Vrednost citologije tehnikom četkice i biopsije u dijagnozi kolorektalnog karcinoma

  • Željka N. Tatomirović 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; University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia.
  • Ivana Tufegdžić Military Medical Academy, Institute of Pathology and Forensic Medicine; University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia.
  • Ljiljana Tomić Military Medical Academy, Institute of Pathology and Forensic Medicine.
  • Jelena Džambas Military Medical Academy, Institute of Pathology and Forensic Medicine.
  • Dino Tarabar Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia; Military Medical Academy, Clinic for Gastroenterology and Hepatology, Belgrade, Serbia.
DOI: https://doi.org/10.2298/VSP160112115T
Ključne reči: colorectal neoplasms||, ||kolorektalne neoplazme, adenocarcinoma||, ||adenokarcinom, diagnosis||, ||dijagnoza, biopsy||, ||biopsija, cytological techniques||, ||citološke tehnike, sensitivity and specificity||, ||senzitivnost i specifičnost,

Sažetak


Uvod/Cilj. Iako je dobro poznat visok senzitivitet citologije tehnikom četkice u dijagnozi kolerektalnog karcinoma, ova vrsta dijagnostike nije u rutinskoj upotrebi, a poslednjih godina je čak i u padu. Cilj ove studije bila je procena vrednosti citologije tehnikom četkice u dijagnozi kolorektalnog karcinoma, poređenjem rezultata ove citološke tehnike i biopsije, a zatim rezultata obe ove dijagnostičke metode sa konačnom patohistološkom dijagnozom resektata creva. Metode. U ovu retrospektivnu studiju bila su uključena 173 bolesnika sa citološkim uzorcima lezije kolorektalne regije, uzetim tokom kolonoskopije. Kod 166 bolesnika urađena je i biopsija, a kod 116 i reseksija creva. Ukupno 106 bolesnika imalo je sve tri dijagnostičke procedure. Rezultati. Od 166 bolesnika koji su imali i citološke i biopsijske uzorke, dijagnoze su se slagale kod njih 129 (77,7%): kod 109 (65,7%) dijagnostikovan je adenokarcinom, što je potvrđeno na resektatu creva kod 75 bolesnika, a kod 14 (8,4%) dijagnostikovana je benigna lezija, tako da nije bilo potrebe za resekcijom creva. Kod 6 (3,6%) bolesnika, i citologija i biopsija su bile negativne, ali je resektat bio maligan. Kod 10 bolesnika s malignom citologijom kojima nije rađena i biopsija, resekcijom creva potvrđen je malignitet. Senzitivnost detekcije maligniteta citologijom iznosila je 87,9%, a biopsijom 78,3% (ali ova rezlika nije dosegla i statističku značajnost, p = 0,083). Obe metode imale su specifičnost i pozitivnu prediktivnu vrednost 100%. Negativna prediktivna vrednost za citologiju iznosila je 50%, a za biopsiju 37,8%. Tačnost citologije bila je 89,2%, a biopsije 80,8%. Kombinacija rezultata citologije i biopsije povećala je senzitivitet preoperativne dijagnostike na 94,8%, što je statistički značajno više od senzitiviteta biopsije (p < 0,001), ali ne i od senzitiviteta citologije (p = 0,102). Zaključak. Obe metode imaju komparabilne i senzitivitet i tačnost. Njihovom kombinacijom povećava se senzitivnost preoperativne dijagnostike kolorektalnog adenokarcinoma, a time dobija i bolja mogućnost procene daljeg dijagnostičkog i terapijskog pristupa.

Biografija autora

Željka N. Tatomirović, Military Medical Academy, Institute of Pathology and Forensic Medicine, Belgrade, Serbia; University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia
Odsek za citologiju, vanredni profesor

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Objavljeno
2017/07/07
Broj časopisa
Vol. 74 Br. 7 (2017)
Rubrika
Originalni članak