanuela Maria Morello
- Department of Veterinary Sciences, University of Torino, Largo Braccini 2, 10095 Grugliasco, Italy
| | - Luca Bertola
- Department of Veterinary Medicine and Animal Sciences, University of Milan, Via dell' Università 1, 26900 Lodi, Italy
| | - Lorella Maniscalco
- Department of Veterinary Sciences, University of Torino, Largo Braccini 2, 10095 Grugliasco, Italy
| | - Marina Martano
- Department of Veterinary Medical Sciences, University of Parma, Strada del Taglio 10, 43126 Parma, Italy
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Burge R, Woolard KD, Willcox JL, Rebhun RB, Burton JH, Al-Nadaf S, Skorupski KA. High-Grade, Stage 2 Mast Cell Tumors: Outcome in Dogs With Local and Systemic Therapy. J Am Anim Hosp Assoc 2023; 59:167-176. [PMID: 37432790 DOI: 10.5326/jaaha-ms-7319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2023] [Indexed: 07/13/2023]
Abstract
Canine mast cell tumors (MCTs) have highly variable clinical behavior, and predicting outcomes in individual dogs remains challenging. Many studies combine dogs with varying tumor grades, clinical stage, or treatments, confounding those results. The purpose of this retrospective study was to determine outcome and prognostic factors in a specific subset of dogs with high-grade, stage 2, cutaneous MCTs treated with adequate local control via surgery with or without radiation therapy and adjuvant cytotoxic chemotherapy. Seventeen dogs met the inclusion criteria, and the median survival time was 259 days. Development of local recurrence, tumor location, and presence of ulceration were all associated with shorter survival times. Tumor size, mitotic count, chemotherapy protocol, lymph node classification, and radiation therapy were not significantly associated with outcome. In this study, a specific population of dogs characterized by high-grade MCTs with local lymph node metastasis who received aggressive local and systemic therapy had a median survival of about 8.5 mo. Dogs with ulcerated tumors, recurrent tumors, or tumors located on the head had a worse outcome despite aggressive therapy. These results may serve as a basis of comparison for future research exploring alternative treatment combinations in this specific population of dogs.
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Affiliation(s)
- Rhonda Burge
- From the Department of Veterinary Clinical Sciences (R.B.), College of Veterinary Medicine, The Ohio State University, Columbus, Ohio
| | - Kevin D Woolard
- Department of Pathology, Microbiology, and Immunology (K.D.W.), School of Veterinary Medicine, University of California, Davis, California
| | - Jennifer L Willcox
- Department of Surgical and Radiological Sciences (J.L.W., R.B.R., S.A.-N., K.A.S.), School of Veterinary Medicine, University of California, Davis, California
| | - Robert B Rebhun
- Department of Surgical and Radiological Sciences (J.L.W., R.B.R., S.A.-N., K.A.S.), School of Veterinary Medicine, University of California, Davis, California
| | - Jenna H Burton
- Clinical Sciences Department, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado (J.H.B.)
| | - Sami Al-Nadaf
- Department of Surgical and Radiological Sciences (J.L.W., R.B.R., S.A.-N., K.A.S.), School of Veterinary Medicine, University of California, Davis, California
| | - Katherine A Skorupski
- Department of Surgical and Radiological Sciences (J.L.W., R.B.R., S.A.-N., K.A.S.), School of Veterinary Medicine, University of California, Davis, California
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6
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Bertram CA, Aubreville M, Donovan TA, Bartel A, Wilm F, Marzahl C, Assenmacher CA, Becker K, Bennett M, Corner S, Cossic B, Denk D, Dettwiler M, Gonzalez BG, Gurtner C, Haverkamp AK, Heier A, Lehmbecker A, Merz S, Noland EL, Plog S, Schmidt A, Sebastian F, Sledge DG, Smedley RC, Tecilla M, Thaiwong T, Fuchs-Baumgartinger A, Meuten DJ, Breininger K, Kiupel M, Maier A, Klopfleisch R. Computer-assisted mitotic count using a deep learning–based algorithm improves interobserver reproducibility and accuracy. Vet Pathol 2021; 59:211-226. [PMID: 34965805 PMCID: PMC8928234 DOI: 10.1177/03009858211067478] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The mitotic count (MC) is an important histological parameter for prognostication of malignant neoplasms. However, it has inter- and intraobserver discrepancies due to difficulties in selecting the region of interest (MC-ROI) and in identifying or classifying mitotic figures (MFs). Recent progress in the field of artificial intelligence has allowed the development of high-performance algorithms that may improve standardization of the MC. As algorithmic predictions are not flawless, computer-assisted review by pathologists may ensure reliability. In the present study, we compared partial (MC-ROI preselection) and full (additional visualization of MF candidates and display of algorithmic confidence values) computer-assisted MC analysis to the routine (unaided) MC analysis by 23 pathologists for whole-slide images of 50 canine cutaneous mast cell tumors (ccMCTs). Algorithmic predictions aimed to assist pathologists in detecting mitotic hotspot locations, reducing omission of MFs, and improving classification against imposters. The interobserver consistency for the MC significantly increased with computer assistance (interobserver correlation coefficient, ICC = 0.92) compared to the unaided approach (ICC = 0.70). Classification into prognostic stratifications had a higher accuracy with computer assistance. The algorithmically preselected hotspot MC-ROIs had a consistently higher MCs than the manually selected MC-ROIs. Compared to a ground truth (developed with immunohistochemistry for phosphohistone H3), pathologist performance in detecting individual MF was augmented when using computer assistance (F1-score of 0.68 increased to 0.79) with a reduction in false negatives by 38%. The results of this study demonstrate that computer assistance may lead to more reproducible and accurate MCs in ccMCTs.
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Affiliation(s)
- Christof A. Bertram
- University of Veterinary Medicine, Vienna, Austria
- Freie Universität Berlin, Berlin, Germany
| | | | | | | | - Frauke Wilm
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Christian Marzahl
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | | | | | | | | | | | | | | | | | | | | | | | | | - Sophie Merz
- IDEXX Vet Med Labor GmbH, Kornwestheim, Germany
| | | | | | | | | | | | | | - Marco Tecilla
- Roche Pharmaceutical Research and Early Development (pRED), Basel, Switzerland
| | | | | | | | | | | | - Andreas Maier
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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Bellamy E, Berlato D. Canine cutaneous and subcutaneous mast cell tumours: a review. J Small Anim Pract 2021; 63:497-511. [PMID: 34671978 DOI: 10.1111/jsap.13444] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 06/26/2021] [Accepted: 09/06/2021] [Indexed: 01/12/2023]
Abstract
Cutaneous and subcutaneous mast cell tumours are common neoplasms in the dog. While the majority can be treated with adequate local therapy alone, a subset demonstrates a biologically aggressive behaviour associated with local recurrence or metastasis. This article reviews the diagnosis and tumour staging of canine mast cell tumours alongside treatment options and the evidence supporting their use. In addition, prognostic markers are evaluated to highlight how one can recognise mast cell tumours that may behave in a biologically aggressive manner as well as the challenges of tumours that are large, infiltrative or in locations not amenable to wide surgical excision.
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Affiliation(s)
- E Bellamy
- Dick White Referrals, Six Mile Bottom, Cambridgeshire, CB8 0UH, UK
| | - D Berlato
- AniCura AOI Center AG, Hünenberg, 6331, Switzerland
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8
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Fejös C, Troedson K, Ignatenko N, Zablotski Y, Hirschberger J. Extensive staging has no prognostic value in dogs with low-risk mast cell tumours. Vet Comp Oncol 2021; 20:265-275. [PMID: 34564910 DOI: 10.1111/vco.12773] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 09/16/2021] [Accepted: 09/24/2021] [Indexed: 12/16/2022]
Abstract
In canine mast cell tumours (MCTs), distant metastasis (DM) occurs infrequently. However, high-risk MCTs or tumours with certain negative prognostic factors (NPFs) are those more prone to develop metastatic disease. Accordingly, a thorough workup might not be necessary for MCTs lacking NPFs. The objective of this study was to evaluate the rate of DM and, therefore, the benefit of extensive staging in dogs presenting with and without NPFs. Furthermore, the association between the selected NPFs and DM was assessed, and factors that may have influenced outcome were evaluated. Dogs presenting with at least one NPF (Patnaik III/Kiupel high-grade, LN metastasis, rapid growth, ulceration, recurrence, high-risk location) were defined as high-risk and without as low-risk MCTs. Ninety-nine dogs were included, with 49% of MCTs in the high-risk and 51% in the low-risk group. All seven dogs with DM were identified in the high-risk group; 43% were Patnaik III/Kiupel high-grade tumours. The median survival time (MST) for this subgroup was 84 days. Patnaik III/Kiupel high-grade and rapid growth were NPFs significantly associated with DM at staging. Furthermore, a significant difference (p < .001) in MST was demonstrated between the high-risk and low-risk groups (899 days vs. not reached). NPFs significantly associated with outcome were rapid growth, presence of DM at staging, and surgical tumour excision. These results indicate that extensive staging in the absence of NPFs does not seem to be beneficial. On the other hand, by using the selected NPFs, a subset of MCTs prone to DM can be identified.
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Affiliation(s)
- Csilla Fejös
- Clinic of Small Animal Medicine, Faculty of Veterinary Medicine, Ludwig-Maximilian University, Munich, Germany
| | - Karin Troedson
- Clinic of Small Animal Medicine, Faculty of Veterinary Medicine, Ludwig-Maximilian University, Munich, Germany
| | - Nataliia Ignatenko
- Clinic of Small Animal Medicine, Faculty of Veterinary Medicine, Ludwig-Maximilian University, Munich, Germany
| | - Yury Zablotski
- Clinic of Small Animal Medicine, Faculty of Veterinary Medicine, Ludwig-Maximilian University, Munich, Germany
| | - Johannes Hirschberger
- Clinic of Small Animal Medicine, Faculty of Veterinary Medicine, Ludwig-Maximilian University, Munich, Germany
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Bongiovanni L, Andriessen A, Silvestri S, Porcellato I, Brachelente C, de Bruin A. H2AFZ: A Novel Prognostic Marker in Canine Melanoma and a Predictive Marker for Resistance to CDK4/6 Inhibitor Treatment. Front Vet Sci 2021; 8:705359. [PMID: 34485433 PMCID: PMC8415453 DOI: 10.3389/fvets.2021.705359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 07/19/2021] [Indexed: 11/13/2022] Open
Abstract
Uncontrolled proliferation is a key feature of tumor progression and malignancy. This suggests that cell-cycle related factors could be exploited as cancer biomarkers and that pathways specifically involved in the cell cycle, such as the Rb-E2F pathway, could be targeted as an effective anti-tumor therapy. We investigated 34 formalin-fixed paraffin-embedded (FFPE) tissue samples of canine cutaneous melanocytoma, cutaneous melanoma, and oral melanoma. Corresponding clinical follow-up data were used to determine the prognostic value of the mRNA expression levels of several cell cycle regulated E2F target genes (E2F1, DHFR, CDC6, ATAD2, MCM2, H2AFZ, GINS2, and survivin/BIRC5). Moreover, using four canine melanoma cell lines, we explored the possibility of blocking the Rb-E2F pathway by using a CDK4/6 inhibitor (Palbociclib) as a potential anti-cancer therapy. We investigated the expression levels of the same E2F target gene transcripts before and after treatment to determine the potential utility of these molecules as predictive markers. The E2F target gene H2AFZ was expressed in 91.43% of the primary tumors and H2AFZ expression was significantly higher in cases with unfavorable clinical outcome. Among the other tested genes, survivin/BIRC5 showed as well-promising results as a prognostic marker in canine melanoma. Three of the four tested melanoma cell lines were sensitive to the CDK4/6 inhibitor. The resistant cell line displayed higher expression levels of H2AFZ before treatment compared to the CDK4/6 inhibitor-sensitive cell lines. The present results suggest that CDK4/6 inhibitors could potentially be used as a new anti-cancer treatment for canine melanoma and that H2AFZ could serve as a prognostic and predictive marker for patient selection.
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Affiliation(s)
- Laura Bongiovanni
- Department of Biomolecular Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Netherlands
| | - Anneloes Andriessen
- Department of Biomolecular Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Netherlands
| | | | - Ilaria Porcellato
- Department of Veterinary Medicine, University of Perugia, Perugia, Italy
| | - Chiara Brachelente
- Department of Veterinary Medicine, University of Perugia, Perugia, Italy
| | - Alain de Bruin
- Department of Biomolecular Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Netherlands.,Department of Pediatrics, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
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Morello EM, Cino M, Giacobino D, Nicoletti A, Iussich S, Buracco P, Martano M. Prognostic Value of Ki67 and Other Clinical and Histopathological Factors in Canine Apocrine Gland Anal Sac Adenocarcinoma. Animals (Basel) 2021; 11:ani11061649. [PMID: 34199347 PMCID: PMC8228493 DOI: 10.3390/ani11061649] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 05/29/2021] [Accepted: 05/31/2021] [Indexed: 12/15/2022] Open
Abstract
Simple Summary Apocrine gland anal sac adenocarcinoma (AGASACA) is a locally aggressive tumor with a high metastatic rate to the regional ileo-sacral lymph nodes and later to distant sites. Clinical signs depend on the tumor and regional lymph nodes size or on the paraneoplastic hypercalcemia. Therefore, dogs are often referred for perineal swelling, tenesmus, constipation and/or polyuria, polydipsia. Surgical excision of both the neoplastic anal sac and the metastatic regional lymph nodes represents the standard of care. Adjuvant chemotherapy and/or radiotherapy are also indicated. Prognostic factors include tumor size, hypercalcemia, regional lymph nodes metastasis and tumor histologic features. The aim of the study was to retrospectively evaluate the prognostic significance of tumor Ki67 expression. The authors’ hypothesis was that higher Ki67 index correlated with decreased disease-free interval and overall survival time. Clinical data such as tumor size, regional lymph nodes metastasis and hypercalcemia at presentation and histological features such as tumor pattern, mitotic count, necrosis, inflammatory infiltration, vascular invasion, anisokaryosis, and anisocytosis were also investigated and correlated to the oncologic outcome in the dogs included in the study. Abstract Apocrine gland anal sac adenocarcinoma (AGASACA) is locally aggressive and highly metastatic to regional lymph nodes. The aim of this study was to evaluate the prognostic significance of Ki67 in surgically excised AGASACA. Prognostic impact of size, regional lymph nodes metastasis, hypercalcemia, histologic pattern, mitotic count, necrosis, inflammatory and lympho-vascular invasion, anisokaryosis and anisocytosis was also evaluated. Thirty-five dogs were included, twenty-four of which also had metastatic lymph nodes. When the entire population was evaluated, only metastatic disease spread to regional lymph nodes, and necrosis and inflammatory infiltration were correlated to prognosis. When only dogs with metastatic disease were evaluated, size, solid histologic pattern, presence of lymphatic and vascular invasion showed influence on prognosis. Ki67 index was not associated with survival time and disease free interval in any case. The results of this study showed that lymph nodes metastasis at diagnosis reduced disease free interval. Moreover, tumor size greater than 5.25 cm, presence of lymphatic and vascular invasion and a solid histologic pattern were associated with a shorter survival time in dogs with metastasis to regional lymph nodes. Ki67 expression was not significantly associated with prognosis, therefore it could not be considered as a prognostic factor in this tumor type, while the role of hypercalcemia remained unclear.
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Affiliation(s)
- Emanuela Maria Morello
- Department of Veterinary Sciences, University of Torino, Largo Braccini 2, 10095 Grugliasco, Italy; (E.M.M.); (D.G.); (A.N.); (S.I.); (P.B.)
| | - Marzia Cino
- Department of Medical-Veterinary Science, Univesrity of Parma, Strada del Taglio 10, 43126 Parma, Italy;
- Correspondence: ; Tel.: +39-0521034786
| | - Davide Giacobino
- Department of Veterinary Sciences, University of Torino, Largo Braccini 2, 10095 Grugliasco, Italy; (E.M.M.); (D.G.); (A.N.); (S.I.); (P.B.)
| | - Arturo Nicoletti
- Department of Veterinary Sciences, University of Torino, Largo Braccini 2, 10095 Grugliasco, Italy; (E.M.M.); (D.G.); (A.N.); (S.I.); (P.B.)
| | - Selina Iussich
- Department of Veterinary Sciences, University of Torino, Largo Braccini 2, 10095 Grugliasco, Italy; (E.M.M.); (D.G.); (A.N.); (S.I.); (P.B.)
| | - Paolo Buracco
- Department of Veterinary Sciences, University of Torino, Largo Braccini 2, 10095 Grugliasco, Italy; (E.M.M.); (D.G.); (A.N.); (S.I.); (P.B.)
| | - Marina Martano
- Department of Medical-Veterinary Science, Univesrity of Parma, Strada del Taglio 10, 43126 Parma, Italy;
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11
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Berlato D, Bulman-Fleming J, Clifford CA, Garrett L, Intile J, Jones P, Kamstock DA, Liptak JM, Pavuk A, Powell R, Rasotto R. Value, Limitations, and Recommendations for Grading of Canine Cutaneous Mast Cell Tumors: A Consensus of the Oncology-Pathology Working Group. Vet Pathol 2021; 58:858-863. [PMID: 33888024 DOI: 10.1177/03009858211009785] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
One of the primary objectives of the Oncology Pathology Working Group (OPWG), a joint initiative of the Veterinary Cancer Society and the American College of Veterinary Pathologists, is for oncologists and pathologists to collaboratively generate consensus documents to standardize aspects and provide guidelines for oncologic pathology. Consensus is established through review of relevant peer-reviewed literature relative to a subgroup's particular focus. In this article, the authors provide a critical review of the current literature for grading of canine cutaneous mast cell tumors, suggest guidelines for reporting, and provide recommendations for its clinical interpretation. The article mainly focuses on histologic grading, but relevant information on mitotic count and cytological grading are also discussed. This document represents the opinions of the working group and the authors but does not constitute a formal endorsement by the American College of Veterinary Pathologists or the Veterinary Cancer Society.
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Affiliation(s)
| | | | | | | | - Joanne Intile
- 70727North Carolina State University, Raleigh, NC, USA
| | - Pamela Jones
- QBiotics Group Limited, Yungaburra, Queensland, Australia
| | | | - Julius M Liptak
- VCA Canada-Alta Vista Animal Hospital, Ottawa, Ontario, Canada
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12
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Freytag JO, Queiroz MR, Govoni VM, Pereira IVA, Pulz LH, de Francisco Strefezzi R, Queiroga FL, Cogliati B. Prognostic value of immunohistochemical markers in canine cutaneous mast cell tumours: A systematic review and meta-analysis. Vet Comp Oncol 2021; 19:529-540. [PMID: 33724647 DOI: 10.1111/vco.12692] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 02/26/2021] [Accepted: 03/13/2021] [Indexed: 12/29/2022]
Abstract
Histological grading systems remain cornerstones in the prognosis of canine cutaneous mast cell tumours (MCTs), but the distinct biological behaviour of each tumour often necessitates the use of complementary markers. Although a plethora of immunohistochemical markers have been proposed as prognostic factors, few are presently applied in routine diagnosis. This systematic review and meta-analysis was designed to establish which immunohistochemical markers have verifiable prognostic value for cutaneous MCTs in dogs. A Boolean search of five databases identified 200 articles for screening, of which 73 were selected for full-text assessment and 24 ultimately included in the systematic review. Odds Ratio (OR) was adopted as the summary measure for subsequent meta-analysis but only 15 articles, relating to the immunomarkers Ki-67 (9), KIT (5), and BAX (2), provided either a value for OR or sufficient data to calculate this statistic. Meta-analysis verified that canine cutaneous MCTs with elevated expression of Ki-67 or BAX, as well aberrant immuno-expression of KIT, showed an increased odds of death, with respective OR values of 11.2 (95% CI 6.3-20.0; p < .01), 9.9 (95% CI 1.3-73.6; p = .03), and 4.1 (95% CI 1.1-15.3; p = .03). Despite KIT, Ki67, and BAX arise as suitable prognostic factor for canine MCTs, this study highlighted the lack of important clinical and statistical data in many published articles, rendering it impossible to complete the meta-analysis of several potentially valuable immunohistochemical markers.
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Affiliation(s)
- Jennifer Ostrand Freytag
- Department of Pathology, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil
| | - Mariana Ramos Queiroz
- Department of Preventive Veterinary Medicine and Animal Health, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil
| | - Verônica Mollica Govoni
- Department of Pathology, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil
| | - Isabel Veloso Alves Pereira
- Department of Pathology, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil
| | - Lidia Hildebrand Pulz
- Department of Veterinary Medicine, Faculty of Animal Science and Food Engineering, University of São Paulo, Pirassununga, Brazil
| | - Ricardo de Francisco Strefezzi
- Department of Veterinary Medicine, Faculty of Animal Science and Food Engineering, University of São Paulo, Pirassununga, Brazil
| | - Felisbina Luisa Queiroga
- Center for Research and Technology of Agro-Environment and Biological Sciences (CITAB), University of Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - Bruno Cogliati
- Department of Pathology, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, Brazil
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13
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Néčová S, Mason SL, North SM. Outcome of dogs with intermediate grade low mitotic index high Ki67 mast cell tumours treated with surgery and single agent lomustine. Aust Vet J 2021; 99:146-151. [PMID: 33565080 DOI: 10.1111/avj.13059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 01/02/2021] [Accepted: 01/10/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVES The objective of this retrospective study was to evaluate the outcome of dogs when grade II mast cell tumour (MCT) with low mitotic index (MI) and high Ki67 were treated with adjuvant lomustine. ANIMALS Client owned dogs with spontaneously occurring disease treated with adjuvant chemotherapy for grade II mast cell tumour with low MI (≤5/10HPF) and high Ki67 (>1.8%) with no evidence of metastatic disease at presentation. PROCEDURES Lomustine was administered every 3 weeks with three or four planned cycles. Response to treatment was assessed by regular re-staging ultrasound with or without cytopathological examination of liver and spleen or through medical records from the referring veterinarian. Disease-free interval (DFI) and median survival time (MST) were calculated using Kaplan-Meier method. RESULTS Twenty-one dogs were included. All dogs underwent surgical excision and two dogs received adjuvant radiotherapy. None of the patients developed local recurrence. Three dogs (14.3%) developed metastatic disease. The DFI of these dogs was 141, 186 and 223 days. Median follow-up period of the whole study population was 1112 days (358-2619). MST for patients with metastatic disease was 417 days. MST of the whole group was not reached. One-year and 2-year survivals were 95.2% and 90.5%, respectively. CONCLUSIONS AND CLINICAL RELEVANCE This study population had low rates of tumour recurrence and improved survival compared to previously published data of similar population of dogs with low MI/high Ki67 MCT without adjuvant chemotherapy.
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Affiliation(s)
- S Néčová
- Small Animal Oncology, Southfields Veterinary Specialists (formerly VRCC), Laindon, SS15 6TP, UK
| | - S L Mason
- Small Animal Oncology, Southfields Veterinary Specialists (formerly VRCC), Laindon, SS15 6TP, UK
| | - S M North
- Small Animal Oncology, Southfields Veterinary Specialists (formerly VRCC), Laindon, SS15 6TP, UK
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14
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Abrams BE, Putterman AB, Ruple A, Wavreille V, Selmic LE. Variability in tumor margin reporting for soft tissue sarcoma and cutaneous mast cell tumors in dogs: A systematic review. Vet Surg 2020; 50:259-272. [DOI: 10.1111/vsu.13539] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 10/01/2020] [Accepted: 10/17/2020] [Indexed: 12/16/2022]
Affiliation(s)
- Brittany E. Abrams
- Department of Veterinary Clinical Sciences College of Veterinary Medicine, The Ohio State University Columbus Ohio
| | - Allison B. Putterman
- Department of Veterinary Clinical Medicine College of Veterinary Medicine, University of Illinois at Urbana‐Champaign Urbana Illinois
| | - Audrey Ruple
- Department of Comparative Pathobiology College of Veterinary Medicine, Purdue University West Lafayette, Indiana
| | - Vincent Wavreille
- Department of Veterinary Clinical Sciences College of Veterinary Medicine, The Ohio State University Columbus Ohio
| | - Laura E. Selmic
- Department of Veterinary Clinical Sciences College of Veterinary Medicine, The Ohio State University Columbus Ohio
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15
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Rigas K, Biasoli D, Polton G, Finotello R, Murphy S, Di Palma S, Starkey M, Verganti S. Mast cell tumours in dogs less than 12 months of age: a multi-institutional retrospective study. J Small Anim Pract 2020; 61:449-457. [PMID: 32715502 DOI: 10.1111/jsap.13181] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 03/24/2020] [Accepted: 04/20/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To describe the clinicopathological and genetic characteristics of mast cell tumours in dogs less than 12 months old. MATERIALS AND METHODS Retrospective review of dogs aged less than 12 months when diagnosed with mast cell tumours at three referral hospitals in the UK. RESULTS Sixteen pure-bred dogs were included, of which 11 were female. The median age at first presentation and diagnosis were 7.6 and 9 months, respectively. In 13 dogs the mast cell tumours were cutaneous and in three they were subcutaneous. Four cutaneous mast cell tumours were described as high-grade (Patnaik or Kiupel) and nine were Patnaik grade II; three had mitotic index of >5 in 10 high-power fields. Of the three subcutaneous tumours, two had an infiltrative growth pattern and one had mitotic index of 10 per 10 high-power fields. Of 10 tested dogs, seven had c-kit mutations in exon 11 and Ki-67 score was above the cut-off value in nine. Four of 12 cases showed evidence of metastasis in the regional lymph nodes. After varying treatment protocols, all patients were alive and disease free at a median of 1115 days after diagnosis. CLINICAL SIGNIFICANCE The prognosis of mast cell tumours in dogs less than a year old appears better than the adult counterparts, even without extensive treatment.
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Affiliation(s)
- K Rigas
- Oncology service, Small Animal Teaching Hospital, School of Veterinary Science, University of Liverpool, Leahurst Campus, Chester High Road , UK
| | - D Biasoli
- Molecular Oncology Group, Animal Health Trust, Lanwades Park, Kentford, Newmarket, CB8 7UU, UK
| | - G Polton
- Oncology department, North Downs Specialist Referrals, 3 & 4 The Brewerstreet Dairy Business Park, Brewer St, Bletchingley, RH1 4QP, UK
| | - R Finotello
- Oncology service, Small Animal Teaching Hospital, School of Veterinary Science, University of Liverpool, Leahurst Campus Chester High Road, Neston, Wirral, CH64 7TE, UK
| | - S Murphy
- Centre for Small Animal Studies, Animal Health Trust, Lanwades Park, Kentford, Newmarket, CB8 7UU, UK
| | - S Di Palma
- Molecular Oncology Group, Animal Health Trust, Lanwades Park, Kentford, Newmarket, CB8 7UU, UK.,Aptuit Srl, Italy
| | - M Starkey
- Molecular Oncology Group, Animal Health Trust, Lanwades Park, Kentford, Newmarket, CB8 7UU, UK
| | - S Verganti
- Centre for Small Animal Studies, Animal Health Trust, Lanwades Park, Kentford, Newmarket, CB8 7UU, UK
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16
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Pecceu E, Serra Varela JC, Handel I, Piccinelli C, Milne E, Lawrence J. Ultrasound is a poor predictor of early or overt liver or spleen metastasis in dogs with high-risk mast cell tumours. Vet Comp Oncol 2020; 18:389-401. [PMID: 31863546 DOI: 10.1111/vco.12563] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 12/08/2019] [Accepted: 12/11/2019] [Indexed: 12/12/2022]
Abstract
Conflicting evidence exists regarding the importance of routine abdominal ultrasound (US) with hepatic and splenic fine needle aspiration (FNA) cytology during staging of canine mast cell tumours (MCT). The objective of this study was to correlate ultrasonographic and cytologic findings in dogs with strictly defined high-risk MCTs and to determine the influence on outcome. Our hypothesis was that US poorly predicts visceral metastasis in high-risk MCTs and that early metastasis is associated with improved outcome when compared to overt metastasis. US of liver and spleen correlated to cytologic results, categorized as no metastasis, early metastasis or overt metastasis. Of 82 dogs prospectively enrolled, 18% had early visceral metastasis and 7% had overt metastasis on cytology; 67% with visceral metastasis had regional LN metastasis. US was a poor predictor of metastasis with sensitivity, specificity, positive predictive value and negative predictive value for the spleen of 67%, 68%, 21% and 94%, respectively and for the liver of 29%, 93%, 56% and 82%, respectively. Median time to progression (TTP) for dogs with no metastasis, early metastasis and overt metastasis was not reached, 305 and 69 days, respectively (P < .001). Median survival time (MST) for the 3 groups were not reached, 322 and 81 days, respectively (P < .001). High Patnaik or Kiupel grade, early metastasis, overt metastasis and adequate local control were significantly associated with outcome. Early visceral metastasis was associated with poorer outcome compared to dogs without metastasis, however, a subset of dogs experienced long-term control.
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Affiliation(s)
- Evi Pecceu
- Royal (Dick) School of Veterinary Studies & Roslin Institute, University of Edinburgh, Roslin, UK
| | - Juan Carlos Serra Varela
- Royal (Dick) School of Veterinary Studies & Roslin Institute, University of Edinburgh, Roslin, UK
| | - Ian Handel
- Royal (Dick) School of Veterinary Studies & Roslin Institute, University of Edinburgh, Roslin, UK
| | - Chiara Piccinelli
- Royal (Dick) School of Veterinary Studies & Roslin Institute, University of Edinburgh, Roslin, UK
| | - Elspeth Milne
- Royal (Dick) School of Veterinary Studies & Roslin Institute, University of Edinburgh, Roslin, UK
| | - Jessica Lawrence
- Royal (Dick) School of Veterinary Studies & Roslin Institute, University of Edinburgh, Roslin, UK
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17
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Reynolds BD, Thomson MJ, O'Connell K, Morgan EJ, Gummow B. Patient and tumour factors influencing canine mast cell tumour histological grade and mitotic index. Vet Comp Oncol 2019; 17:338-344. [PMID: 30891882 DOI: 10.1111/vco.12477] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Revised: 02/24/2019] [Accepted: 03/11/2019] [Indexed: 12/17/2022]
Abstract
The aim of this study was to identify patient and tumour factors most frequently associated with high histological grades of canine mast cell tumours (MCTs). Search criteria in a shared database of multiple Animal Referral Hospital locations within Australia generated 400 canine MCTs in 286 patients. Patient and tumour data were extrapolated and the association between a tumour being histologically high grade and patient and tumour factors, including: patient breed, patient gender and neuter status, patient age at MCT excision, tumour location and tumour size was assessed using univariate analysis. The study consisted of 90 (21.9%) tumours meeting histological high-grade criteria. Shar peis were the most likely breed to have high grade MCTs, whereas the Pug and the Golden Retriever were the least likely breeds to develop high-grade MCTs. No significant difference in risks could be established between the age at which the tumour was excised, or the gender and neuter status of patients. MCTs of the inguinal region were the most likely single location to be high grade. Tumour size did not influence the likelihood of a tumour being high grade or low grade. The results of this study suggest that patient and tumour factors may play a role in the histological grades of canine MCTs.
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Affiliation(s)
- Benjamin D Reynolds
- Department of Oncology, Animal Referral Hospital Brisbane, Brisbane, Queensland, Australia
| | - Maurine J Thomson
- Department of Oncology, Animal Referral Hospital Brisbane, Brisbane, Queensland, Australia
| | - Kathleen O'Connell
- Department of Oncology, Animal Referral Hospital Brisbane, Brisbane, Queensland, Australia
| | - Elizabeth J Morgan
- Department of Oncology, Animal Referral Hospital Brisbane, Brisbane, Queensland, Australia
| | - Bruce Gummow
- Discipline of Veterinary Sciences, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
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18
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Skorupski KA, Alarcón CN, de Lorimier LP, LaDouceur EEB, Rodriguez CO, Rebhun RB. Outcome and clinical, pathological, and immunohistochemical factors associated with prognosis for dogs with early-stage anal sac adenocarcinoma treated with surgery alone: 34 cases (2002-2013). J Am Vet Med Assoc 2019; 253:84-91. [PMID: 29911942 DOI: 10.2460/javma.253.1.84] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine survival time and metastatic rate for dogs with early-stage anal sac adenocarcinoma (ASACA) treated with surgery alone and assess whether specific clinical, pathological, or immunohistochemical factors were predictive of outcome for those dogs. DESIGN Retrospective case series. ANIMALS 34 dogs with early-stage, nonmetastatic ASACA that were treated with surgery only. PROCEDURES Medical record databases of 2 referral hospitals were searched to identify dogs examined between 2002 and 2013 that had a diagnosis of nonmetastatic ASACA that was < 3.2 cm at its largest diameter. Only dogs that received surgical treatment alone were included in the study. For each dog, information extracted from the medical record included signalment, clinical and diagnostic test findings, tumor characteristics, and outcome. When available, archived tumor specimens were histologically reviewed and tumor characteristics were described; Ki-67 and E-cadherin expressions were evaluated by use of immunohistochemical methods. Clinical, pathological, and immunohistochemical factors were assessed for associations with survival time and tumor recurrence and metastasis rates. RESULTS Median survival time was 1,237 days. Seven dogs had tumor recurrence and 9 dogs developed metastatic disease at a median of 354 and 589 days, respectively, after primary tumor removal. Cellular pleomorphism was positively associated with development of metastatic disease. No other factors evaluated were associated with outcome. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated dogs with early-stage nonmetastatic ASACA generally had a favorable outcome following surgical removal of the primary tumor alone. Routine rectal examination may be a simple and useful method for detection of dogs with early-stage ASACA.
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19
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Berlato D, Murphy S, Laberke S, Rasotto R. Comparison of minichromosome maintenance protein 7, Ki67 and mitotic index in the prognosis of intermediate Patnaik grade cutaneous mast cell tumours in dogs. Vet Comp Oncol 2018; 16:535-543. [DOI: 10.1111/vco.12412] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Revised: 05/04/2018] [Accepted: 05/08/2018] [Indexed: 12/26/2022]
Affiliation(s)
- D. Berlato
- Centre for Small Animal Studies; Animal Health Trust; Newmarket UK
| | - S. Murphy
- Centre for Small Animal Studies; Animal Health Trust; Newmarket UK
| | - S. Laberke
- Centre for Small Animal Studies; Animal Health Trust; Newmarket UK
| | - R. Rasotto
- Centre for Small Animal Studies; Animal Health Trust; Newmarket UK
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20
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Reagan JK, Selmic LE, Fallon C, Driskell EA, Garrett LD. Evaluation of information presented within mast cell tumour histopathology reports in the United States: 2012-2015. Vet Med Sci 2018; 4:252-262. [PMID: 29877634 PMCID: PMC6090413 DOI: 10.1002/vms3.107] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
For canine mast cell tumour (MCT), histopathology reports are one of the main factors considered in the decision-making process regarding need and type of adjunctive therapy. However, considerable variation exists in types of information reported, especially relating to surgical margins. The purpose of this study was to describe and evaluate how information is presented within canine MCT histopathology reports across the United States. The reports were collected from medical and surgical oncologists from 4 geographic regions of the USA: Midwest, Northeast, South and West. All reports were obtained between January 1st 2012 and May 1st 2015. Inclusion criteria required that the final diagnosis was MCT, a microscopic description was present, and it was not a scar revision. Three hundred and sixty-eight reports were collected from 26 contributors. While the majority of the reports contained a clinical history (85.9%), information for certain prognostic indicators such as location and mass size was lacking. Grading with both Patnaik and Kiupel systems were described in 76.5% of reports with a single system being used in 7.1% and 15.2% of reports, respectively. Subcutaneous MCT were assigned a grading scheme in 67.2% of reports with 33.3% stating appropriate limitations. Surgical margins were reported in 92% of the reports with 77.2% describing deep and lateral margins separately. Tissue composing the deep margin was only described in 10.9% of the reports. The present results indicate reporting of MCT has variability across pathologists with inconsistencies present in the reporting of clinical history, margin evaluation and subcutaneous MCT grading.
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Affiliation(s)
- Jennifer K. Reagan
- Department of Veterinary Clinical MedicineCollege of Veterinary Medicine Urbana‐ChampaignUniversity of IllinoisUrbanaIllinois
| | - Laura E. Selmic
- Department of Veterinary Clinical MedicineCollege of Veterinary Medicine Urbana‐ChampaignUniversity of IllinoisUrbanaIllinois
| | - Caroline Fallon
- Department of Veterinary Clinical MedicineCollege of Veterinary Medicine Urbana‐ChampaignUniversity of IllinoisUrbanaIllinois
- Department of PathobiologyCollege of Veterinary Medicine Urbana‐ChampaignUniversity of IllinoisUrbanaIllinois
| | - Elizabeth A. Driskell
- Department of Clinical SciencesCollege of Veterinary MedicineAuburn UniversityAuburnAlabama
| | - Laura D. Garrett
- Department of Veterinary Clinical MedicineCollege of Veterinary Medicine Urbana‐ChampaignUniversity of IllinoisUrbanaIllinois
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21
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Horta RDS, Giuliano A, Lavalle GE, Costa MDP, de Araújo RB, Constantino-Casas F, Dobson JM. Clinical, histological, immunohistochemical and genetic factors associated with measurable response of high-risk canine mast cell tumours to tyrosine kinase inhibitors. Oncol Lett 2018; 15:129-136. [PMID: 29387214 PMCID: PMC5768098 DOI: 10.3892/ol.2017.7323] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 09/01/2017] [Indexed: 11/29/2022] Open
Abstract
The aim of the present prospective-retrospective study was to evaluate the response of high-risk canine mast cell tumours (MCTs) to tyrosine kinase inhibitors (TKIs) and to correlate this with prognostic factors. A total of 24 dogs presented with macroscopic cutaneous MCTs at disease stage II or III, and therefore, at high-risk of associated mortality, were included in the study and treated with masitinib (n=20) or toceranib (n=4). A total of 12/24 dogs achieved an objective response and the overall survival (OS) for all subjects was 113 days. Dogs responding to treatment had a significant increase in OS compared to non-responders (146.5 days vs. 47 days, P=0.02). Internal tandem duplications in exon 11 of the c-kit gene were identified in 6/24 cases. Ki67, KIT immunolabelling and c-kit mutation did not provide information regarding prognosis or prediction of response to TKIs in this population. Initial response to TKIs appears to be the most reliable prognostic factor for survival duration.
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Affiliation(s)
- Rodrigo Dos Santos Horta
- Department of Veterinary Medicine, Universidade Vila Velha (UVV), Vila Velha, ES 29120-920, Brazil
| | - Antonio Giuliano
- Department of Veterinary Medicine, The Queen's Veterinary School Hospital, University of Cambridge, Cambridge CB3 0ES, UK
| | - Gleidice Eunice Lavalle
- Department of Veterinary Clinic and Surgery, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG 31270-901, Brazil
| | - Mariana de Pádua Costa
- Department of Veterinary Clinic and Surgery, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG 31270-901, Brazil
| | - Roberto Baracat de Araújo
- Department of Veterinary Clinic and Surgery, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG 31270-901, Brazil
| | - Fernando Constantino-Casas
- Department of Veterinary Medicine, The Queen's Veterinary School Hospital, University of Cambridge, Cambridge CB3 0ES, UK
| | - Jane Margaret Dobson
- Department of Veterinary Medicine, The Queen's Veterinary School Hospital, University of Cambridge, Cambridge CB3 0ES, UK
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22
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Horta RS, Lavalle GE, Monteiro LN, Souza MCC, Cassali GD, Araújo RB. Assessment of Canine Mast Cell Tumor Mortality Risk Based on Clinical, Histologic, Immunohistochemical, and Molecular Features. Vet Pathol 2018; 55:212-223. [DOI: 10.1177/0300985817747325] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Mast cell tumor (MCT) is a frequent cutaneous neoplasm in dogs that is heterogeneous in clinical presentation and biological behavior, with a variable potential for recurrence and metastasis. Accurate prediction of clinical outcomes has been challenging. The study objective was to develop a system for classification of canine MCT according to the mortality risk based on individual assessment of clinical, histologic, immunohistochemical, and molecular features. The study included 149 dogs with a histologic diagnosis of cutaneous or subcutaneous MCT. By univariate analysis, MCT metastasis and related death was significantly associated with clinical stage ( P < .0001, rP = –0.610), history of tumor recurrence ( P < .0001, rP = –0.550), Patnaik ( P < .0001, rP = –0.380) and Kiupel grades ( P < .0001, rP = –0.500), predominant organization of neoplastic cells ( P < .0001, rP = –0.452), mitotic count ( P < .0001, rP = –0.325), Ki-67 labeling index ( P < .0001, rP = –0.414), KITr pattern ( P = .02, rP = 0.207), and c-KIT mutational status ( P < .0001, rP = –0.356). By multivariate analysis with Cox proportional hazard model, only 2 features were independent predictors of overall survival: an amendment of the World Health Organization clinical staging system (hazard ratio [95% CI]: 1.824 [1.210-4.481]; P = .01) and a history of tumor recurrence (hazard ratio [95% CI]: 9.250 [2.158-23.268]; P < .001]. From these results, we propose an amendment of the WHO staging system, a method of risk analysis, and a suggested approach to clinical and laboratory evaluation of dogs with cutaneous MCT.
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Affiliation(s)
| | - Gleidice E. Lavalle
- Department of Veterinary Clinics and Surgery, Veterinary School, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Lidianne N. Monteiro
- Laboratory of Comparative Pathology, Biological Science Institute, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | | | - Geovanni D. Cassali
- Laboratory of Comparative Pathology, Biological Science Institute, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Roberto B. Araújo
- Department of Veterinary Clinics and Surgery, Veterinary School, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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23
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Mutz ML, Boudreaux BB, Royal A, Merchant S, Pucheu-Haston C, Griffith EH, Gieger TL. Cytologic comparison of the percentage of mast cells in lymph node aspirate samples from clinically normal dogs versus dogs with allergic dermatologic disease and dogs with cutaneous mast cell tumors. J Am Vet Med Assoc 2017; 251:421-428. [DOI: 10.2460/javma.251.4.421] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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24
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Gao S, Shen J, Hornicek F, Duan Z. Three-dimensional (3D) culture in sarcoma research and the clinical significance. Biofabrication 2017; 9:032003. [DOI: 10.1088/1758-5090/aa7fdb] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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25
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Gregório H, Raposo T, Queiroga FL, Pires I, Pena L, Prada J. High COX-2 expression in canine mast cell tumours is associated with proliferation, angiogenesis and decreased overall survival. Vet Comp Oncol 2016; 15:1382-1392. [PMID: 28467670 DOI: 10.1111/vco.12280] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 09/30/2016] [Accepted: 10/02/2016] [Indexed: 12/23/2022]
Abstract
COX-2 overexpression is associated with several hallmarks of carcinogenesis such as proliferation, angiogenesis, invasion and metastasis. Fifty cases of canine mast cell tumours (MCT) were retrospectively evaluated and submitted to immunohistochemistry for COX-2, CD31, Ki-67, MAC-387 and CD3. Furthermore its relationship with clinicopathological variables and overall survival (OS) was analysed. COX-2 intensity (P = 0.016), but not COX-2 extension nor score was associated with decreased OS and higher grades of malignancy according to Patnaik (P = 0.002) and Kiupel (P < 0.001) grading systems. Cox-2 intensity was also associated with higher Ki-67 scores (P = 0.009), higher mitotic index (P = 0.022) and higher microvascularization density (P = 0.045). No association was observed for COX-2 intensity and CD3-T lymphocyte (P = 0.377) and macrophage infiltration (P = 0.261) by MAC-387 immunollabelling, suggesting an active role of COX-2 in MCT oncogenesis mainly through proliferation and angiogenesis stimulation making it a potentially clinical relevant prognosis marker and therapeutic target.
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Affiliation(s)
- H Gregório
- CHV, Centro Hospitalar Veterinário, Porto, Portugal.,Department of Veterinary Sciences, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal
| | - T Raposo
- Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham, UK
| | - F L Queiroga
- Department of Veterinary Sciences, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal.,Center for Technology of Agro-Environment and Biological Sciences (CITAB), University of Trás-os-Montes and Alto Douro, Vila Real, Portugal.,Center for the Study of Animal Sciences, CECA-ICETA, University of Porto, Porto, Portugal
| | - I Pires
- Department of Veterinary Sciences, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal.,CECAV, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal
| | - L Pena
- Department of Veterinary Medicine and Science, University Complutense of Madrid, Veterinary School Hospital, Madrid, Spain
| | - J Prada
- Department of Veterinary Sciences, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal.,CECAV, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal
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26
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Skor O, Fuchs-Baumgartinger A, Tichy A, Kleiter M, Schwendenwein I. Pretreatment leukocyte ratios and concentrations as predictors of outcome in dogs with cutaneous mast cell tumours. Vet Comp Oncol 2016; 15:1333-1345. [PMID: 27723224 DOI: 10.1111/vco.12274] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 08/26/2016] [Accepted: 09/11/2016] [Indexed: 12/31/2022]
Abstract
Leukocyte ratios correlate with outcome in several human cancers. Little is known about their prognostic significance in mast cell tumour (MCT). The aim of the study was to evaluate the prognostic significance of pretreatment leukocyte concentrations and their ratios in dogs with MCT for survival. Medical records of 92 dogs with MCT were retrospectively reviewed. Tumour diagnosis was made by tumour biopsy or fine-needle aspirate. Only dogs without prior treatment were included. Eosinophil, lymphocyte, monocyte and neutrophil concentration were obtained by ADVIA 2120™ (Siemens Healthcare, Vienna, Austria). Neutrophil-to-eosinophil ratio (NER), lymphocyte-to-monocyte ratio (LMR) and neutrophil-to-lymphocyte ratio (NLR) were calculated from collected leukocyte concentrations. Relative eosinophil concentration (REC), NER (P < 0.001), NLR (P = 0.001) and LMR (P < 0.001) were significant prognostic factors for outcome in univariate analysis. REC (P = 0.008) and NER (P = 0.001) remained independent predictors of survival in multiple analyses. Leukocyte concentrations and ratios, especially REC and NER may serve as prognostic indicators in MCT.
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Affiliation(s)
- O Skor
- Department for Companion Animals and Horses, University of Veterinary Medicine, Vienna, Austria
| | | | - A Tichy
- Department for Biomedical Sciences, University of Veterinary Medicine, Vienna, Austria
| | - M Kleiter
- Department for Companion Animals and Horses, University of Veterinary Medicine, Vienna, Austria
| | - I Schwendenwein
- Department for Pathobiology, University of Veterinary Medicine, Vienna, Austria
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van Lelyveld S, Warland J, Miller R, Maw H, Foale R, Goodfellow M, Dobson J. Comparison between Ki-67 index and mitotic index for predicting outcome in canine mast cell tumours. J Small Anim Pract 2015; 56:312-9. [DOI: 10.1111/jsap.12320] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Revised: 11/30/2014] [Accepted: 12/01/2014] [Indexed: 01/07/2023]
Affiliation(s)
- S. van Lelyveld
- Dovecote Veterinary Hospital; 5 Delven Lane, Derby Castle Donington Derby DE74 2LJ
- Davies Veterinary Specialists, Manor Farm Business Park; Higham Gobion, Hitchin Hertfordshire SG5 3HR
| | - J. Warland
- Department of Veterinary Medicine; University of Cambridge; Cambridge CB3 OES
| | - R. Miller
- Dick White Referrals, Station Farm; Six Mile Bottom Cambridgeshire CB8 0UH
| | - H. Maw
- Department of Veterinary Medicine; University of Cambridge; Cambridge CB3 OES
| | - R. Foale
- Dick White Referrals, Station Farm; Six Mile Bottom Cambridgeshire CB8 0UH
| | - M. Goodfellow
- Davies Veterinary Specialists, Manor Farm Business Park; Higham Gobion, Hitchin Hertfordshire SG5 3HR
| | - J. Dobson
- Department of Veterinary Medicine; University of Cambridge; Cambridge CB3 OES
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