Anatomia patológica no diagnóstico do câncer: implicações para a prevenção quaternária

Autores

  • Matthieu Yver Marne La Vallée Public Hospital

DOI:

https://doi.org/10.5712/rbmfc10(35)1057

Palavras-chave:

Prevenção Quaternária, Patologia Cirúrgica, Neoplasias do Colo do Útero

Resumo

A anatomia patológica é a especialidade médica responsável pelo diagnóstico de câncer. Apesar de muito importante, a partir do desenvolvimento da oncologia, sua ligação com o sobrediagnóstico e sobretratamento permanece ainda pouco estudada. Apesar de grande midiatização, a biologia
molecular não trouxe muito progresso para a classificação dos tumores. Ao contrário, a aparição silenciosa de imunohistoquímica, no final da década de 1980, foi o que melhorou significativamente as classificações tumorais, a ponto de ser possível lançar dúvidas sobre os resultados de alguns ensaios clínicos desse período. Este artigo discute como o auge e o abuso da imunohistoquímica pode ter levado ao sobrediagnóstico. Ele também destaca que a padronização ISO 15189, assim como a complexidade de classificação tumoral, podem também contribuir para a indução do sobretratamento. Em suma, a leitura crítica e a compreensão dos laudos de patologia por parte dos médicos de família são essenciais. Portanto, os médicos de família não deveriam hesitar em discutir o diagnóstico de câncer com o patologista e, em alguns casos, também questionar a decisão do oncologista. Essa abordagem pode ser considerada uma ação de prevenção quaternária que pode prevenir o sobretratamento.

Downloads

Não há dados estatísticos.

Métricas

Carregando Métricas ...

Biografia do Autor

Matthieu Yver, Marne La Vallée Public Hospital

 

The author is a privileged observer. Working since 15 years as a surgical pathologist, he began his career as resident of JM Coindre, PhD, a famous international expert on sarcoma. After being assistant in the pathology department of St Louis hospital, Paris, he is now head of the pathology department of a public hospital in France. He has published several papers in Human Pathology. This article is the fruit of years of work experiences and doubts. The reading of the philosophes like Michel Foucault or Jean Baudrillard have been of high value to think about pathology more globally.

Referências

Tan SY, Brown J. Rudolph Virchow (1821-1902): “pope of pathology”. Singapore Med J. 2006;47(7):567-568. PMid:16810425.

Rosai J. Guiding the surgeon’s hand: the history of American surgical pathology. Washington, DC: Armed Forces Institute of Pathology, 1997.

Wick MR. Histochemistry as a tool in morphological analysis: a historical review. Ann Diagn Pathol. 2012;16(1):71-78. http://dx.doi.org/10.1016/j.anndiagpath.2011.10.010 PMid:22261397. DOI: https://doi.org/10.1016/j.anndiagpath.2011.10.010

Wikipedia. Ventana medical systems [cited 2014 Dec 20]. Available from: https://en.wikipedia.org/wiki/Ventana_Medical_Systems

Biz Tucson Special Report Ventana Medical Systems. 2012. [cited 2014 May 29]. Available from: http://issuu.com/mcserres/docs/special_report_ventana/1

Grimelius L. Methods in neuroendocrine histopathology, a methodological overview. Ups J Med Sci. 2008;113(3):243-260. http://dx.doi.org/10.3109/2000-1967-238 PMid:18991238. DOI: https://doi.org/10.3109/2000-1967-238

Welch HG, Black WC. Overdiagnosis in cancer. J Natl Cancer Inst. 2010;102(9):605-613.http://dx.doi.org/10.1093/jnci/djq099 PMid:20413742. DOI: https://doi.org/10.1093/jnci/djq099

Esserman LJ, Thompson IM, Reid B, Nelson P, Ransohoff DF, Welch HG, et al. Addressing overdiagnosis and overtreatment in cancer: a prescription for change. Lancet Oncol. 2014;15(6):234-242.http://dx.doi.org/10.1016/S1470-2045(13)70598-9 PMid:24807866. DOI: https://doi.org/10.1016/S1470-2045(13)70598-9

Esserman LJ, Thompson IM Jr, Reid B. Overdiagnosis and overtreatment in cancer: an opportunity for improvement. JAMA. 2013;310(8):797-798. http://dx.doi.org/10.1001/jama.2013.108415 PMid:23896967. DOI: https://doi.org/10.1001/jama.2013.108415

Cetin Y. Chromogranin A immunoreactivity and Grimelius’ argyrophilia. Anat Embryol (Berl). 1992;185(3):207-215. http://dx.doi.org/10.1007/BF00211819 PMid:1349463. DOI: https://doi.org/10.1007/BF00211819

Gatter KC, Alcock C, Heryet A, Mason DY. Clinical importance of analysing malignant tumours of uncertain origin with immunohistological techniques. Lancet. 1985;325(8441):1302-1305.http://dx.doi.org/10.1016/S0140-6736(85)92794-1 PMid:2860495. DOI: https://doi.org/10.1016/S0140-6736(85)92794-1

Sabath AP, Kiviat NB. Review: detection and classification of cervical neoplasia in the era of HPV. Pathology Case Review. 2010;15(4):101-140. http://dx.doi.org/10.1097/PCR.0b013e3181e711ff DOI: https://doi.org/10.1097/PCR.0b013e3181e711ff

McEvoy & Farmer. Anatomic pathology markets in the United States: excerpts from our new report. 2011. [cited 2014 Dec 18]. 20 p. Available from: http://www.mcevoyandfarmer-pathology.com/wp-content/uploads/2012/12/USPathReportContents.pdf. (US Pathology 2011 Report).

Kyrgiou M, Koliopoulos G, Martin-Hirsch P, Arbyn M, Prendiville W, Paraskevaidis E. Obstetric outcomes after conservative treatment for intraepithelial or early invasive cervical lesions: systematic review and meta-analysis. Lancet. 2006;367(9509):489-498. http://dx.doi.org/10.1016/S0140-6736(06)68181-6 PMid:16473126. DOI: https://doi.org/10.1016/S0140-6736(06)68181-6

Carrigg A, Teschendorf C, Amaro D, Weidner N, Tipps A, Shabaik A, et al. Examination of sources of diagnostic error leading to cervical cone biopsies with no evidence of dysplasia. Am J Clin Pathol. 2013;139(4):422-427.http://dx.doi.org/10.1309/AJCP6BSD0SNGQLHQ PMid:23525611. DOI: https://doi.org/10.1309/AJCP6BSD0SNGQLHQ

Rakha EA, Starczynski J, Lee AH, Ellis IO. The updated ASCO/CAP guideline recommendations for HER2 testing in the management of invasive breast cancer: a critical review of their implications for routine practice. Histopathology. 2014;64(5):609-615. http://dx.doi.org/10.1111/his.12357 PMid:24382093. DOI: https://doi.org/10.1111/his.12357

Pu X, Shi J, Li Z, Feng A, Ye Q. Comparison of the 2007 and 2013 ASCO/CAP evaluation systems for HER2 amplification in breast cancer. Pathol Res Pract. 2014;211(6):421-425.http://dx.doi.org/10.1016/j.prp.2014.09.010 PMid:25818873. DOI: https://doi.org/10.1016/j.prp.2014.09.010

The New York Times. Roche buying Ventana for $3.4 billion. 2008 Jan 22. [cited 2014 Sept 14]. Available from: http://www.nytimes.com/2008/01/22/business/worldbusiness/22iht-22rocheFW.9396266.html?_r=0

Tomáš Z. Accreditation in clinical laboratories. Biochemia Medica. 2010;20(2):215-220. http://dx.doi.org/10.11613/BM.2010.026 DOI: https://doi.org/10.11613/BM.2010.026

International Organization for Standardization (ISO). Frequently asked questions related to the A2LA ISO 15189 medical laboratory accreditation program [cited 2014 Nov 11]. Available from: http://www.a2la.org/faq/medical_15189.pdf

Lee EW, Deng FM, Melamed J, Mendrinos S, Das K, Hochman T, et al. Grading variability of urothelial carcinoma: experience from a single academic medical center. Can J Urol. 2014;21(4):7374-7378. PMid:25171282.

Roychowdhury M. Bladder Urothelial tumors - WHO / ISUP classification (2004). 2011. [cited 2015 jan. 12] Available from: http://www.pathologyoutlines.com/topic/bladderwhoisup.html

Oosterhuis JWA, Schapers RFM, Janssen-Heijnen MLG, Pauwels RPE, Newling DW, ten Kate F. Histological grading of papillary urothelial carcinoma of the bladder: prognostic value of the 1998 WHO/ISUP classification system and comparison with conventional grading systems. J Clin Pathol. 2002;55(12):900-905.http://dx.doi.org/10.1136/jcp.55.12.900 PMid:12461053. DOI: https://doi.org/10.1136/jcp.55.12.900

Khan MS, Luong TV, Watkins J, Toumpanakis C, Caplin ME, Meyer T. A comparison of Ki-67 and mitotic count as prognostic markers for metastatic pancreatic and midgut neuroendocrine neoplasms. Br J Cancer. 2013;108(9):1838-1845. http://dx.doi.org/10.1038/bjc.2013.156 PMid:23579216. DOI: https://doi.org/10.1038/bjc.2013.156

Armstrong S. A matter of life and death. Dundee: University Press; 2008. [cited 2014 May 29]. Available from: http://www.pathsoc.org/conversations/index.php

Shah AA, Frierson HF Jr, Cathro HP. Analysis of immunohistochemical stain usage in different pathology practice settings. Am J Clin Pathol. 2012;138(6):831-836.http://dx.doi.org/10.1309/AJCPAGVTCKDXKK0X PMid:23161717. DOI: https://doi.org/10.1309/AJCPAGVTCKDXKK0X

DiGiuseppe JA, Sauvageot J, Epstein JI. Increasing incidence of minimal residual cancer in radical prostatectomy specimens. Am J Surg Pathol. 1997;21(2):174-178.http://dx.doi.org/10.1097/00000478-199702000-00006 PMid:9042283. DOI: https://doi.org/10.1097/00000478-199702000-00006

Sandhu GS, Andriole GL. Overdiagnosis of prostate cancer. Am J Pathol. 1987;129(1):140-151. PMid:3310650.

Lund L, Svolgaard N, Poulsen MH. Prostate cancer: a review of active surveillance. Res Rep Urol. 2014;6:107-112. PMid:25202685. DOI: https://doi.org/10.2147/RRU.S41653

Raab SS. The cost-effectiveness of immunohistochemistry. Arch Pathol Lab Med. 2000;124(8):1185-1191. PMid:10923081.

Colin C, Devouassoux-Shisheboran M, Sardanelli F. Is breast cancer overdiagnosis also nested in pathologic misclassification? Radiology. 2014;273(3):652-655.http://dx.doi.org/10.1148/radiol.14141116 PMid:25420166. DOI: https://doi.org/10.1148/radiol.14141116

Publicado

2015-06-24

Como Citar

1.
Yver M. Anatomia patológica no diagnóstico do câncer: implicações para a prevenção quaternária. Rev Bras Med Fam Comunidade [Internet]. 24º de junho de 2015 [citado 28º de março de 2024];10(35):1-7. Disponível em: https://rbmfc.org.br/rbmfc/article/view/1057

Plaudit