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RESUMO -Os autores avaliaram a concordância diagnóstica cito-histológica de lesões de colo uterino e discutiram as eventuais discrepâncias. OBJETIVO. Averiguar o nível de concordância cito-histológica nos casos da Divisão de Patologia do Instituto Adolfo Lutz (IAL) e aprimorar a estratégia de garantia de qualidade na instituição. MATERIAL E MÉTODO. Estudaram 157 casos consecutivos dos arquivos do IAL em que foram enviadas citologia cérvico-vaginal e biópsia. RESULTADO. Houve concordância absoluta em 119 (75,8%) casos; nos demais, a citologia superestimou 11 lesões (7,0%) e subestimou 27 (17,2%). Observou-se que em 5 casos, inicialmente diag-nosticados como inflamatório pela citologia, dois foram, à revisão, considerados como NIC 1; os demais foram ratificados como inflamatórios, apesar de suas respectivas biópsias terem diagnóstico de neoplasia intra-epitelial cervical. CONCLUSÃO. Tais resultados demonstram a importância da correlação cito-histológica para o sistema de garantia de qualidade em diagnóstico citológico e apontam para a colheita como um dos fatores determinantes nas discrepâncias diagnósticas.

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Cofilin-1 (CFL1), a small protein of 18 kDa, has been studied as a biomarker due to its involvement in tumor cell migration and invasion. Our aim was to evaluate CFL1 as an indicator of malignancy and aggressiveness in sputum samples. CFL1 was analyzed by ELISA immunoassay in the sputum of 73 lung cancer patients, 13 cancer-free patients, and 6 healthy volunteers. Statistical analyses included ANOVA, ROC curves, Spearman correlation, and logistic regression. Sputum CFL1 levels were increased in cancer patients compared to cancer-free patients and volunteers (P<0.05). High expression of sputum CFL1 was correlated to T4 stage (P=0.01) and N stage (P=0.03), tobacco history (P=0.01), and squamous cell carcinoma histologic type (P=0.04). The accuracy of sputum CFL1 in discriminating cancer patients from cancer-free patients and healthy volunteers were 0.78 and 0.69, respectively. CFL1 at a cut-off value of 415.25 pg/mL showed sensitivity/specificity of 0.80/0.70 in differentiating between healthy volunteers and cancer patients. Sputum CFL1 was also able to identify cancer-free patients from patients with lung cancer. The AUC was 0.70 and, at a cut-off point ≥662.63 pg/mL, we obtained 60% sensitivity and 54% specificity. Logistic regression analysis controlled for tobacco history, histologic types, and N stage showed that cancer cell-associated CFL1 was an independent predictor of death. Smoker patients with squamous cell carcinoma, lymph node metastasis and sputum CFL1>1.475 pg/mL showed augmented chance of death, suggesting lung cancer aggressiveness. CFL1 presented diagnostic value in detecting lung cancer and was associated to tumor aggressiveness.

The knowledge of the relative frequencies, associated with clinical information, can be helpful in the selection of further investigation for the metastatic adenocarcinomas.

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