Surgical pathology in cancer diagnosis: implications for quaternary prevention

Matthieu Yver

Resumo


Surgical pathology is the medical specialty in charge of cancer diagnosis. Although very important since oncology development, its link with overdiagnosis and overtreatment remains understudied. Despite big mediatisation, molecular biology has not brought much progress to tumour classifications. On the contrary, the silent apparition of immunohistochemistry at the end of the 1980's improved much of tumour classifications so significantly that it could cast doubts in some trials’ results of that period. This article discusses how the booming and abuse of immunohistochemistry might have led to overdiagnosis. It also highlights that the ISO 15189 standardization, as well as the tumour classification complexity, might function to induce overtreatment. In summary, critical reading and understanding of pathology reports by general practitioners are essential. Therefore, family doctors should not hesitate to discuss the cancer diagnosis with the pathologist, and in some cases also question the oncologist decision. This approach can be considered a quaternary prevention action which can prevent overtreatment.


Palavras-chave


Quaternary Prevention; Pathology, Surgical; Uterine Cervical Neoplasms; Conflict of Interest.

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Referências


Tan SY, Brown J. Rudolph Virchow (1821-1902): “pope of pathology”. Singapore Med J. 2006;47(7):567-568. PMid:16810425.

Rosai J. Guiding the surgeon’s hand: the history of American surgical pathology. Washington, DC: Armed Forces Institute of Pathology, 1997.

Wick MR. Histochemistry as a tool in morphological analysis: a historical review. Ann Diagn Pathol. 2012;16(1):71-78. http://dx.doi.org/10.1016/j.anndiagpath.2011.10.010 PMid:22261397.

Wikipedia. Ventana medical systems [cited 2014 Dec 20]. Available from: https://en.wikipedia.org/wiki/Ventana_Medical_Systems

Biz Tucson Special Report Ventana Medical Systems. 2012. [cited 2014 May 29]. Available from: http://issuu.com/mcserres/docs/special_report_ventana/1

Grimelius L. Methods in neuroendocrine histopathology, a methodological overview. Ups J Med Sci. 2008;113(3):243-260. http://dx.doi.org/10.3109/2000-1967-238 PMid:18991238.

Welch HG, Black WC. Overdiagnosis in cancer. J Natl Cancer Inst. 2010;102(9):605-613.http://dx.doi.org/10.1093/jnci/djq099 PMid:20413742.

Esserman LJ, Thompson IM, Reid B, Nelson P, Ransohoff DF, Welch HG, et al. Addressing overdiagnosis and overtreatment in cancer: a prescription for change. Lancet Oncol. 2014;15(6):234-242.http://dx.doi.org/10.1016/S1470-2045(13)70598-9 PMid:24807866.

Esserman LJ, Thompson IM Jr, Reid B. Overdiagnosis and overtreatment in cancer: an opportunity for improvement. JAMA. 2013;310(8):797-798. http://dx.doi.org/10.1001/jama.2013.108415 PMid:23896967.

Cetin Y. Chromogranin A immunoreactivity and Grimelius’ argyrophilia. Anat Embryol (Berl). 1992;185(3):207-215. http://dx.doi.org/10.1007/BF00211819 PMid:1349463.

Gatter KC, Alcock C, Heryet A, Mason DY. Clinical importance of analysing malignant tumours of uncertain origin with immunohistological techniques. Lancet. 1985;325(8441):1302-1305.http://dx.doi.org/10.1016/S0140-6736(85)92794-1 PMid:2860495.

Sabath AP, Kiviat NB. Review: detection and classification of cervical neoplasia in the era of HPV. Pathology Case Review. 2010;15(4):101-140. http://dx.doi.org/10.1097/PCR.0b013e3181e711ff

McEvoy & Farmer. Anatomic pathology markets in the United States: excerpts from our new report. 2011. [cited 2014 Dec 18]. 20 p. Available from: http://www.mcevoyandfarmer-pathology.com/wp-content/uploads/2012/12/USPathReportContents.pdf. (US Pathology 2011 Report).

Kyrgiou M, Koliopoulos G, Martin-Hirsch P, Arbyn M, Prendiville W, Paraskevaidis E. Obstetric outcomes after conservative treatment for intraepithelial or early invasive cervical lesions: systematic review and meta-analysis. Lancet. 2006;367(9509):489-498. http://dx.doi.org/10.1016/S0140-6736(06)68181-6 PMid:16473126.

Carrigg A, Teschendorf C, Amaro D, Weidner N, Tipps A, Shabaik A, et al. Examination of sources of diagnostic error leading to cervical cone biopsies with no evidence of dysplasia. Am J Clin Pathol. 2013;139(4):422-427.http://dx.doi.org/10.1309/AJCP6BSD0SNGQLHQ PMid:23525611.

Rakha EA, Starczynski J, Lee AH, Ellis IO. The updated ASCO/CAP guideline recommendations for HER2 testing in the management of invasive breast cancer: a critical review of their implications for routine practice. Histopathology. 2014;64(5):609-615. http://dx.doi.org/10.1111/his.12357 PMid:24382093.

Pu X, Shi J, Li Z, Feng A, Ye Q. Comparison of the 2007 and 2013 ASCO/CAP evaluation systems for HER2 amplification in breast cancer. Pathol Res Pract. 2014;211(6):421-425.http://dx.doi.org/10.1016/j.prp.2014.09.010 PMid:25818873.

The New York Times. Roche buying Ventana for $3.4 billion. 2008 Jan 22. [cited 2014 Sept 14]. Available from: http://www.nytimes.com/2008/01/22/business/worldbusiness/22iht-22rocheFW.9396266.html?_r=0

Tomáš Z. Accreditation in clinical laboratories. Biochemia Medica. 2010;20(2):215-220. http://dx.doi.org/10.11613/BM.2010.026

International Organization for Standardization (ISO). Frequently asked questions related to the A2LA ISO 15189 medical laboratory accreditation program [cited 2014 Nov 11]. Available from: http://www.a2la.org/faq/medical_15189.pdf

Lee EW, Deng FM, Melamed J, Mendrinos S, Das K, Hochman T, et al. Grading variability of urothelial carcinoma: experience from a single academic medical center. Can J Urol. 2014;21(4):7374-7378. PMid:25171282.

Roychowdhury M. Bladder Urothelial tumors - WHO / ISUP classification (2004). 2011. [cited 2015 jan. 12] Available from: http://www.pathologyoutlines.com/topic/bladderwhoisup.html

Oosterhuis JWA, Schapers RFM, Janssen-Heijnen MLG, Pauwels RPE, Newling DW, ten Kate F. Histological grading of papillary urothelial carcinoma of the bladder: prognostic value of the 1998 WHO/ISUP classification system and comparison with conventional grading systems. J Clin Pathol. 2002;55(12):900-905.http://dx.doi.org/10.1136/jcp.55.12.900 PMid:12461053.

Khan MS, Luong TV, Watkins J, Toumpanakis C, Caplin ME, Meyer T. A comparison of Ki-67 and mitotic count as prognostic markers for metastatic pancreatic and midgut neuroendocrine neoplasms. Br J Cancer. 2013;108(9):1838-1845. http://dx.doi.org/10.1038/bjc.2013.156 PMid:23579216.

Armstrong S. A matter of life and death. Dundee: University Press; 2008. [cited 2014 May 29]. Available from: http://www.pathsoc.org/conversations/index.php

Shah AA, Frierson HF Jr, Cathro HP. Analysis of immunohistochemical stain usage in different pathology practice settings. Am J Clin Pathol. 2012;138(6):831-836.http://dx.doi.org/10.1309/AJCPAGVTCKDXKK0X PMid:23161717.

DiGiuseppe JA, Sauvageot J, Epstein JI. Increasing incidence of minimal residual cancer in radical prostatectomy specimens. Am J Surg Pathol. 1997;21(2):174-178.http://dx.doi.org/10.1097/00000478-199702000-00006 PMid:9042283.

Sandhu GS, Andriole GL. Overdiagnosis of prostate cancer. Am J Pathol. 1987;129(1):140-151. PMid:3310650.

Lund L, Svolgaard N, Poulsen MH. Prostate cancer: a review of active surveillance. Res Rep Urol. 2014;6:107-112. PMid:25202685.

Raab SS. The cost-effectiveness of immunohistochemistry. Arch Pathol Lab Med. 2000;124(8):1185-1191. PMid:10923081.

Colin C, Devouassoux-Shisheboran M, Sardanelli F. Is breast cancer overdiagnosis also nested in pathologic misclassification? Radiology. 2014;273(3):652-655.http://dx.doi.org/10.1148/radiol.14141116 PMid:25420166.




DOI: https://doi.org/10.5712/rbmfc10(35)1057

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