Teste de receptores de estrógeno e progesterona em carcinoma de mama
concordância dos resultados entre laboratórios locais e de referência no Brasil
Palavras-chave:
Neoplasias da mama, Receptores estrogênicos, Receptores de progesterona, Imunoistoquímica, BrasilResumo
CONTEXTO E OBJETIVO: O carcinoma de mama é responsável por cerca de um quarto de todos os cânceres em mulheres. O teste de receptores de estrógeno e progesterona se tornou parte essencial da avaliação clínica de pacientes com carcinoma de mama; assim, resultados precisos são fundamentais para identificação de pacientes que podem se beneficiar da terapia hormonal. O presente estudo tem por objetivo investigar a concordância nos resultados do teste de receptores hormonais entre um laboratório referência e laboratórios locais (ou comunitários) do Brasil. TIPO DE ESTUDO E LOCAL: Estudo retrospectivo em laboratório referência em patologia no Brasil. MÉTODOS: A concordância nos resultados dos testes de receptores hormonais entre um laboratório referência e 146 diferentes laboratórios locais brasileiros foi comparada em 500 casos de carcinoma invasivo de mama através da imunoistoquímica. RESULTADOS: Houve concordância de 89,4% (447/500 casos) e 85,0% (425/500 casos) nos resultados dos testes de receptores de estrógeno (k = 0,744, P < 0,001) e progesterona (k = 0,688, P < 0,001), respectivamente, entre laboratórios locais e referência, similar à descrita em outros países. A taxa de resultados falso-negativos nos testes de receptores de estrógeno e progesterona em laboratórios locais foi de 8,7% e 14,4%, respectivamente. A taxa de resultados falso-positivos nos testes de receptores de estrógeno e progesterona em laboratórios locais foi de 15,5% e 16,0%, respectivamente. CONCLUSÃO: Questões técnicas e de interpretação dos resultados podem explicar a maior parte das discordâncias nos testes de receptores hormonais em laboratórios locais. A validação dos testes de receptores de estrógeno e progesterona pelos laboratórios locais com medidas de controle de qualidade rigorosas é fortemente recomendada de modo a evitar o tratamento errôneo de pacientes com carcinoma de mama.
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