O rácio neutrófilo-linfócito como fator de prognóstico para melanomas da cavidade oral em cães
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2019
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O melanoma é uma neoplasia dos melanócitos, células que estão presentes em
diversas localizações, como a pele, mucosa oral e junções mucocutâneas do lábio e dos
dígitos. Esta é a neoplasia oral mais comum em cães, tendo por norma um comportamento
bastante agressivo.
Dada a natureza desta neoplasia, que na maioria dos casos apresenta um mau
prognóstico associado a um tempo de sobrevida curto mesmo com recurso a tratamento, nasce
a necessidade de dar uma resposta mais urgente no momento da sua suspeita quanto à
previsibilidade do seu comportamento.
De forma a perceber quais os fatores de prognóstico mais importantes no melanoma
e a sua relação com a sobrevida, realizou-se uma revisão sistemática da literatura, na qual se
pôde verificar que os fatores de prognóstico com maior frequência de avaliação são o índice
mitótico, o índice de Ki67 e a dimensão tumoral.
O presente trabalho tem como objetivo avaliar o significado prognóstico da resposta
inflamatória e imunitária do organismo, através do cálculo do rácio neutrófilo/linfócito no
momento do diagnóstico de melanoma oral, e perceber como se traduzem os resultados
obtidos no prognóstico e sobrevida dos animais.
Avaliaram-se então, os hemogramas de 16 cães diagnosticadas com melanoma oral,
obtendo-se assim uma mediana para o rácio neutrófilo/linfócito de 3,7. Esta mediana foi usada
como valor ‘cut-off’, que quando avaliado em relação à sobrevida, permitiu concluir que os
cães com um valor inferior a este, atingiram uma mediana de sobrevida de 13 meses,
enquanto que os cães com um rácio superior a este apresentarem uma mediana de sobrevida
de apenas 7 meses. Encontrando assim uma diferença estatisticamente significativa (p =
0,044) na comparação entre os 2 grupos, e concluindo que o rácio neutrófilo/linfócito possui
valor como indicador prognóstico neste estudo.
Melanoma is a neoplasm originating in menalocytes that are present in various locations, such as the skin, oral mucosa and mucocutaneous joints of the lip and digits. This is the most common oral neoplasia in dogs, with a very aggressive behavior. Given the nature of this neoplasm, which in most cases is presented with a poor prognosis associated with a short survival time even with treatment, the need arises to give a more urgent response at the time of its suspicion of the predictability of its behavior. In order to understand the most important prognostic factors in melanoma and its relation with survival, a systematic review of the literature was carried out, in which it was verified that the prognostic factors with higher frequency of evaluation are the mitotic index, Ki67 index and the tumor size. The present study aims to evaluate the prognostic significance of the inflammatory and immune response of the organism by calculating the neutrophil / lymphocyte ratio at the time the oral melanoma is diagnosed and to understand how the results obtained in the prognosis and survival are translated for the animals. Hemograms of 16 dogs diagnosed with oral melanoma were then evaluated, resulting in a median for the neutrophil / lymphocyte ratio of 3.7. This median was used as a cut-off value, which when evaluated in relation to survival, allowed to conclude that dogs with a lower value reached a median survival of 13 months, while dogs with a ratio higher than have a median survival of only 7 months. Finding a statistically significant difference (p = 0.044) in the comparison between the 2 groups, and concluding that the neutrophil / lymphocyte ratio was a useful prognostic indicator in this study.
Melanoma is a neoplasm originating in menalocytes that are present in various locations, such as the skin, oral mucosa and mucocutaneous joints of the lip and digits. This is the most common oral neoplasia in dogs, with a very aggressive behavior. Given the nature of this neoplasm, which in most cases is presented with a poor prognosis associated with a short survival time even with treatment, the need arises to give a more urgent response at the time of its suspicion of the predictability of its behavior. In order to understand the most important prognostic factors in melanoma and its relation with survival, a systematic review of the literature was carried out, in which it was verified that the prognostic factors with higher frequency of evaluation are the mitotic index, Ki67 index and the tumor size. The present study aims to evaluate the prognostic significance of the inflammatory and immune response of the organism by calculating the neutrophil / lymphocyte ratio at the time the oral melanoma is diagnosed and to understand how the results obtained in the prognosis and survival are translated for the animals. Hemograms of 16 dogs diagnosed with oral melanoma were then evaluated, resulting in a median for the neutrophil / lymphocyte ratio of 3.7. This median was used as a cut-off value, which when evaluated in relation to survival, allowed to conclude that dogs with a lower value reached a median survival of 13 months, while dogs with a ratio higher than have a median survival of only 7 months. Finding a statistically significant difference (p = 0.044) in the comparison between the 2 groups, and concluding that the neutrophil / lymphocyte ratio was a useful prognostic indicator in this study.
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Orientação: Lénio Ribeiro, Hugo Gregório
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MESTRADO INTEGRADO EM MEDICINA VETERINÁRIA, VETERINÁRIA, MEDICINA VETERINÁRIA, CANÍDEOS, CÃES, NEOPLASIAS, PROGNÓSTICOS, ANÁLISE DE SOBREVIVÊNCIA, VETERINARY MEDICINE, CANIDS, DOGS, PROGNOSIS, SURVIVAL ANALYSIS, PORTUGAL, PORTUGAL