Avaliação da fibrose tecidual e sua correlação com a malignidade em neoplasias mamárias caninas
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Data
2017-03-07
Autores
Toledo, Gabriela Noronha de [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
As neoplasias mamárias em cadelas são as neoplasias mais comuns e metade dos tumores apresentam classificação histopatológica maligna no momento do diagnóstico. Objetivou-se neste estudo avaliar a fibrose tecidual e correlação com a malignidade nas neoplasias mamárias em cadelas. Foram selecionadas 85 amostras de nódulos mamários que foram divididos em Grupo 1: neoplasias mamárias benignas (n = 21); Grupo 2: neoplasias mamárias malignas (n = 64). Foram preparados cortes histopatológicos com hematoxilina e eosina e tricômio de Masson para vizibilização de tecido conjuntivo e avaliação de fibrose tecidual por meio da análise do programa Image ProPlus versão 4.5. Foi realizada análise estatística pelo teste de Kruskal Wallis, correlação pelo teste de Pearson e com o valor da mediana da porcentagem de fibrose nos tumores malignos foi testada a sensibilidade, especificidade, valor preditivo positivo e negativo, acurácia do teste para diagnóstico de malignidade e relação entre a porcentagem de fibrose e probabilidade do diagnóstico ser maligno pela regressão logística binária com nível de significância de 5% para todos os testes. A idade mais frequente foi 10 anos e diversas raças foram encontradas com predomínio de fêmeas mestiças. As lesões mamárias não neoplásicas foram hiperplasia ductal (4) e lobular (6) e as neoplasias benignas foram: adenoma cístico (1), complexo (4) e tubular (2) e tumor misto benigno (4). As neoplasias malignas foram carcinoma complexo (7), de células escamosas (2), tubulopapilífero (18), sólido (13) in situ (3) e tumor misto maligno (21). O grau histopatológico mais frequente foi grau I (29) seguido do grau II (28) e III (7). A fibrose nas neoplasias mamárias malignas foi classificada como severa (45), moderada (14) e discreta (5). A análise estatística revelou diferença significativa (p = 0.0284) na porcentagem de fibrose em relação ao diagnóstico histopatológico das neoplasias mamárias. A mediana da porcentagem de fibrose nas neoplasias malignas foi de 58%. A prevalência foi de 75%, sensibilidade de 45%, especificidade de 86%, VPP de 90% e VPN de 34%. A verossimilidade positiva foi de 94%, a negativa foi de 24% e a acurácia do teste foi de 38%. Por meio da regressão logística binária estimou-se que a porcentagem de fibrose é preditiva da malignidade das neoplasias mamárias em 46% (p = 0,074). Concluiu-se que embora os dados revelados neste estudo não tenham certificado que a fibrose tecidual adjacente indica malignidade das neoplasias mamárias por si só, a presença de fibrose pode ser considerada notável como parâmetro de prognóstico histológico para as neoplasias mamárias em cadelas.
Breast neoplasms in bitches are the most common neoplasms and half of the tumors present malignant histopathological classification at the time of diagnosis. The objective of this study was to evaluate tissue fibrosis and the correlation with malignancy in mammary neoplasms in bitches. It was selected 85 samples of mammary nodules that were divided into Group 1: benign mammary neoplasms (n = 21); Group 2: malignant breast neoplasms (n = 64). Histopathological sections were prepared with hematoxylin and eosin and Masson's trichrome for the visualization of connective tissue and assessment of tissue fibrosis through the analysis of the Image ProPlus version 4.5 program. Statistical analysis was performed using the Kruskal-Wallis test, Pearson test correlation and the median percentage of fibrosis in malignant tumors. Sensitivity, specificity, positive and negative predictive value, test accuracy for malignancy diagnosis and relation between the percentage of fibrosis and the probability of diagnosis being malignant were tested by binary logistic regression with significance level of 5% for all tests. The most frequent age was 10 years and several races were found with predominance of mixed females. Non-neoplastic mammary lesions were ductal (4) and lobular hyperplasia (6) and benign neoplasms were: cystic (1), complex (4) and tubular (2) adenoma and benign mixed tumor (4). Malignant neoplasms were complex (7), squamous (2), tubulopapillary (18), solid (13) in situ carcinoma (3) and malignant mixed tumor (21). The most frequent histopathological grade was grade I (29) followed by grade II (28) and III (7). Fibrosis in malignant breast neoplasms was classified as severe (45), moderate (14), and discrete (5). Statistical analysis revealed a significant difference (p = 0.0284) in the percentage of fibrosis in relation to the histopathological diagnosis of breast neoplasms. The median percentage of fibrosis in malignant neoplasms was 58%. Prevalence was 75%, sensitivity 45%, specificity 86%, PPV 90% and NPV 34%. The positive verossimity was 94%, the negative was 24% and the accuracy of the test was 38%. By means of binary logistic regression it was estimated that the percentage of fibrosis is predictive of the malignancy of mammary neoplasms in 46% (p = 0.074). It was concluded that although the data revealed in this study did not certify that adjacent tissue fibrosis indicates malignancy of mammary neoplasms by itself, the presence of fibrosis can be considered as a parameter of histological prognosis for breast neoplasms in bitches
Breast neoplasms in bitches are the most common neoplasms and half of the tumors present malignant histopathological classification at the time of diagnosis. The objective of this study was to evaluate tissue fibrosis and the correlation with malignancy in mammary neoplasms in bitches. It was selected 85 samples of mammary nodules that were divided into Group 1: benign mammary neoplasms (n = 21); Group 2: malignant breast neoplasms (n = 64). Histopathological sections were prepared with hematoxylin and eosin and Masson's trichrome for the visualization of connective tissue and assessment of tissue fibrosis through the analysis of the Image ProPlus version 4.5 program. Statistical analysis was performed using the Kruskal-Wallis test, Pearson test correlation and the median percentage of fibrosis in malignant tumors. Sensitivity, specificity, positive and negative predictive value, test accuracy for malignancy diagnosis and relation between the percentage of fibrosis and the probability of diagnosis being malignant were tested by binary logistic regression with significance level of 5% for all tests. The most frequent age was 10 years and several races were found with predominance of mixed females. Non-neoplastic mammary lesions were ductal (4) and lobular hyperplasia (6) and benign neoplasms were: cystic (1), complex (4) and tubular (2) adenoma and benign mixed tumor (4). Malignant neoplasms were complex (7), squamous (2), tubulopapillary (18), solid (13) in situ carcinoma (3) and malignant mixed tumor (21). The most frequent histopathological grade was grade I (29) followed by grade II (28) and III (7). Fibrosis in malignant breast neoplasms was classified as severe (45), moderate (14), and discrete (5). Statistical analysis revealed a significant difference (p = 0.0284) in the percentage of fibrosis in relation to the histopathological diagnosis of breast neoplasms. The median percentage of fibrosis in malignant neoplasms was 58%. Prevalence was 75%, sensitivity 45%, specificity 86%, PPV 90% and NPV 34%. The positive verossimity was 94%, the negative was 24% and the accuracy of the test was 38%. By means of binary logistic regression it was estimated that the percentage of fibrosis is predictive of the malignancy of mammary neoplasms in 46% (p = 0.074). It was concluded that although the data revealed in this study did not certify that adjacent tissue fibrosis indicates malignancy of mammary neoplasms by itself, the presence of fibrosis can be considered as a parameter of histological prognosis for breast neoplasms in bitches
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Glândula mamária, Histopatologia, Oncologia veterinária