Valor do exame citológico intraoperatório do linfonodo sentinela no câncer de mama
Palavras-chave:
Linfonodo sentinela, câncer de mama, citologiaResumo
Objetivo: Avaliar o valor do imprint citológico na análise intraoperatória do linfonodo sentinela (LS) em pacientes com câncer de mama. Métodos: Estudo de concordância para avaliação da técnica do imprint citológico como teste diagnóstico do LS no intraoperatório, entre pacientes com diagnóstico de câncer de mama, no período de janeiro de 2007 a janeiro de 2017. Resultados: Foram estudados 210 casos de pacientes com câncer de mama submetidas à citologia de impressão (IC) do linfonodo sentinela no intraoperatório, com idade entre 24 e 86 anos (média de 59 anos e mediana de 60 anos). A sensibilidade do estudo intraoperatório foi de 58,3% (IC95% 46,1–69,8) e a especificidade de 97,8% (IC95% 93,8–99,5). O valor preditivo positivo (VPP) foi de 93,3% (IC95% 81,7–98,6) e o valor preditivo negativo (VPN) de 81,8% (IC95% 75,1–87,4%). Das variáveis analisadas, a presença de macrometástase foi a única que aumentou significativamente a sensibilidade do imprint para 73,2% (IC95%, 59,7–84,2%), enquanto na micrometástase apresentou sensibilidade de apenas 6,3% (IC95% 0,2–30,2). Conclusão: A utilização do imprint citológico no estudo intraoperatório do LS apresentou boa acurácia na previsão do status axilar. Entretanto, é importante o pleno conhecimento, pelo cirurgião e patologista, do conjunto de variáveis clínicas e histológicas que podem influenciar a sensibilidade do método.
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Copyright (c) 2018 Talita Siemann Santos Pereira, Guilherme Loureiro Werneck, Henrique de Castro Rodrigues, Ana Helena Pereira Correia, Afrânio Coelho de Oliveira
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
