Indicadores prognósticos para mastocitomas: estudo morfométrico e imunoistoquímico / Prognostic indicators for mast cell tumors: a morphometric and immunohistochemical study
AUTOR(ES)
Ricardo de Francisco Strefezzi
DATA DE PUBLICAÇÃO
2007
RESUMO
Ninety-three canine cutaneous mast cell tumors, of 74 dogs, had their clinical history investigated. Among these, 25 cases were submitted to nuclear morphometric analysis on cytopathology slides stained by panoptic method and hematoxylin &eosin; and 28 cases were submitted to histopathologic grading and immunohistochemistry to evaluate KIT, BAX, Ki-67 e PCNA expressions, in order to identify the best prognostic indicators for this neoplasm. The nuclear cytomorphometric parameters used in the present study were: area, average-diameter and perimeter. The tumors were histologically classified as grades I (well differentiated), II (of intermediate differentiation) or III (poorly differentiated), as proposed by Patnaik, Ehler and MacEwen (1984). The results obtained by the indicators investigated were compared to the histopathologic grading, as well as to post-surgical survival times and mortality due to mast cell disease. Cytomorphometry was correlated with mortality and survival times in both staining methods. Among the immunohistochemical markers, Ki-67 and BAX expressions were efficient in predicting survival times and mortality due to mast cell tumors. KIT and PCNA expressions were not prognostic indicators for this tumor. The increases observed in the cytomorphometric parameters, and Ki-67 and BAX positive nuclei percentages were correlated with higher mortality rates and reduced post-surgical survival times. Finally, using the histopathologic grading system, we obtained the best results on histopathology, being this the most trustworhty method of this diagnostic panel. Our results presents a new grading system for canine cutaneous mast cell tumors, based on morphometric analysis on cytopathology slides, and confirm that immunohistochemical evaluation of Ki-67 and BAX expression may contribute to mast cell grading, leading to more accurate prognosis and treatment.
ASSUNTO(S)
sarcoma de mastócito immunohistochemistry morphometry cytology histopatologia histopathology imunoistoquímica mastocytoma morfometria citologia
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