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Master's Dissertation
DOI
10.11606/D.5.2005.tde-10102014-103659
Document
Author
Full name
Maria Cristina de Lorenzo Messina
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2005
Supervisor
Committee
Castro, Luiz Guilherme Martins (President)
Maruta, Celina Wakisaka
Moraes, Aparecida Machado de
Title in Portuguese
Análise da correlação entre tipos histológicos de carcinoma basocelular encontrados nas biópsias pré-operatórias e respectivas peças cirúrgicas
Keywords in Portuguese
Biópsia/classificação
Carcinoma basocelular/cirurgia
Carcinoma basocelular/patologia
Estudos retrospectivos
Técnicas histológicas//estatística & dados numéricos
Abstract in Portuguese
O carcinoma basocelular (CBC) é tumor constituído por diferentes tipos histológicos, que demonstram diverso potencial de agressividade. Sabe-se que a correlação entre os tipos histológicos de CBC encontrados no material de biópsia pré-operatória e no material da peça cirúrgica excisional não é total. Na literatura esta correlação varia de 42,7 a 80,0% quando analisados os tipos histológicos predominantes (THP). No presente estudo foi feita análise retrospectiva de 70 casos de CBC primário submetidos a biópsia préoperatória e cirurgia excisional. A amostra foi analisada estatisticamente quanto ao gênero e idade dos doentes e localização anatômica dos CBC, demonstrando ser comparável aos demais estudos da literatura. Também foram avaliados o tamanho médio tumoral e o tipo de reconstrução utilizado. A média do maior eixo dos CBC foi de 20 mm e 54% dos casos necessitaram reconstrução complexa, como retalhos e enxertos, mostrando ser amostra representativa de tumores de médio a grande porte. A avaliação histológica foi feita de modo padronizado, determinando tanto o THP quanto os tipos histológicos acessórios (THA) encontrados no material das biópsias pré-operatórias e nas peças cirúrgicas excisionais. Houve 78,3% de correlação entre THP da biópsia e peça cirúrgica, 87,0% de correlação entre THP e/ou THA da biópsia e THP da peça cirúrgica e 92,7% de correlação entre tipos agressivos ou não agressivos. Conclui-se que a biópsia préoperatória é útil para predizer o THP de CBC da peça cirúrgica excisional na maioria dos casos. No entanto, é importante ressaltar que, quando descrito apenas o THP encontrado na biópsia, ocorre 21,7% de falha no diagnóstico. Quando descritos THP e THA encontrados na biópsia a falha diagnóstica cai para 13%. Quando a intenção da biópsia for a determinação da presença de tipos de CBC agressivos ou não, a falha no diagnóstico é de apenas 7,3%
Title in English
Correlation between histological types of basal cell carcinoma found in preoperative biopsies and respective surgical specimens
Keywords in English
Basal cell carcinoma/pathology
Basal cell carcinoma/surgery
Biopsy/classification
Histological techniques/statistic & numeric data
Retrospective studies
Abstract in English
Basal cell carcinoma (BCC) is a tumor presenting many histological types, each one possessing a specific aggressivity potential. It's known that correlation between histological types found in preoperative biopsy specimens and excisional surgery specimens is not total. When correlation between predominant histological types (PHT) is analyzed, concordance value varies from 42,7 to 80,0% in the literature. In the present study 70 primary BCC submitted to preoperative biopsy and excisional surgery were retrospectively analyzed. The sample was statistically analyzed in terms of patients' gender and age and anatomical location of the tumour and was found to be similar to other reports in the literature. Average size of tumors and type of surgical reconstruction employed were also evaluated. Average size of the largest tumour axis was 20 mm and 54% of the cases needed complex reconstructions, such as flaps and grafts, demonstrating that the sample was represented by medium to large sized tumors. Histological evaluation was made in a patterned way, determining PHT and accessory histological types (AHT) in both preoperative biopsies and excisional surgery specimens. Results obtained were: 78.3% correlation between biopsy PHT and excisional surgery PHT, 87.0% correlation between biopsy PHT and/or AHT and excisional surgery PHT and 92.7% correlation when BCC were classified as "aggressive" or "non aggressive" . Conclusion: preoperative biopsy is useful to predict BCC's PHT of excisional surgery specimen in most cases. However, it's important to note that when biopsy findings are limited to the description of the PHT , there is a 21.7% diagnostic failure. When both PHT and AHT found in biopsy are described, diagnostic failure falls to 13%. When the intention is determining the presence of aggressive or non aggressive types of BCC, diagnostic failure is only 7.3%
 
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Publishing Date
2014-10-10
 
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