Perfil dos resultados histopatológicos de biópsias de ovário de um laboratório de referência em patologia de Brasília, ao longo de 5 anos

Authors

  • Camila Lopes Moreira da Silva
  • Vitória Vieira
  • Flávia Alves Neves Mascarenhas
  • Cristiane Henriques Soares de Paiva Lopes

DOI:

https://doi.org/10.34119/bjhrv6n4-106

Keywords:

ovário, tumor, neoplasias ovarianas

Abstract

As patologias ovarianas são um grupo heterogêneo de doenças e incluem um grande percentual de alterações benignas e um número menor de neoplasias malignas, que apresenta a maior taxa de letalidade entre todos os tumores ginecológicos, e representam 30% dos cânceres ginecológicos no Brasil. O estudo configura-se como observacional, analítico e transversal e avalia o percentual de neoplasias malignas, benignas e borderline nos resultados histopatológicos de biópsias de ovário analisadas em um laboratório de referência em patologia, em Brasília, entre 2015 e 2020, descrevendo o perfil etário das pacientes e os subtipos de tais neoplasias, resultando na seleção de 3.348 pacientes. Entre elas, observou-se que a maioria possuía entre 20 e 49 anos, totalizando 61,70% dos casos. Em relação às neoplasias malignas, das 1.174 amostras, 64,4% eram de pacientes com mais de 50 anos. A origem das pacientes foi predominantemente do sistema particular, sendo apenas 21 (0,63%) provenientes do serviço público; dessas, seis (28,6%) obtiveram diagnóstico de neoplasias malignas, caracterizando maior percentual de número de casos malignos provenientes do setor público. Mais da metade dos resultados das biópsias ovarianas foi normal (58,24%). Entre as patologias ovarianas, as neoplasias benignas foram as mais frequentes (21,23%); dessas, o teratoma cistico maduro representou a maioria (40,37%). Os casos de endometrioma e endometriose abrangeram 12,27% do total das biópsias. Os tumores malignos (7,38%) e borderline (2,27%) de ovário representaram 9,65% dos casos analisados no período, no total de 323 casos. O tipo histológico epitelial representou 62,35% das neoplasias malignas, e, entre essas, o adenocarcinoma seroso foi o mais comum (47,4% dos casos). Curiosamente, os tumores do cordão sexual foram mais frequentes do que os de células germinativas nesta pesquisa (31,58 % x 6,07%), especialmente pelo número de tumores de células estromais da granulosa (72 casos no período). Metade das metástases para ovário foi originada no intestino. O câncer de ovário é um tema de extrema relevância na ginecologia, seja pela dificuldade de rastreio e diagnóstico precoces, seja pela alta prevalência na população feminina. É necessário maior desenvolvimento científico e pesquisa nesse campo da ciência. Esse estudo é uma tentativa de resumir dados epidemiológicos regionais que contribuirão na construção de futuros projetos.

References

AMERICAN CANCER SOCIETY. Cancer facts & figures 2017. Atlanta, GA.: American Cancer Society, 2017.

AMERICAN CANCER SOCIETY. Cancer Facts & Figures 2020. Atlanta, GA: American Cancer Society; 2020.

AMERICAN CANCER SOCIETY. Ovarian cancer: early detection, diagnosis, and staging. Last Medical Review: April 11, 2018. Last Revised: April 11, 2018. Available at: https://www.cancer.org/content/dam/CRC/PDF/Public/ 8775.00.pdf.

ANDREWS L, MUTCH DG. Hereditary ovarian cancer and risk reduction. Best Pract Res Clin Obstet Gynaecol. 2017;41:31–48. doi:10.1016/j.bpobgyn.2016.10.017

BANERJEE, Susana; KAYE, Stanley B. New strategies in the treatment of ovarian cancer: current clinical perspectives and future potential. Clinical cancer research, v. 19, n. 5, p. 961-968, 2013.

BEZERRA A L R, LORENZATO F R B. Granulosa Cell Tumors of the Ovary: A Study of 24 Cases. RBGO 26 (8): 605-610, 2004.

BUYS SS, PARTRIDGE E, BLACK A, et al. Effect of screening on ovarian cancer mortality: the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Randomized Controlled Trial. JAMA 305(22):2295, 2011

COLLINSON F, QIAN W, FOSSATI R, LISSONI A, Williams C, Parmar M, et al. Optimal treatment of early-stage ovarian cancer. Ann Oncol Off J Eur Soc Med Oncol. 2014 Jun;25(6):1165-71. Doi: 10.1093/annonc/mdu116. Epub 2014 Mar 14.

CHO KR, SHIH IEM. Ovarian cancer. Annu Rev Pathol. 2009;4:287-313. Doi:10.1146/annurev.pathol.4.110807.092246

COLOMBO, N. et al. Non-epithelial ovarian cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of oncology, v. 23, n. suppl_7, p. vii20-vii26, 2012.

DEMIR, Richard H.; MARCHAND, Greg J. Adnexal masses suspected to be benign treated with laparoscopy. JSLS: Journal of the Society of Laparoendoscopic Surgeons, v. 16, n. 1, p. 71, 2012.

DELLA PEPA, Chiara et al. Low grade serous ovarian carcinoma: from the molecular characterization to the best therapeutic strategy. Cancer treatment reviews, v. 41, n. 2, p. 136-143, 2015.

D ́IPPOLITO, Giuseppe et al. Neoplasias sólidas de ovário: análise sistematizada e ensaio iconográfico. Rev Image; v. 28 n. 3: p. 165–170. 2006.

EGGINK, Florine A.; KOOPMANS, Corine M.; NIJMAN, Hans W. Surgery for patients with newly diagnosed advanced ovarian cancer: which patient, when and extent?. Current opinion in oncology, v. 29, n. 5, p. 351-358, 2017.

FAUBION SS, KUHLE CL, SHUSTER LT, ROCCA WA. Long-term health consequences of premature or early menopause and considerations for management. Climacteric. 2015;18(4):483-91. doi: 10.3109/13697137.2015.1020484.

FERLAY, J. et al. GLOBOCAN 2012 v1.0, cancer incidence and mortality worldwide. Int J câncer, 136 (5), E359-86. Section of Cancer Surveillance, Internacional Agency for Research no Cancer, Lyon, France, 2013.

FERRARO, Simona et al. Serum human epididymis protein 4 vs carbohydrate antigen 125 for ovarian cancer diagnosis: a systematic review. Journal of clinical pathology, v. 66, n. 4, p. 273- 281, 2013.

FROYMAN W, TIMMERMAN D. Methods of Assessing Ovarian Masses: International Ovarian Tumor Analysis Approach. Obstet Gynecol Clin North Am. 2019 Dec;46(4):625-641. doi: 10.1016/j.ogc.2019.07.003. Epub 2019 Sep 25.

GRANDI G, PERRONE AM, TOSS A, VITAGLIANO A, FRISO S, FACCHINETTI F, et al. The generally low sensitivity of CA 125 for FIGO stage I ovarian cancer diagnosis increases for endometrioid histotype. Minerva Med. 2020 Apr;111(2):133-140. doi: 10.23736/S0026-4806.20.06474-5.

HOFFMAN, Barbara L. et al. Ginecologia de WILLIAMS. 2 ed. Porto Alegre. Artmed. 2014. INSTITUTO NACIONAL DE CÂNCER (Brasil). Tipos de câncer de ovário. 2020. Disponível em: https://www.inca.gov.br/tipos-de-cancer/cancer-de-ovario

INSTITUTO NACIONAL DE CÂNCER (Brasil). Estimativa 2018. Incidência do Câncer no Brasil. Rio de Janeiro: INCA, 2017.

INSTITUTO NACIONAL DE CÂNCER (Brasil). Estimativa 2016. Incidência do Câncer no Brasil. Rio de Janeiro: INCA, 2015.

KORENAGA TK, TEWARI KS. Gynecologic cancer in pregnancy. Gynecol Oncol. 2020 Apr 5. pii: S0090-8258(20)30231-6. doi: 10.1016/j.ygyno.2020.03.015. [Epub ahead of print]

KOTSOPOULOS J, GRONWALD J, KARLAN B, et al. Age-specific ovarian cancer risks among women with a BRCA1 or BRCA2 mutation. Gynecol Oncol. 2018 Jul. 150(1):85–91. doi:10.1016.

KUBEČEK O, LACO J, ŠPAČEK J, et al. The pathogenesis, diagnosis, and management of metastatic tumors to the ovary: a comprehensive review. Clin Exp Metastasis. 2017;34(5):295-307. doi:10.1007/s10585-017-9856-8

KURMAN, Robert J.; SHIH, Ie-Ming. The dualistic model of ovarian carcinogenesis: revisited, revised, and expanded. The American journal of pathology, v. 186, n. 4, p. 733-747, 2016.

KURMAN, Robert J.; SHIH, Ie-Ming. Molecular pathogenesis and extraovarian origin of epithelial ovarian cancer—shifting the paradigm. Human pathology, v. 42, n. 7, p. 918-931, 2011.

KURMAN RJ, CARCANGIU ML, HERRINGTON CS, YOUNG RH. WHO Classification of Tumours of Female Reproductive Organs. Fourth Edition. Lyon. IARC WHO Classification of Tumours. 2014.

LIAT, Lerner-Geva et al. Are infertility treatments a potential risk factor for cancer development? Perspective of 30 years of follow-up. Gynecological Endocrinology, v. 28, n. 10, p. 809-814, 2012.

MATULONIS UA, SOOD AK, FALLOWFIELD L, HOWITT BE, SEHOULI J, Karlan BY. Ovarian cancer. Nat Rev Dis Primers. 2016 Aug 25; 2:16061

MENCZER J. Conservative fertility-sparing surgical treatment of invasive epithelial ovarian cancer: when is it acceptable? Isr Med Assoc J. 2013;15(2):116-20.

MOHAMMADIAN, Mahdi et al. Variations in the incidence and mortality of ovarian cancer and their relationship with the human development index in European Countries in 2012.

Biomedical Research and Therapy, v. 4, n. 8, p. 1541-1557, 2017. doi:10.15419/ bmrat.v4i08.228

NICE. Guideline Suspected cancer: recognition and referral. Published: 23 June 2015. Disponível em: https://www.nice.org.uk/guidance/ng12. ISBN: 978-1-4731-1164-6

HOWLADER, N., NOONE, A.M., KRAPCHO, J. Garshell, D. Miller, S.F. Altekruse, C.L. Kosary, M. Yu, J. Ruhl, Z. Tatalovich, A. Mariotto, D.R. Lewis, H.S. CHen, E.J. Feuer, K.A. Cronin, SEER Cancer Statistics Review, 1975–2011, National Cancer Institute Bethesda, MD., 2014

ØRSKOV, Mette et al. Predictors of mortality within 1 year after primary ovarian cancer surgery: a nationwide cohort study. BMJ open, v. 6, n. 4, p. e010123, 2016.

PARK, Yongjung et al. Reference ranges for HE4 and CA125 in a large Asian population by automated assays and diagnostic performances for ovarian cancer. International journal of cancer, v. 130, n. 5, p. 1136-1144, 2012.

PISZCZEK, Carolyn et al. Cancer Risk-Reducing Opportunities in Gynecologic Surgery. Journal of minimally invasive gynecology, v. 25, n. 7, p. 1179-1193, 2018. https://doi.org/10.1016/j.jmig.2017.10.025

POOLE, Elizabeth M. et al. Hormonal and reproductive risk factors for epithelial ovarian cancer by tumor aggressiveness. Cancer Epidemiology and Prevention Biomarkers, v. 22, n. 3, p. 429- 437, 2013.

PRAT J and FIGO Committee on Gynecologic Oncology. FIGO's staging classification for cancer of the ovary, fallopian tube, and peritoneum: abridged republication. J Gynecol Oncol. 2015 Apr;26(2):87-9. doi: 10.3802/jgo.2015.26.2.87.

RASMUSSEN, Christina B. et al. Is pelvic inflammatory disease a risk factor for ovarian cancer?. Cancer Epidemiology and Prevention Biomarkers, v. 26, n. 1, p. 104-109, 2017.

RIVAS-CORCHADO LM, GONZÁLEZ-GERONIZ M, HERNÁNDEZ-HERRERA RJ. Perfil epidemiológico del cáncer de ovario. Ginecol Obstet Mex. 2011; 79(9): 558-64.

RUTTEN MJ, GAARENSTROOM KN, VAN GORP T, VAN MEURS HS, et al. Laparoscopy to predict the result of primary cytoreductive surgery in advanced ovarian cancer patients (LapOvCa- trial): a multicentre randomized controlled study. BMC Cancer. 2012 Jan 20;12:31. ISSN: 1471- 2407.

SCHORGE, John O. et al. SGO White Paper on ovarian cancer: etiology, screening and surveillance. Gynecologic oncology, v. 119, n. 1, p. 7-17, 2010.

SOCIEDADE PORTUGUESA DE GINECOLOGIA. Cancro Ginecológico: Consensos Nacionais 2013. 2012.

STEWART, Louise M. et al. In vitro fertilization, endometriosis, nulliparity and ovarian cancer risk. Gynecologic oncology, v. 128, n. 2, p. 260-264, 2013.

SU, Dada et al. Ovarian cancer risk is reduced by prolonged lactation: a case-control study in southern China. The American journal of clinical nutrition, v. 97, n. 2, p. 354-359, 2013. doi:10.3945/ajcn.112.044719

OKEKE T, ANYAEHIE U, EZENYEAKU C. Premature menopause. Ann Med Health Sci Res. 2013 Jan;3(1):90-5. doi: 10.4103/2141-9248.109458.

TORRE, Lindsey A. et al. Ovarian cancer statistics, 2018. CA: a cancer journal for clinicians, v. 68, n. 4, p. 284-296, 2018.

TOSS, Angela et al. Hereditary ovarian cancer: not only BRCA 1 and 2 genes. BioMed research international, v. 2015, 2015.

VITALE SG, MARILI I, LODATO M, TROPEA A, CIANCI A. The role of cytoreductive surgery in advanced-stage ovarian cancer: a systematic review. Updat Surg. 2013 Dec;65(4):265-70. Doi: 10.1007/s13304-013-0213.4.

WALKER, Joan L. et al. Society of Gynecolic Oncology recommendations for the prevention of ovarian cancer. Society of Ginecolic Oncology, v. 121, n. 13, p. 2108-2120, 2015.

WEIDERPASS, Elisabete et al. Risk factors for epithelial ovarian cancer in Japan-results from the Japan Public Health Center-based Prospective Study cohort. International journal of oncology, v. 40, n. 1, p. 21-30, 2012. doi:10.3892/ijo.2011.1194

WEI, S. U.; LI, H. U. I.; ZHANG, B. E. I. The diagnostic value of serum HE4 and CA-125 and ROMA index in ovarian cancer. Biomedical reports, v. 5, n. 1, p. 41-44, 2016. https://doi.org/10.3892/br.2016.682

WOO, Yin Ling et al. Centralisation of services for gynaecological cancers—a Cochrane systematic review. Gynecologic oncology, v. 126, n. 2, p. 286-290, 2012.

WRIGHT, Alexi A. et al. Neoadjuvant chemotherapy for newly diagnosed, advanced ovarian cancer: Society of Gynecologic Oncology and American Society of Clinical Oncology clinical practice guideline. Gynecologic oncology, v. 143, n. 1, p. 3-15, 2016.

Published

07/20/2023

How to Cite

DA SILVA, C. L. M.; VIEIRA, V.; MASCARENHAS, F. A. N.; LOPES, C. H. S. de P. Perfil dos resultados histopatológicos de biópsias de ovário de um laboratório de referência em patologia de Brasília, ao longo de 5 anos. Brazilian Journal of Health Review, [S. l.], v. 6, n. 4, p. 15317–15336, 2023. DOI: 10.34119/bjhrv6n4-106. Disponível em: https://ojs.brazilianjournals.com.br/ojs/index.php/BJHR/article/view/61572. Acesso em: 17 oct. 2026.

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Original Papers