Utilidad de la inmunohistoquímica KI 67 para el diagnóstico histopatológico de los astrocitomas, protocolo de implementación en el Hospital Oncológico Juan Tanca Marengo Solca período 2012-2014
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2016
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
El objetivo del presente trabajo es diseñar un Protocolo de Implementación para el diagnóstico histopatológico de los Astrocitomas mediante la Inmunohistoquímica Ki 67. En el Hospital Oncológico Dr. Juan Tanca Marengo SOLCA, de Guayaquil, y en la Junta de Beneficencia, atendieron a 180 nuevos pacientes menores de edad y de estos el 15 al 20% resultaron ser tumores cerebrales, estudio realizado en el año 2015.
La Inmunohistoquímica mediante el uso del Ki67, es clave para el diagnóstico del tipo de tumor astrocítico y determina la terapéutica y la consideración pronostica.
Para realizar este estudio se tomaron como muestras, los casos reportados con el diagnóstico histopatológico de Astrocitomas en el período comprendido entre el 2012 y 2014, con el objetivo de establecer la utilidad del Ki 67 para el diagnóstico de los Astrocitomas, diseñando un Protocolo de Implementación. Se estudiaron 100 muestras de tumor Astrocíticos en buen estado, de lo que se pudo acceder al expediente clínico para determinar que contaron con diagnóstico definitivo mediante la técnica de Hematoxilina y Eosina.
Los resultados mostraron que el Astrocitoma que predomino fue el Astrocitoma anaplásico con un 46% seguido del Astrocitoma protoplasmático con un 18%, pero a pesar de existir similitud en cantidades de los dos tipos de Astrocitomas con la Inmunohistoquímica Ki 67, se recalca que no fueron los mismos bloques de parafina los que tuvieron tal coincidencia ya que al realizar el análisis de comparación entre las dos técnicas tanto convencional como con el Ki 67 destacamos que de los 46 bloques de parafina cuyo diagnóstico con el método convencional fue Astrocitoma Anaplásico, solo hubo 6% de coincidencias, es decir que hubo un margen de error de un 87% y el Astrocitoma Protoplasmático de un 18% con Hematoxilina y Eosina hubo solo 3% de coincidencia, con un margen de error de un 33%.
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Por tal motivo reitero la importancia de determinar como norma para el diagnóstico histopatológico de Astrocitomas valorando el grado de proliferación celular.
The objective of this work is to design a Protocol Implementation for histopathological diagnosis of Astrocytomas by Immunohistochemistry Ki 67. At the Oncological Hospital SOLCA Juan Tanca Marengo, Guayaquil, and the Welfare Board 180 new patients attended minors and of these 15 to 20% were found to be brain tumors, a study conducted in 2015. Immunohistochemistry using the Ki67, is key to diagnosing the type of astrocytic tumor and determines the therapeutic and predicts consideration. For this study were taken as samples, reported cases with histopathological diagnosis of Astrocytomas in the period between 2012 and 2014, with the aim of establishing the usefulness of Ki67 for the diagnosis of Astrocytomas, designing a Protocol implementation. Were studied 100 samples of astrocytic tumors in good condition, what could access the medical record to determine that received definitive diagnosis using the technique of Hematoxylin and Eosin. The results showed that the astrocytoma was the predominant anaplastic astrocytoma with 46% followed by protoplasmic astrocytoma with 18%, but although there is similarity in amounts of two types of Astrocytomas with Immunohistochemistry Ki67, stresses that were not the same paraffin blocks which had such a coincidence as to perform comparison analysis between the two both conventional techniques as Ki67 we note that of the 46 paraffin blocks whose diagnosis with the conventional method was anaplastic astrocytoma, only there were 6 % of matches, meaning that there was a margin of error of 87% and astrocytoma Protoplasmic 18% with Hematoxylin and eosin there were only 3% overlap, with a margin of error of 33%.
The objective of this work is to design a Protocol Implementation for histopathological diagnosis of Astrocytomas by Immunohistochemistry Ki 67. At the Oncological Hospital SOLCA Juan Tanca Marengo, Guayaquil, and the Welfare Board 180 new patients attended minors and of these 15 to 20% were found to be brain tumors, a study conducted in 2015. Immunohistochemistry using the Ki67, is key to diagnosing the type of astrocytic tumor and determines the therapeutic and predicts consideration. For this study were taken as samples, reported cases with histopathological diagnosis of Astrocytomas in the period between 2012 and 2014, with the aim of establishing the usefulness of Ki67 for the diagnosis of Astrocytomas, designing a Protocol implementation. Were studied 100 samples of astrocytic tumors in good condition, what could access the medical record to determine that received definitive diagnosis using the technique of Hematoxylin and Eosin. The results showed that the astrocytoma was the predominant anaplastic astrocytoma with 46% followed by protoplasmic astrocytoma with 18%, but although there is similarity in amounts of two types of Astrocytomas with Immunohistochemistry Ki67, stresses that were not the same paraffin blocks which had such a coincidence as to perform comparison analysis between the two both conventional techniques as Ki67 we note that of the 46 paraffin blocks whose diagnosis with the conventional method was anaplastic astrocytoma, only there were 6 % of matches, meaning that there was a margin of error of 87% and astrocytoma Protoplasmic 18% with Hematoxylin and eosin there were only 3% overlap, with a margin of error of 33%.
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Astrocitomas, Hematoxilina, Eosina, Inmunohistoquímica, Proliferación celular, Bloques de parafina, Hospital SOLCA de Guayaquil, Cantón Guayaquil, Ecuador