Intraoperativni citološki otisak sentinelnih limfnih čvorova kod bolesnica sa karcinomom dojke: poređenje sa ledenim rezovima

  • Tatjana Ivković-Kapicl Oncology Institute of Vojvodina, Department for Pathology and Laboratory Medicine, Sremska Kamenica, Serbia
  • Ferenc Vicko University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
  • Milana Panjković University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
  • Zoran Radovanović University of Novi Sad Faculty of Medicine, Novi Sad, Serbia
  • Tijana Vasiljević Oncology Institute of Vojvodina, Department for Pathology and Laboratory Medicine, Sremska Kamenica, Serbia
  • Dragana Radovanović University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
  • Slavica Knežević-Ušaj Oncology Institute of Vojvodina, Department for Pathology and Laboratory Medicine, Sremska Kamenica, Serbia
DOI: https://doi.org/10.2298/VSP171120067I
Ključne reči: limfni čvorovi, stražarski, biopsija, dojka, neoplazme, intraoperativni period, dijagnostičke tehnike i procedure

Sažetak


Uvod/Cilj. Biopsija limfnog čvora stražara (engl. sentinel lymph node – SLN) je standardna procedura za intraoperativnu procenu statusa aksilarnih limfnih čvorova kod bolesnica sa karcinomom dojke koje imaju klinički negativne limfne čvorove pazušne jame. Pregled SLN se intraoperativno izvodi tehnikama ledenih rezova (engl. frozen section – FS), citološke evaluacije otiska (engl. touch imprint cytology – TIC) i metodom amplifikacije nukleinskih kiselina u jednom koraku. Cilj studije bio je da se uporede i procene pouzdanost i tačnost tehnike FS i TIC kao metoda za pregled SLN kod bolesnica sa karcinomom dojke. Metode. SLN, dobijeni od 101 bolesnice, intraoperativno su pregledani na FS bojenim hematoksilin-eozin (HE) bojenjem i citološkom analizom razmaza dobijenim otiskom limfnih čvorova. Rezultati citološke analize poređeni su sa FS nalazom i trajnim histološkim preparatima. Rezultati. Ukupan broj analiziranih SLN iznosio je 163, u proseku 1,6 (1–4) po bolesnici. Na definitivnim, parafinskim preparatima, metastaze u SLN ustanovljene su kod 19 (19%) bolesnica, dok kod 82 (81%) bolesnice u limfnim čvorovima nije bilo tumora. Senzitivnost i specifičnost za TIC iznosila je 73,7% i 99,3%, dok je za tehniku FS senzitivnost bila 84,2%, a specifičnost 100%. Pozitivna/negativna prediktivna vred­nost za TIC je iznosila 93,3%/96,6%, a za metodu FS 100%/97,9%. Zaključak. Naše iskustvo sa metodama TIC i FS u intraoperativnoj proceni statusa SLN kod bolesnica sa karcinomom dojke slično je rezultatima ranije objavljenih studija. Utvrđena je visoka specifičnost za obe metode, ali je senzitivnost tehnike TIC u detekciji metastaza u SLN nešto niža u odnosu na metodu FS. TIC metoda intraoperativnog pregleda SLN može predstavljati pouzdanu alternativu metodi FS zbog jednostavnosti i niske cene.

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Objavljeno
2021/08/19
Broj časopisa
Vol. 77 Br. 2 (2020): Vojnosanitetski pregled
Rubrika
Originalni članak