RESUMO
OBJECTIVE: To describe the use of near-infrared angiography (NIRFA) to identify the vascularization of three canine axial pattern flaps (APFs) omocervical (OMO), thoracodorsal (THO), and caudal superficial epigastric (CSE); to establish a vascular fluorescence pattern (VFP) grading system; and to evaluate the effect of NIRFA on surgeon flap dimension planning compared to traditional landmark palpation (LP) and visualization assessments. STUDY DESIGN: Experimental study. ANIMALS: A total of 15 healthy, client-owned dogs. METHODS: Dogs were sedated and flap sites were clipped. LP-based margins were drawn and preinjection images were recorded. Indocyanine green (ICG) was administered and VFP images were recorded. VFP scores were determined by five surgeons. Margin alterations were performed based on NIRFA-ICG images. Altered measurements were compared between LP and NIRFA-ICG images. RESULTS: Vascularization of the CSE flap was most visible with NIRFA with VFP scores 4/4 for 13/15 dogs. Intersurgeon agreement for VFP grades was poorest for THO (ICC = 0.35) and intermediate for OMO (ICC = 0.49) flaps. Surgeons were more likely to adjust dimensions for CSE flaps relative to OMO (OR 17.3, 95% CI: 6.2, 47.8) or THO (25.5; 8.6, 75.7). CONCLUSION: Using a grading system, we demonstrated that the CSE flap was most visible. Surgeons were more likely to adjust the LP-CSE flap margins based on fluorescence patterns and were more likely to rely on LP when visualization scores were low. CLINICAL SIGNIFICANCE: NIRFA has possible applications identifying some direct cutaneous arteries of APFs and their associated angiosomes in real-time. Further investigation is indicated to study NIRFA's potential to improve patient specific APF planning.
RESUMO
The objective of this retrospective study was to evaluate the expression of receptor tyrosine kinases (RTKs) in canine adrenal tumors and correlate this expression with features of tumor aggressiveness and survival in dogs undergoing adrenalectomy. Forty-three canine adrenal tumors were evaluated for expression of c-kit, fms-like tyrosine kinase 3 (flt-3), platelet-derived growth factor receptor-ß (PDGFR-ß), and vascular endothelial growth factor receptor 2 (VEGFR2) using immunohistochemistry. Tumor RTK staining characteristics were compared to normal adrenals. Medical records were reviewed for data regarding patient outcome and tumor characteristics. Expression of c-kit, flt-3, PDGFR-ß, and VEGFR2 was detected in 26.9%, 92.3%, 96.2%, and 61.5% of cortical tumors and 0%, 63.2%, 47.4%, and 15.8% of pheochromocytomas, respectively. Expression of RTKs was not significantly increased when compared to normal adrenals and did not correlate with survival after adrenalectomy. Receptor tyrosine kinases are not overexpressed in canine adrenal tumors compared to normal adrenal tissue. Therapeutic inhibition of these receptors may still represent an effective approach in cases where receptor activation is present.
L'objectif de cette étude rétrospective était d'évaluer l'expression des récepteurs tyrosine kinases (RTKs) dans les tumeurs surrénales canines et de corréler cette expression avec des caractéristiques d'agressivité tumorale et de survie chez les chiens subissant une surrénalectomie.Quarante-trois tumeurs surrénales canines ont été évaluées pour l'expression de c-kit, de la tyrosine kinase 3 de type fms (flt-3), du récepteur du facteur de croissance dérivé des plaquettes-ß (PDGFR-ß) et du récepteur du facteur de croissance endothélial vasculaire 2 (VEGFR2) par immunohistochimie. Les caractéristiques de coloration de la tumeur RTK ont été comparées à celles des surrénales normales. Les dossiers médicaux ont été examinés pour les données concernant les résultats des patients et les caractéristiques de la tumeur. L'expression de c-kit, flt-3, PDGFR-ß et VEGFR2 a été détectée dans 26,9 %, 92,3 %, 96,2 % et 61,5 % des tumeurs corticales et 0 %, 63,2 %, 47,4 % et 15,8 % des phéochromocytomes, respectivement. L'expression des RTK n'était pas significativement augmentée par rapport aux surrénales normales et n'était pas corrélée avec la survie après surrénalectomie. Les récepteurs tyrosine kinases ne sont pas surexprimés dans les tumeurs surrénales canines par rapport au tissu surrénalien normal. L'inhibition thérapeutique de ces récepteurs peut encore représenter une approche efficace dans les cas où l'activation du récepteur est présente.(Traduit par Docteur Serge Messier).
