60例犬乳腺肿瘤病理组织学、手术及预后的调查与研究
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摘要
犬乳腺肿瘤是小动物临床常见的一种母犬肿瘤病,对犬的健康构成严重的威胁。本调查收集了2006～2010年期间上海地区60例犬乳腺肿瘤临床病例,经病史调查、临床症状检查获取个体资料,探讨其发病率与品种、年龄的相关性；通过手术治疗,探讨手术技术及预后效果；通过显微、超微病理组织学检查,进行病理组织诊断与分类,鉴别其良性与恶性,并提出治疗和预后建议。本试验获得以下结果：1调查上海几所宠物医院60例犬乳腺肿瘤病例,结果显示：犬乳腺肿瘤多发于京巴犬和西施犬(30.00%和26.67%),杂种犬也有较高的发病率(15.00%)；发病年龄多数为8-10岁,中老年犬发生乳腺肿瘤的危险性较高；一生未怀孕、未绝育、假孕及子宫蓄脓病史多发；多发于日粮以饭菜加肉类的饲喂方式(38.33%),而饲喂犬粮的发病率较低(13.33%)；发生部位主要为单个乳腺发病,多发于后腹对及腹股沟对乳腺(68.57%),由前胸对到腹股沟对,乳腺肿瘤的发生成递增趋势。
2外科手术摘除乳腺肿瘤样本31例,获取肿瘤组织样本,通过显微和超微观察,对其肿瘤组织、细胞及细胞器病理形态、病变类型及其严重程度加以分析。结果显示：31例乳腺肿瘤中良性肿瘤12例(38.7%),恶性肿瘤19例(61.8%)；良性中以乳腺纤维腺瘤为多发(16.13%),恶性中则以浸润性癌为多发(29.03%)。犬恶性乳腺肿瘤的超微结构主要表现为：细胞浆内细胞器增多特别是粗面内质网明显增多。核分裂相明显,形态不规则,严重畸形,核固缩明显,核膜不平滑。
3主要实施肿瘤手术疗法。对手术摘除技术予以改进。并对犬乳腺肿瘤性质(良性和恶性)、瘤体大小术后预后以及不同手术摘除方法(简单肿块摘除、单个乳腺摘除、区域乳腺摘除、一侧乳腺摘除)的术后预后进行调查分析。结果表明,随着肿瘤质量的增加,患犬术后不良的比例增大：25%(<50 g)、37.5%(50～100 g)、50%(100～200g)、57.1%(>200 g)。实施单侧乳腺切除术1例,术后康复；实施单个乳腺切除3例,康复2例(66.67%),实施区域乳腺肿瘤摘除术27例,康复12例(48.0%)。表明,实施单个乳腺切除术或单侧乳腺切除术对预后有一定影响。
In veterinary clinic, canine mammary tumor is a common type of tumors in female dogs which threatens the health of dogs. We collected 60 cases of this disease from shanghai area, and studied them about individual background to reveal correlations between the background and incidence; Tumor samples were collected from clinical cases which were treated with operation, and then analyzed at cytology, histology and ultra-microstructure level. The results were obtained in this study as follows:
1 60mammary tumor cases were collected at three small animal hospitals in Shanghai. Etiology was studied. Breeds at risk for developing mammary gland tumors included Pekingese, Shih Tzu, Germany Shepherds, Pomeranian and Poodle also had a high incidence rate. Incidence of Pekingese and Shih Tzu were 30.0% and 26.67%, respectively among these breeds. The age of dogs at diagnosis mostly ranged from 8 to 10 years old. Aged and middle aged dogs were at higher risk. Non-pregnant and intact dogs in life or dogs with pseudopregnancy, pyometra might significantly increase the incidence of mammary tumor. Dogs which fed with table scraps were at higher risk(38.33%), and those fed with commercial food were less affected (13.33%). Tumors occurred in a single mammary gland or several glands. The last two pairs of glands (the 4th and 5th glands) were affected the most commonly. After surgical treatment, we found the size of the mammary tumor was relative to patient's prognosis. And selection of single gland of mammectomy or total mammectomy aslo affected the prognosis.
2 Tumor specimens about 31 cases extirpated from surgical operations, were detected by the histopathological means. Pathologic morphological changes, types and degrees of mammary tumor were analyzed, which can supply to provide the types of mammary tumor and pathologic changes. The results showed that there were 12 benign cases (38.7%) and 19 malignant cases (61.8%) among 31 cases. The benign mammary tumors most included fibroadenoma (16.13%) and the malignant cases most were breast tuber-adenoma (29.03%). Structure of malignant mammary tumors mainly with electronmicroscopy showed that the intracytoplasmic organelle especially rough surfaced endoplasmic reticulum (RER) had obviously increased; There were obvious karyoschisis in nucleolus, and irregular even malformed form. The nucleoli were evidently pycnosis and the karyotheca were unsmooth. This article understand the pathological change of cells in the sub-cell (organelle) level, which can provide the diagnosis and the treatment basis to canine mammary tumor.
3 The surgical therapy weas mainly practiced in mammary tumors. The results of follow-up visit after operation showed that will have some influence on prognosis, which included the benign or malignant, the size of canine mammary tumor, and excising of partial or all mammary. The results showed the increasing ratio of inefficacy after tumor excision operation with the bigger tumors:25%(< 100 g),37.5%(50～100 g),50%(100～200 g),57.1%(>200 g). A dog recovered in a case of unilateral mastectomy; 2 dogs recovered (66.67%) in 3 cases of single mastectomy,12 dogs recovered (48.0%) in 27 cases of regional excision tumor. That indicated that single or unilateral mastectomy have effected on prognosis.
2外科手术摘除乳腺肿瘤样本31例,获取肿瘤组织样本,通过显微和超微观察,对其肿瘤组织、细胞及细胞器病理形态、病变类型及其严重程度加以分析。结果显示：31例乳腺肿瘤中良性肿瘤12例(38.7%),恶性肿瘤19例(61.8%)；良性中以乳腺纤维腺瘤为多发(16.13%),恶性中则以浸润性癌为多发(29.03%)。犬恶性乳腺肿瘤的超微结构主要表现为：细胞浆内细胞器增多特别是粗面内质网明显增多。核分裂相明显,形态不规则,严重畸形,核固缩明显,核膜不平滑。
3主要实施肿瘤手术疗法。对手术摘除技术予以改进。并对犬乳腺肿瘤性质(良性和恶性)、瘤体大小术后预后以及不同手术摘除方法(简单肿块摘除、单个乳腺摘除、区域乳腺摘除、一侧乳腺摘除)的术后预后进行调查分析。结果表明,随着肿瘤质量的增加,患犬术后不良的比例增大：25%(<50 g)、37.5%(50～100 g)、50%(100～200g)、57.1%(>200 g)。实施单侧乳腺切除术1例,术后康复；实施单个乳腺切除3例,康复2例(66.67%),实施区域乳腺肿瘤摘除术27例,康复12例(48.0%)。表明,实施单个乳腺切除术或单侧乳腺切除术对预后有一定影响。
In veterinary clinic, canine mammary tumor is a common type of tumors in female dogs which threatens the health of dogs. We collected 60 cases of this disease from shanghai area, and studied them about individual background to reveal correlations between the background and incidence; Tumor samples were collected from clinical cases which were treated with operation, and then analyzed at cytology, histology and ultra-microstructure level. The results were obtained in this study as follows:
1 60mammary tumor cases were collected at three small animal hospitals in Shanghai. Etiology was studied. Breeds at risk for developing mammary gland tumors included Pekingese, Shih Tzu, Germany Shepherds, Pomeranian and Poodle also had a high incidence rate. Incidence of Pekingese and Shih Tzu were 30.0% and 26.67%, respectively among these breeds. The age of dogs at diagnosis mostly ranged from 8 to 10 years old. Aged and middle aged dogs were at higher risk. Non-pregnant and intact dogs in life or dogs with pseudopregnancy, pyometra might significantly increase the incidence of mammary tumor. Dogs which fed with table scraps were at higher risk(38.33%), and those fed with commercial food were less affected (13.33%). Tumors occurred in a single mammary gland or several glands. The last two pairs of glands (the 4th and 5th glands) were affected the most commonly. After surgical treatment, we found the size of the mammary tumor was relative to patient's prognosis. And selection of single gland of mammectomy or total mammectomy aslo affected the prognosis.
2 Tumor specimens about 31 cases extirpated from surgical operations, were detected by the histopathological means. Pathologic morphological changes, types and degrees of mammary tumor were analyzed, which can supply to provide the types of mammary tumor and pathologic changes. The results showed that there were 12 benign cases (38.7%) and 19 malignant cases (61.8%) among 31 cases. The benign mammary tumors most included fibroadenoma (16.13%) and the malignant cases most were breast tuber-adenoma (29.03%). Structure of malignant mammary tumors mainly with electronmicroscopy showed that the intracytoplasmic organelle especially rough surfaced endoplasmic reticulum (RER) had obviously increased; There were obvious karyoschisis in nucleolus, and irregular even malformed form. The nucleoli were evidently pycnosis and the karyotheca were unsmooth. This article understand the pathological change of cells in the sub-cell (organelle) level, which can provide the diagnosis and the treatment basis to canine mammary tumor.
3 The surgical therapy weas mainly practiced in mammary tumors. The results of follow-up visit after operation showed that will have some influence on prognosis, which included the benign or malignant, the size of canine mammary tumor, and excising of partial or all mammary. The results showed the increasing ratio of inefficacy after tumor excision operation with the bigger tumors:25%(< 100 g),37.5%(50～100 g),50%(100～200 g),57.1%(>200 g). A dog recovered in a case of unilateral mastectomy; 2 dogs recovered (66.67%) in 3 cases of single mastectomy,12 dogs recovered (48.0%) in 27 cases of regional excision tumor. That indicated that single or unilateral mastectomy have effected on prognosis.
引文
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