Abstract：
BACKGROUND: Fibroblasts and/or collagen fibrils have not been included in previous cytologic grading schemes of canine mast cell tumors (MCTs), and their association with biological behavior is broadly debated.
OBJECTIVE: This study aimed to evaluate the cytologic findings of canine MCT, with emphasis on the microenvironment, and propose a novel cytologic grading system correlated with mortality and histologic grade.
METHODS: Cytology smears of canine cutaneous MCTs were retrospectively reviewed and compared with their histopathologic counterparts using Cohen´s Kappa test. One-year survival rates were also compared with the cytologic and histopathologic variables using Pearson´s correlation test.
RESULTS: From 92 first-occurrence canine cutaneous MCTs, the five features most associated with mortality were selected for a new grading system. The five features were cytoplasmic granulation, fibroblast and/or collagen fibril concentrations, and the presence of mitotic figures, multinucleation, and karyomegaly. Among concordant histopathologic and cytologic cases (ie, the same grades using both systems), mortality rates were 2.6% (1/38) for low-grade and 71.4% (10/14) for high-grade cases (P < 0.001, chi-square). For false-negative and false-positive results, mortality rates were 33% (1/3) and 45% (5/11), respectively (P = 0.707).
CONCLUSIONS: Unlike the Camus cytologic grading system, the present amendment excluded binucleation and included fibroblasts and/ or collagen fibrils, which in higher concentrations were associated with increased survival and a low histopathologic grade. Cytologic grading with the inclusion of fibroblast and collagen fibril concentrations correlated with survival, as did the Camus cytologic and Kiupel histopathologic grades; however, further studies are needed to confirm the prognostic value of this novel cytologic grading scheme.
OBJECTIVE: This study aimed to evaluate the cytologic findings of canine MCT, with emphasis on the microenvironment, and propose a novel cytologic grading system correlated with mortality and histologic grade.
METHODS: Cytology smears of canine cutaneous MCTs were retrospectively reviewed and compared with their histopathologic counterparts using Cohen´s Kappa test. One-year survival rates were also compared with the cytologic and histopathologic variables using Pearson´s correlation test.
RESULTS: From 92 first-occurrence canine cutaneous MCTs, the five features most associated with mortality were selected for a new grading system. The five features were cytoplasmic granulation, fibroblast and/or collagen fibril concentrations, and the presence of mitotic figures, multinucleation, and karyomegaly. Among concordant histopathologic and cytologic cases (ie, the same grades using both systems), mortality rates were 2.6% (1/38) for low-grade and 71.4% (10/14) for high-grade cases (P < 0.001, chi-square). For false-negative and false-positive results, mortality rates were 33% (1/3) and 45% (5/11), respectively (P = 0.707).
CONCLUSIONS: Unlike the Camus cytologic grading system, the present amendment excluded binucleation and included fibroblasts and/ or collagen fibrils, which in higher concentrations were associated with increased survival and a low histopathologic grade. Cytologic grading with the inclusion of fibroblast and collagen fibril concentrations correlated with survival, as did the Camus cytologic and Kiupel histopathologic grades; however, further studies are needed to confirm the prognostic value of this novel cytologic grading scheme.
摘要：
背景：成纤维细胞和/或胶原纤维尚未被纳入犬肥大细胞肿瘤（MCT）的细胞学分级方案，它们与生物学行为的联系存在广泛争议。
目的：本研究旨在评估犬MCT的细胞学结果，强调微环境，并提出了一种与死亡率和组织学分级相关的新型细胞学分级系统。
方法：回顾性回顾了犬皮肤MCT的细胞学涂片，并使用Cohen'sKappa检验与组织病理学对照进行了比较。还使用Pearson相关性检验将一年生存率与细胞学和组织病理学变量进行了比较。
结果：来自92例首次出现的犬皮肤MCT，与死亡率最相关的5个特征被选择用于新的分级系统.五个特征是细胞质颗粒化，成纤维细胞和/或胶原蛋白原纤维浓度，有丝分裂图的存在，多核化,和核仁肿大。在一致的组织病理学和细胞学病例中（即，使用两个系统的相同等级)，低级别病例死亡率为2.6%(1/38),高级别病例死亡率为71.4%(10/14)(P<0.001,卡方).对于假阴性和假阳性结果，死亡率分别为33%(1/3)和45%(5/11),分别(P=0.707)。
结论：与Camus细胞学分级系统不同，本修正案排除了双核化，包括成纤维细胞和/或胶原纤维，在较高的浓度下，与存活率增加和组织病理学分级低相关。包含成纤维细胞和胶原纤维浓度的细胞学分级与存活相关，Camus细胞学和Kiupel组织病理学分级也是如此；然而，需要进一步的研究来证实这种新型细胞学分级方案的预后价值.
目的：本研究旨在评估犬MCT的细胞学结果，强调微环境，并提出了一种与死亡率和组织学分级相关的新型细胞学分级系统。
方法：回顾性回顾了犬皮肤MCT的细胞学涂片，并使用Cohen'sKappa检验与组织病理学对照进行了比较。还使用Pearson相关性检验将一年生存率与细胞学和组织病理学变量进行了比较。
结果：来自92例首次出现的犬皮肤MCT，与死亡率最相关的5个特征被选择用于新的分级系统.五个特征是细胞质颗粒化，成纤维细胞和/或胶原蛋白原纤维浓度，有丝分裂图的存在，多核化,和核仁肿大。在一致的组织病理学和细胞学病例中（即，使用两个系统的相同等级)，低级别病例死亡率为2.6%(1/38),高级别病例死亡率为71.4%(10/14)(P<0.001,卡方).对于假阴性和假阳性结果，死亡率分别为33%(1/3)和45%(5/11),分别(P=0.707)。
结论：与Camus细胞学分级系统不同，本修正案排除了双核化，包括成纤维细胞和/或胶原纤维，在较高的浓度下，与存活率增加和组织病理学分级低相关。包含成纤维细胞和胶原纤维浓度的细胞学分级与存活相关，Camus细胞学和Kiupel组织病理学分级也是如此；然而，需要进一步的研究来证实这种新型细胞学分级方案的预后价值.
