Evaluación de la capacidad de la citología cervicovaginal para detectar recurrencias de cáncer cervicouterino (evaluation of cervicovaginal cytology capacity to detect cervical uterine cancer recurrences)

Johana Contreras

Resumen


Resumen

Objetivo: Evaluar la capacidad de la citología cervicovaginal convencional en detectar recurrencias en el seguimiento de pacientes tratadas por cáncer cervicouterino.

Métodos: Se realizó un estudio de cohorte retrospectivo con 483 pacientes con diagnóstico de cáncer cervicouterino en el Instituto Oncológico Nacional  (ION) de Panamá en el período de 2012 a 2015  y se evalúo la capacidad diagnostica de la citología cervicovaginal convencional para detectar recurrencia de cáncer de cérvix.

Resultados: De las 483 pacientes tratadas por cáncer cervicouterino, 65 (13%) presentaron  recurrencias.  Las recurrencias fueron detectadas por citología cervicovaginal convencional sólo en 7 pacientes (11%). La sensibilidad de la citología cervicovaginal fue de 11% con una especificidad de 100%. El VPP fue de 100% y el VPN de 88%. El cociente de probabilidad negativo fue de 0.89. La tasa de falsos positivos fue de 0% y la de falsos negativos de 89%.

Conclusiones: La citología cervicovaginal de rutina no demostró sensibilidad adecuada para la detección de las recurrencias.  La mayoría de las pacientes presentaron recurrencias sintomáticas asociadas a citologías negativas.

Palabras claves: cáncer cervicouterino, citología cervicovaginal convencional, recurrencia.

Abstract

Objective:  To evaluate the ability of conventional cervicovaginal cytology to detect recurrences in the follow-up of patients treated for cervical uterine cancer.

Methods: A retrospective cohort study was conducted with 483 patients diagnosed with cervical uterine cancer at the National Oncology Institute (Instituto Oncológico Nacional, ION) in Panama from 2012 to 2015 and evaluated the diagnostic ability of conventional cervicovaginal cytology to detect recurrence of cervical cancer.

Results:  Of the 483 patients treated for cervical cancer, 65 (13%) had recurrences. Recurrences were detected by conventional cervicovaginal cytology only in seven patients (11%). The sensitivity of cervicovaginal cytology was 11% with a specificity of 100%. The positive predictive value was 100% and the negative predictive value was 88%. The negative probability ratio was 0.89. The false positive rate was 0% and the false negative rate was 89%.

Conclusions:  Routine cervicovaginal cytology did not demonstrate adequate sensitivity for the detection of recurrences. Most of the patients had symptomatic recurrences associated with negative cytologies.

Keywords: Cervical cancer, conventional cervicovaginal cytology, recurrence.


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Referencias


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