Citología como predictor de la respuesta al tratamiento en cáncer diferenciado de tiroides
DOI:
https://doi.org/10.53591/10.53591revfcm.v4i1.2158Palabras clave:
citología tiroidea, cáncer diferenciado de tiroides, respuesta al tratamientoResumen
Introducción: El carcinoma diferenciado de tiroides (CDT) son neoplasias que se derivan de las células foliculares, representando más del 90,6% de neoplasias en tiroides. La citología tiroidea por punción es un procedimiento para el diagnóstico y decisión del tratamiento; sin embargo, es poco lo que conocemos cuando la relacionamos con la respuesta inicial al tratamiento.
Objetivo: Demostrar la relación entre la citología por punción aspiración con aguja fina de tiroides y la respuesta al tratamiento en cáncer diferenciado de tiroides.
Metodología: Estudio descriptivo, relacional, no experimental de corte transversal; en pacientes con CDT del hospital de Especialidades Guayaquil “Dr. Abel Gilbert Pontón” en el 2018 y 2019.
Resultados: se evaluó a 163 pacientes, el grupo etario más frecuente fue de 40 a 49 años (28,8%), las mujeres alcanzaron un 91,4%, la categoría Bethesda VI un 52,8%, el carcinoma papilar un 95,1%; el riesgo de recurrencia intermedio un 41,1%, y la respuesta excelente un 46,6%. Al comparar el riesgo de recurrencia y la respuesta al tratamiento, el bajo riesgo tuvo respuesta excelente en el 58,5%, y alto riesgo una respuesta estructural incompleta en un 45,2%. Además, al asociar la categoría Bethesda II con una respuesta excelente, se presentó dicha asociación en un 88,2%, con significancia estadística.
Conclusión: La citología tiroidea se relaciona con la respuesta inicial al tratamiento, en donde Bethesda II se asocia a una respuesta excelente de manera directa, con alta intensidad y con un nivel de predicción moderado.
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Ali, S. Z. (2017). The Bethesda system for reporting thyroid cytopathology: Definitions, criteria, and explanatory notes. New York, NY: Springer Science+Business Media.
Amin, M. B., Greene, F. L., Edge, S. B., Compton, C. C., Gershenwald, J. E., Brookland, R. K., … Winchester, D. P. (2017). The Eighth Edition AJCC Cancer Staging Manual: Continuing to build a bridge from a population-based to a more “personalized” approach to cancer staging: The Eighth Edition AJCC Cancer Staging Manual. CA: A Cancer Journal for Clinicians, 67(2), 93-99. https://doi.org/10.3322/caac.21388
Araque, K. A., Gubbi, S., y Klubo-Gwiezdzinska, J. (2020). Updates on the Management of Thyroid Cancer. Hormone and Metabolic Research = Hormon- Und Stoffwechselforschung = Hormones Et Metabolisme, 52(8), 562-577. https://doi.org/10.1055/a-1089-7870
Asa, S. L. (2019). The Current Histologic Classification of Thyroid Cancer. Endocrinology and Metabolism Clinics of North America, 48(1), 1-22. https://doi.org/10.1016/j.ecl.2018.10.001
Blum, M. (2020). Ultrasonography of the Thyroid. En K. R. Feingold, B. Anawalt, A. Boyce, G.
Chrousos, W. W. de Herder, K. Dhatariya, … D. P. Wilson (Eds.), Endotext. South Dartmouth (MA): MDText.com, Inc. Recuperado de http://www.ncbi.nlm.nih.gov/books/NBK285555/
Cabanillas, M. E., McFadden, D. G., y Durante, C. (2016). Thyroid cancer. The Lancet, 388(10061), 2783- 2795. https://doi.org/10.1016/S0140-6736(16)30172-6
Ciarallo, A., y Rivera, J. (2020). Radioactive Iodine Therapy in Differentiated Thyroid Cancer: 2020 Update. AJR. American Journal of Roentgenology, 215(2), 285-291. https://doi.org/10.2214/AJR.19.22626
Cibas, E. S., y Ali, S. Z. (2017). The 2017 Bethesda System for Reporting Thyroid Cytopathology. Thyroid: Official Journal of the American Thyroid Association, 27(11), 1341-1346. https://doi.org/10.1089/thy.2017.0500
Curado, M., Edwards, W., Shin, H., Storm, H., Ferlay, J., Heanue, M., y Boyle, P. (2007). Cancer Incidence in Five Continents Volume IX. Lyon: ARC scientific publications no. 160. Recuperado de https://publications.iarc.fr/Book-And-Report-Series/Iarc-Scientific-Publications/Cancer-Incidence-In-Five-Continents-Volume-IX-2007
Dean, D. S., y Gharib, H. (2015). Fine-Needle Aspiration Biopsy of the Thyroid Gland. En K. R. Feingold, B. Anawalt, A. Boyce, G. Chrousos, W. W. de Herder, K. Dhatariya, … D. P. Wilson (Eds.), Endotext. South Dartmouth (MA): MDText.com, Inc. Recuperado de http://www.ncbi.nlm.nih.gov/books/NBK285544/
Domanski, H. A. (2007). Fine-needle aspiration cytology of soft tissue lesions: Diagnostic challenges. Diagnostic Cytopathology, 35(12), 768-773. https://doi.org/10.1002/dc.20765
Domanski, H. A. (2019). Atlas of fine needle aspiration cytology.
Ferlay, J., Steliarova-Foucher, E., Lortet-Tieulent, J., Rosso, S., Coebergh, J. W. W., Comber, H., … Bray, F. (2013). Cancer incidence and mortality patterns in Europe: Estimates for 40 countries in 2012. European Journal of Cancer (Oxford, England: 1990), 49(6), 1374-1403. https://doi.org/10.1016/j.ejca.2012.12.027
García, M. G., Takahashi, A. M. L., y Huerta, F. J. G. (2014). Cáncer diferenciado de tiroides: Una antigua enfermedad con nuevos conocimientos. Gaceta Médica de México., 13.
Haugen, B. R., Alexander, E. K., Bible, K. C., Doherty, G. M., Mandel, S. J., Nikiforov, Y. E., … Wartofsky, L. (2016). 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid, 26(1), 1-133. https://doi.org/10.1089/thy.2015.0020
Jeon, M. J., Kim, W. G., Park, W. R., Han, J. M., Kim, T. Y., Song, D. E., … Kim, W. B. (2014). Modified dynamic risk stratification for predicting recurrence using the response to initial therapy in patients with differentiated thyroid carcinoma. European Journal of Endocrinology, 170(1), 23-30. https://doi.org/10.1530/EJE-13-0524
Kilfoy, B. A., Zheng, T., Holford, T. R., Han, X., Ward, M. H., Sjodin, A., … Zhang, Y. (2009). International patterns and trends in thyroid cancer incidence, 1973–2002. Cancer causes & control : CCC, 20(5), 525- 531. https://doi.org/10.1007/s10552-008-9260-4
Kleiman, D. A., Beninato, T., Soni, A., Shou, Y., Zarnegar, R., y Fahey, T. J. (2013). Does Bethesda Category Predict Aggressive Features in Malignant Thyroid Nodules? Annals of Surgical Oncology, 20(11), 3484-3490. https://doi.org/10.1245/s10434-013-3076-5
Leenhardt, L., Bernier, M. O., Boin-Pineau, M. H., Conte Devolx, B., Maréchaud, R., Niccoli-Sire, P., … De Vathaire, F. (2004). Advances in diagnostic practices affect thyroid cancer incidence in France. European Journal of Endocrinology, 150(2), 133-139. https://doi.org/10.1530/eje.0.1500133
Lima, A. R. L. R., Medeiros, K. M. M. de, Parente, C. de M. R. V., Caldas, A. de S., Faria, M. dos S., Magalhães, M., y Sobral, C. S. P. (2019). Does the Bethesda category predict aggressive features in differentiated thyroid cancer? Archives of Endocrinology and Metabolism, 63(1), 12-15. https://doi.org/10.20945/2359-3997000000098
Liu, X., Medici, M., Kwong, N., Angell, T. E., Marqusee, E., Kim, M. I., … Alexander, E. K. (2016). Bethesda Categorization of Thyroid Nodule Cytology and Prediction of Thyroid Cancer Type and Prognosis. Thyroid, 26(2), 256-261. https://doi.org/10.1089/thy.2015.0376
López Gavilanez, E., Bautista Litardo, N., Navarro Chávez, M., Hernández Bonilla, M., y Segale Bajaña, A. (2020). Thyroid cancer in Ecuador. BMC Cancer, 20(1), 637. https://doi.org/10.1186/s12885-020-07137-0
López Gavilanez, E. L., Guerrero Franco, K., Segale Bajaña, A., Bautista Litardo, N., Navarro Chávez, M., Bonilla, M. H., … loor Goya, M. (2018). Trends of Thyroid Cancer Mortality Rates in Ecuador. Journal of Endocrinology and Diabetes, 5(5), 1-6. https://doi.org/10.15226/2374-6890/5/5/001114
Luster, M., Duntas, L., y Wartofsky, L. (Eds.). (2019). The thyroid and its diseases: A comprehensive guide for the clinician. Cham, Switzerland: Springer.
Momesso, D. (2019). Clinical risk predictors for differentiated thyroid cancer management: What is new? Archives of Endocrinology and Metabolism, 63(1), 2-4. https://doi.org/10.20945/2359-3997000000110
Momesso, D. P., Vaisman, F., Yang, S. P., Bulzico, D. A., Corbo, R., Vaisman, M., y Tuttle, R. M. (2016). Dynamic Risk Stratification in Patients with Differentiated Thyroid Cancer Treated Without Radioactive Iodine. The Journal of Clinical Endocrinology & Metabolism, 101(7), 2692-2700. https://doi.org/10.1210/jc.2015-4290
Nardi, F., Basolo, F., Crescenzi, A., Fadda, G., Frasoldati, A., Orlandi, F., … Vitti, P. (2014). Italian consensus for the classification and reporting of thyroid cytology. Journal of Endocrinological Investigation, 37(6), 593-599. https://doi.org/10.1007/s40618-014-0062-0 National Cancer Institute U.S. (2021). Thyroid Cancer—Cancer Stat Facts. Recuperado 25 de octubre de 2021, de https://seer.cancer.gov/statfacts/html/thyro.html
Organisation mondiale de la santé, y Centre international de recherche sur le cancer (Eds.). (2017). WHO classification of tumours of endocrine organs (4th ed). Lyon: International agency for research on cancer.
Pacini, F., Basolo, F., Bellantone, R., Boni, G., Cannizzaro, M. A., De Palma, M., … Vitti, P. (2018). Italian consensus on diagnosis and treatment of differentiated thyroid cancer: Joint statements of six Italian societies. Journal of Endocrinological Investigation, 41(7), 849-876. https://doi.org/10.1007/s40618-018-0884-2
Pacini, Furio, y DeGroot, L. J. (2013). Thyroid Cancer. En K. R. Feingold, B. Anawalt, A. Boyce, G. Chrousos, W. W. de Herder, K. Dhatariya, … D. P. Wilson (Eds.), Endotext. South Dartmouth (MA): MDText.com, Inc. Recuperado de http://www.ncbi.nlm.nih.gov/books/NBK285559/
Pemayun, T. G. D. (2016). Current Diagnosis and Management of Thyroid Nodules. Acta Medica Indonesiana, 48(3), 247-257.
Perrier, N. D., Brierley, J. D., y Tuttle, R. M. (2018). Differentiated and anaplastic thyroid carcinoma: Major changes in the American Joint Committee on Cancer eighth edition cancer staging manual: Differentiated and Anaplastic Thyroid Carcinoma: AJCC Staging Manual Eighth Edition Changes. CA: A Cancer Journal for Clinicians, 68(1), 55-63. https://doi.org/10.3322/caac.21439
Pitoia, F., y Schmidt, A. (2019). La respuesta excelente al tratamiento en pacientes con cáncer diferenciado de tiroides se mantiene a lo largo del seguimiento independientemente del riesgo de recurrencia inicial. Rev. argent. endocrinol. metab, 40-49. Rm, T., B, H., y Nd, P. (2017). Updated American Joint Committee on Cancer/Tumor-Node-Metastasis Staging System for Differentiated and Anaplastic Thyroid Cancer (Eighth Edition): What Changed and Why? Thyroid : official journal of the American Thyroid Association, 27(6). https://doi.org/10.1089/thy.2017.0102
Schmidbauer, B., Menhart, K., Hellwig, D., y Grosse, J. (2017). Differentiated Thyroid Cancer— Treatment: State of the Art. International Journal of Molecular Sciences, 18(6), 1292. https://doi.org/10.3390/ijms18061292
Siegel, R., Ma, J., Zou, Z., y Jemal, A. (2014). Cancer statistics, 2014. CA: A Cancer Journal for Clinicians, 64(1), 9-29. https://doi.org/10.3322/caac.21208
Sierra, M. S., Soerjomataram, I., y Forman, D. (2016). Thyroid cancer burden in Central and South America. Cancer Epidemiology, 44, S150-S157. https://doi.org/10.1016/j.canep.2016.07.017
Solis-Pazmino, P., Salazar-Vega, J., Lincango-Naranjo, E., Garcia, C., Koupermann, G. J., Ortiz-Prado, E., … Brito, J. P. (2021). Thyroid cancer overdiagnosis and overtreatment: A cross- sectional study at a thyroid cancer referral center in Ecuador. BMC Cancer, 21(1), 42. https://doi.org/10.1186/s12885-020-07735-y
Tepeoğlu, M., Bilezikçi, B., y Bayraktar, S. G. (2014). A histological assessment of the Bethesda system for reporting thyroid cytopathology (2010) abnormal categories: A series of 219 consecutive cases. Cytopathology, 25(1), 39-44. https://doi.org/10.1111/cyt.12051
Thompson, L. D. (2016). Ninety-four cases of encapsulated follicular variant of papillary thyroid carcinoma: A name change to Noninvasive Follicular Thyroid Neoplasm with Papillary-like Nuclear Features would help prevent overtreatment. Modern Pathology, 29(7), 698-707. https://doi.org/10.1038/modpathol.2016.65
Trimboli, P., Palermo, A., Deandrea, M., Piccardo, A., Campennì, A., Valabrega, S., … Crescenzi, A. (2019). Prognosis of patients with differentiated thyroid carcinomas having a preoperative cytological report of indeterminate at low or high risk. A multicenter study. Endocrine, 66(3), 557-562. https://doi.org/10.1007/s12020-019-02013-9
Tuttle, R. M., Ahuja, S., Avram, A. M., Bernet, V. J., Bourguet, P., Daniels, G. H., … Hegedüs, L. (2019). Controversies, Consensus, and Collaboration in the Use of 131I Therapy in Differentiated Thyroid Cancer: A Joint Statement from the American Thyroid Association, the European Association of Nuclear Medicine, the Society of Nuclear Medicine and Molecular Imaging, and the European Thyroid Association. Thyroid, 29(4), 461-470. https://doi.org/10.1089/thy.2018.0597
Tuttle, R. M., y Alzahrani, A. S. (2019). Risk Stratification in Differentiated Thyroid Cancer: From Detection to Final Follow-Up. The Journal of Clinical Endocrinology & Metabolism, 104(9), 4087-4100. https://doi.org/10.1210/jc.2019-00177
Wang, L. Y., y Ganly, I. (2018). Post-treatment surveillance of thyroid cancer. European Journal of Surgical Oncology: The Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology, 44(3), 357-366. https://doi.org/10.1016/j.ejso.2017.07.004
Wang, T. S., y Sosa, J. A. (2018). Thyroid surgery for differentiated thyroid cancer—Recent advances and future directions. Nature Reviews. Endocrinology, 14(11), 670-683. https://doi.org/10.1038/s41574-018-0080-7
