Sensibilidade e especificidade do linfonodo sentinela axilar pós-quimioterapia neoadjuvante no câncer de mama avançado
Palavras-chave:
Neoplasias da mama, Biópsia do linfonodo sentinela, Quimioterapia neoadjuvante, Sensibilidade e especificidadeResumo
Objetivo: Avaliar a concordância dos achados histopatológicos em linfonodos sentinela e axilares, após quimioterapia neoadjuvante para câncer de mama avançado. Método: Por estudo prospectivo, clínico, foram comparados histopatologicamente grupos de linfonodos de 21 mulheres,
com câncer de mama em estádios III ou IV, submetidas a quimioterapia neoadjuvante, biópsia de
linfonodo sentinela pelo azul patente e mastectomia radical, no Hospital Universitário Oswaldo
Cruz, Recife, PE, de outubro de 2005 a outubro de 2006. Com o programa Statistical Package
for Social Sciences 13.0, empregaram-se: teste exato de Fisher em nível de significância de 5%,
teste Kappa e cálculos de concordância, sensibilidade, especificidade, valores preditivos positivo
e negativo, proporção de falso-negativos e positivos. Foram excluídas 7/28 (25%) pacientes por
impossibilidade de identificar linfonodo sentinela. Resultados: O número de linfonodos sentinela
excisados igualou-se a um (19/21; 90,5% pacientes) ou dois (2/21; 9,5% pacientes). As taxas de
concordância, falso-negativos, falso-positivos, sensibilidade e especificidade de células neoplásicas
em linfonodo sentinela, comparadas à dos axilares, foram: 71,4%, 38,5%, 12,5%, 61,5% e 87,5%,
respectivamente, com grau de concordância significativo (p = 0,027; к = 0,447). Conclusão: Ao ser
comparado a outros trabalhos, o presente estudo identificou menor taxa de concordância, maior
de falso-negativos e igual taxa de identificação, com baixa sensibilidade, alta especificidade e grau
de concordância significativo.
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Copyright (c) 2026 Sílvia Oliveira Bezerra, Antonio Simão dos Santos Figueira FIlho
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