Page 6 - Clinical Connections - Spring 2023

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Page 6 - Clinical Connections - Spring 2023
P. 6

RVC RESEARCH    STUDY    VETERINARY SERVICES       RVC.AC.UK
         Pathology

        STOMACH CANCER IN SMALL ANIMALS:
        THE IMPORTANCE OF AN EARLY DIAGNOSIS


        Alejandro Suarez-Bonnet, Lecturer in Comparative Pathology, Alexandros Chardas, Lecturer in
        Anatomic Pathology and Simon L Priestnall, Professor of Veterinary Anatomic Pathology
              ancer is a leading cause of death   gastric cancer, there is no definitive cause   Improving prognosis
              in companion animals. Animals will   so  far  identified  in  cats  and  dogs.  Both   Overall, after diagnosis, the median survival
        C succumb to the disease in cases   genetic and environmental factors are likely   times does not usually exceed three to four
        where treatment options are scarce or   to play a key role in its appearance and   months, but an early diagnosis plus surgical
        when a late diagnosis greatly reduces the   progression.                and  medical  treatment  (chemotherapy)
        possibilities to perform surgery or provide   Chronic gastritis has been reported to be   could extend the survival time up to four
        adequate medical treatment.         associated with the appearance of stomach   years. For this reason, an early diagnosis,
          Equally, as quality of life and veterinary   cancer  in  dogs.  Consequently, if  a  patient   as occurs in humans, is essential to improve
        care has improved in the last 40 years,   develops any of the previously described   the prognosis and expand the disease-free
        the  frequency  of  cancer  diagnosis  has   clinical signs a detailed clinical examination   period of patients with gastric cancer.
        soared,  and  consequently  our  patients   should be performed, which could include
        and  their  owners  require  a  proportionate   direct examination  of  the  mucosa  by
        response to provide a fast and accurate   endoscopy.
        histopathological diagnosis, facilitating the   At the time of the endoscopy, the
        best clinical decision-making process.   veterinary surgeon can observe the gastric
          Gastric (stomach) cancer is uncommon in   mucosa and appreciate any abnormalities,
        dogs and cats, but its true prevalence may   such as erosions, ulcerations or masses. If
        be higher because the disease produces   any morphological abnormality is observed,   Figure 2: A microscopic image of a canine
                                                                                 gastric carcinoma.
        non-specific  clinical  signs.  These  include,   the endoscope is used to take biopsies that
        chronic  intermittent  vomiting,  progressive   will allow the pathologist to diagnose what   The  RVC’s  Diagnostic  Pathology
        weight loss and poor appetite. Consequently,   kind of lesion is present and to differentiate   Service is keen to receive histopathological
        the diagnosis occurs when the disease is at   between a pure inflammatory process and a   samples, endoscopic biopsies, or full-
        an advanced stage.                  cancerous lesion.                   thickness biopsies from patients with clinical
          Researchers    have      identified   Unfortunately, gastric carcinomas can be   signs of gastrointestinal disease. Our team
        predispositions in certain breeds such as   difficult to diagnose as they may not form   of  board-certified  veterinary  pathologists
        rough  collies,  Staffordshire  bull  terriers,   a true ‘mass’, but rather tumour cells grow   has  an  international  reputation  in  the  field
        Chows, Belgian shepherds, Norwegian   directly in the layers beneath the surface   of oncologic pathology and gastrointestinal
        lundehunds, cairn terriers, and West   mucosa, which cannot be sampled with   disease,  reflected  in  the  publication
        Highland white terriers.            endoscopic samples. Where there is a   of   numerous   peer-review   scientific
          Although the incidence of this tumour   suspicion of cancer, based on examination   manuscripts.
        in  dogs  is  rare,  some  researchers  have   of  an  endoscopic  biopsy,  or  persistent   Recently  our  group  has  demonstrated
        reported increasing rates in recent years.   clinical signs, a full-thickness biopsy of the   that molecules of interest in human gastric
        Unlike in  humans,  where  infection  with   stomach wall taken surgically would be   cancer, such as 14-3-3σ and CD44, are also
        the bacteria  Helicobacter pylori has been   recommended.               overexpressed in canine gastric carcinomas.
        strongly  associated with  development  of                              These preliminary results pave the way to
                                                                                further investigate the development and use
                                                                                of drugs that specifically target 14-3-3σ and
                                                                                CD44 in dogs with gastric cancer. Until then,
                                                                                early  clinical  investigation  and  a  prompt
                                                                                diagnosis are key to improve the prognostic
                                                                                of such cases.
                                                                                 Our turnaround time for all routine
                                                                                samples is 48 hours from receipt of the
                                                                                specimen  into  the  laboratory.  The  report
                                                                                contains a full ‘board-style’ histological
                                                                                description, diagnosis and comment, which
                                                                                is tailored specifically to the case. We are
                                                                                always keen to follow up cases over the
                                                                                phone or by email.



                                                                                       For the Diagnostic Pathology Service,
                                                                                     please call:01707 666 208
         Figure 1: Endoscopic image of a gastric cancer. The normal stomach mucosa is pale pink, and the     Email:
         tumour, pointed by arrows, consists of an area of ulcer. Image courtesy of Dr Diego Casas Garcia  diagnosticlabs@rvc.ac.uk


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