Cytopathology and the Micronucleus Test in Monitoring Post-Radiotherapy Patients for Cervical Cancer

Abstract

The use of radiotherapy as a form of treatment for cervical cancer induces morphological changes both in neoplastic cells and in normal epithelial and stromal cells. These alterations represent a challenge for the identification of residual lesions, generating a scenario of complexity in the post-radiotherapy cytopathological evaluation. Therefore, the objective of this study was to comparatively analyze the cytopathological examination (Conventional Cytology X Liquid-Based Cytology) with the Micronucleus Test of post-radiotherapy patients for cervical cancer and to describe the genotoxicity of radiation. This is a cross-sectional, descriptive study whose population consisted of ten patients with cervical cancer undergoing radiotherapy at the Cancer Hospital II of the National Cancer Institute (INCA – Rio de Janeiro/RJ, Brazil). For analysis of the Micronucleus Test, a control group with ten patients, equivalent to the study group, was included. The results showed that the low quality of Conventional Cytology in cases of post-radiotherapy control of cervical cancer can be a barrier to the speed of diagnosis and identification of recurrent lesions. A relevant alternative is the use of Liquid-Based Cytology, which contributes positively to the quality of diagnosis in irradiated patients, mainly associated with the Micronucleus Test, but the adoption of Liquid-Based Cytology for mass screening may be hampered by the cost of the technique. On the other hand, the use of the Micronucleus Test, which proved to be significant in irradiated patients, is a low cost and easy analysis technique. Therefore, in view of the above, we propose, as a follow-up protocol for patients undergoing radiotherapy for cervical cancer, performing Liquid-Based Cytology associated with the Micronucleus Test, which can be extended to other types of tumors.