Korelacija citološke i histopatološke dijagnoze nemikrocelularnog karcinoma pluća i tačnost citologije u dijagnostici karcinoma pluća

  • Jelena Džambas Military Medical Academy, Institute of Pathology and Forensic Medicine, Belgrade, Serbia; University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia
  • Ivan Aleksić Military Medical Academy, Institute of Pathology and Forensic Medicine, Belgrade, Serbia; University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia
  • Vesna Škuletić Military Medical Academy, Institute of Pathology and Forensic Medicine, Belgrade, Serbia; University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia
  • Snežana Cerović Military Medical Academy, Institute of Pathology and Forensic Medicine, Belgrade, Serbia; University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia
  • Dragana Tegeltija Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia; University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
DOI: https://doi.org/10.2298/VSP200618117D
Ključne reči: biopsija;, bronhoskopija;, pluća, nesitnoćelijski karcinom;, citološke tehnike;, histološke tehnike;, prognoza;, senzitivnost i specifičnost.

Sažetak


Uvod/Cilj. Karcinom pluća je jedan od najučestalijih karcinoma u svetu. Kod više od 70% bolesnika dijagnostikuje se u odmaklim stadijumima bolesti kada su terapijske mogućnosti ograničene i zasnovane na dijagnozi citološkog ili patohistološkog materijala. Kod novih personalizovanih vidova terapije veliki je značaj citologije u dijagnostici i subtipizaciji nemikrocelularnih karcinoma pluća (non-small cell lung cancer – NSCLC). Cilj rada bio je da se utvrdi podudarnost između citološke dijagnoze NSCLC i patohistološke dijagnoze, kao i tačnost, senzitivnost, specifičnost, i pozitivni i negativni prognostički značaj citologije u dijagnostici karcinoma pluća. Metode. Istraživanje je sprovedeno kao retrospektivno i obuhvatilo je 169 bolesnika kojima je tokom dve godine dijagnostikovan NSCLC na citološkom uzorku, pri čemu su bolesnici istovremeno imali i uzorak male biopsije, kao i hirurški uzorak za patohistološku dijagnostiku, čije dijagnoze su upoređivane sa citološkom dijagnozom.


Patohistološka dijagnoza na hirurškim uzorcima bila je zlatni standard za utvrđivanje podudarnosti između citološke dijagnoze NSCLC i patohistološke dijagnoze, kao i tačnosti, senzitivnosti, specifičnosti, pozitivnog i negativnog prognostičkog značaja citologije kao metode u dijagnostici karcinoma pluća. Rezultati. U istraživanje je bilo uključeno 129 (76,3%) muškaraca i 40 (23,7%) žena, starosti između 39 i 83 godina, prosečno 62,53 ± 7,6. Nije bilo statistički značajne razlike u starosti bolesnika različitog pola (p = 0,207). Među citološkim dijagnozama najčešći je bio NSCLC kod 99 (58,58%) bolesnika. Podudarnost između citoloških i patohistoloških dijagnoza bila je prisutna kod 61,48% bolesnika. Nije bilo statistički značajne razlike između citoloških i patohistoloških dijagnoza materijala male biopsije (p = 0,856). Citologija, kao dijagnostička metoda za karcinom pluća pokazala je senzitivnost 94,98%, specifičnost 98,60%, pozitivni prognostički značaj 95,72%, negativni prognostički značaj 98,35% i tačnost 97,71%. Zaključak. Citološka dijagnostika NSCLC je tačna, visoko senzitivna i specifična i korisna za bolesnike. Kod većine bolesnika dijagnoza se postavlja u odmaklom stadijumu bolesti, kada je karcinom inoperabilan, a jedini dostupni materijal za postavljanje dijagnoze je mala količina materijala dobijeng tokom bronhoskopije.

 

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Objavljeno
2022/05/20
Broj časopisa
Vol. 79 Br. 4 (2022)
Rubrika
Originalni članak