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1.
Article in English | LILACS | ID: biblio-1369046

ABSTRACT

Introduction: Cervical cancer is the third most common malignant tumor in the female population and the fourth cause of death from cancer in women in Brazil. The squamocolumnar junction and the transformation zone concentrate 90% of pre-invasive and invasive cervical lesions. Objective: To evaluate the prevalence of cytology without cells of the squamocolumnar junction and feasibility of active search. Methods: Cross-sectional study at a university hospital between 2017 and 2018. The prevalence of cytology without squamocolumnar junction cells was calculated. A convenience sample was obtained and mean age and relationship with presence of transformation zone cells were calculated. An active search was performed and cytology collected, with estrogen preparation if indicated. Medical records of the other women were analyzed. Results: Squamocolumnar junction cells were not found in 28.84% of samples. Mean age was 53 years, without association with presence of squamocolumnar junction cells (p=0.409). Seventy-six women returned, 36 of which (47.37%) used estrogen. Level 2 or 3 cervical intraepithelial neoplasia, microinvasive carcinoma or cancer was not identified. A total of 134 medical records were analyzed; only 36 women (26.87%) completed screening. Conclusions: The presence of squamocolumnar junction cells indicates quality of cytology; the use of estrogen in postmenopausal women favors its collection. There were difficulties in active search. An immediate repetition of cytology should be considered.


Introdução: O câncer de colo uterino é o terceiro tumor maligno mais frequente na população feminina e a quarta causa de morte de mulheres por câncer no Brasil. A junção escamo-colunar e a zona de transformação concentram 90% das lesões pré-invasoras e invasoras cervicais. Objetivo: Avaliar prevalência de colpocitologias sem células da junção escamo-colunar e a viabilidade de busca ativa. Métodos: Estudo transversal em hospital universitário entre 2017 e 2018. Calculada prevalência de citologias sem células da junção escamo-colunar. Obtida amostra por conveniência, calculada média de idade e relação com a presença da junção escamo-colunar. Realizada busca ativa e colhidas citologias com preparo estrogênico, se indicado. Analisados os prontuários das demais mulheres. Resultados: A prevalência de ausência de células da junção escamo-colunar foi de 28,84%. A média de idade foi 53 anos, sem associação com presença da junção escamo-colunar (p=0,409). Retornaram 76 mulheres e 36 (47,37%) usaram estrogênio. Não identificamos neoplasia intraepitelial cervical graus 2 ou 3, carcinoma microinvasor e câncer. Analisados 134 prontuários, dos quais apenas 36 mulheres (26,87%) concluíram o rastreio. Conclusões: A presença de células da junção escamo-colunar indica qualidade da coleta, e o uso de estrogênio na pós-menopausa favorece sua obtenção. Houve dificuldade de busca ativa. A repetição imediata da citologia deve ser considerada.


Subject(s)
Humans , Uterine Cervical Neoplasms , Cervical Intraepithelial Neoplasia , Papillomavirus Infections , Women , Carcinoma , Prevalence
2.
Femina ; 50(1): 35-50, 20220131. ilus
Article in Portuguese | LILACS | ID: biblio-1358220

ABSTRACT

As neoplasias intraepiteliais cervicais correspondem a alterações identificadas por rastreamento citológico cervical e estudo histológico, pós-biópsia incisional guiada por colposcopia ou procedimento diagnóstico excisional. Podem ser tratadas com abordagens conservadoras e procedimentos excisionais. A vacinação anti-HPV e o tratamento excisional oportuno constituem, respectivamente, prevenção primária e secundária contra o câncer do colo uterino.(AU)


Cervical intraephitelial neoplasms correspond to changes identified by cervical citological screening and histological study, post-incisional biopsy guided by colposcopy or excisional diagnostic procedure. They can be treated with conservative approaches and excision procedures. Anti-HPV vaccination and timely excional treatment are primary and secondary prevention against cervical cancer, respectively.(AU)


Subject(s)
Humans , Female , Cervix Uteri/cytology , Cervical Intraepithelial Neoplasia/surgery , Cervical Intraepithelial Neoplasia/diagnosis , Squamous Intraepithelial Lesions/surgery , Squamous Intraepithelial Lesions/diagnosis , Squamous Intraepithelial Lesions/diagnostic imaging , Cervical Intraepithelial Neoplasia/diagnostic imaging , Colposcopy , Conization/instrumentation , Papillomavirus Infections/pathology , High-Intensity Focused Ultrasound Ablation , Hysterectomy
3.
Rev. bras. anal. clin ; 53(3): 228-231, 20210930.
Article in Portuguese | LILACS | ID: biblio-1368034

ABSTRACT

O câncer do colo do útero é o quarto tumor mais comum entre mulheres no mundo e o terceiro no Brasil. A detecção precoce e a identificação das lesões cervicais são essenciais no rastreamento do câncer cervical. Nos últimos anos, vários marcadores têm sido apresentados como possíveis candidatos para a triagem eficiente de exames citológicos com anormalidades das células epiteliais. O objetivo deste trabalho é analisar a correlação com a expressão imuno-histoquimica dos biomarcadores p16 e Ki-67 com lesão intraepitelial cervical de alto grau na detecção molecular DNA/HPV de alto risco. A metodologia de pesquisa empregada é uma revisão sistemática, realizada por meio de buscas nas bases de dados eletrônica Literatura Latino-Americana em Ciência e Saúde (LILACS), Scientific Electronic Library Online (SCIELO), National Library of Medicine (MEDLINE) de artigos publicados no período de 2005 a 2019 nos idiomas português, inglês e espanhol. Concluiu-se que o uso das proteínas p16 e Ki67 auxilia na identificação das mudanças que acontecem durante a progressão da lesão cervical, aprimorando os métodos de rastreio atuais. O gene p53, a pRb e ciclinas também têm um papel crítico na carcinogênese e, desta maneira, também têm sido indicados para entrar nos painéis de estudo.


Cervical cancer is the fourth most common tumor among women in the world and the third in Brazil. Early detection and identification of cervical lesions are essential in screening for cervical cancer. In recent years, several markers have been presented as possible candidates for efficient screening of cytological exams with abnormalities of epithelial cells. The objective of this work is to analyze the correlation with the immunohistochemical expression of the biomarkers p16 and ki-67 with high-grade cervical intraepithelial lesion in high-risk DNA / HPV molecular detection. The research methodology employed is a systematic review, carried out by searching the electronic databases Latin American Literature in Science and Health (LILACS), Scientific Electronic Library Online (SCIELO), National Library of Medicine (MEDLINE) of published articles from 2005 to 2019 in Portuguese, English and Spanish. It was concluded that the use of proteins p16 and Ki67, help to identify the changes that happen during the progression of the cervical lesion, improving the current screening methods. The p53 gene, the retinoblastoma protein ­ pRb and cyclins also plays a critical role in carcinogenesis and thus, they have also been indicated to enter the study panels.


Subject(s)
Uterine Cervical Neoplasms , Cervical Intraepithelial Neoplasia , Papillomavirus Infections , Papillomaviridae , Immunohistochemistry , Biomarkers , Ki-67 Antigen , Genes, p16
4.
Rev. bras. ginecol. obstet ; 43(9): 682-689, Sept. 2021. graf
Article in English | LILACS | ID: biblio-1351778

ABSTRACT

Abstract Objective The aim of the present study was to compare the local and systemic expression of the factors linked to the interferon alpha (IFN-α) activation pathway in different degrees of cervical intraepithelial neoplasia (CIN) and cervical cancer. Methods A total of 128 patients with CIN I, CIN II, CIN III and cervical cancer was evaluated. The real-time polymerase chain reaction (RT-PCR) technique was used to evaluate the gene expression of IFNR1, IFNR2, IFN-α, oligoadenylate synthase (2'5′OAS), cytokine signal suppressor 1 (SOCS) 1, SOCS3, signal transducer and transcription activator 1 (STAT1), and IRF9 from 128 biopsies. A total of 46 out of 128 samples were evaluated by flow cytometry for IFNAR1, IFNAR2, STAT1, IRF7 and IFN-α in peripheral blood cells. Results Patients with CIN II and III (63 samples) had a low local expression of IFNR1, but not IFNR2. Patients with some degree of injury showed high expression of SOCS1 and SOCS3. Systemically, patients with CIN II and III (20 samples) had a significant increase in IFNR1, IFNR2, STAT1, IRF7, and IFN-α in helper, cytotoxic T lymphocytes, and in monocytes. Conclusion Patients with high-grade lesions have increased systemic expression of IFN-α and its activation pathways in helper and cytotoxic T lymphocytes, as well as in monocytes due to an exacerbation of the immune response in these patients. This phenomenon is not accompanied by resolution of the lesion due to a defect in the IFN-α activation pathway that revealed by low local IFNAR1 expression and high local expression of SOCS1 and SOCS3.


Resumo Objetivo O objetivo do presente estudo foi comparar a expressão local e sistêmica dos fatores ligados à via de ativação do interferon alfa (IFN-α) em diferentes graus de neoplasia intraepitelial cervical (NIC) e câncer cervical (CA) Métodos Foram avaliados 128 pacientes com NIC I, NIC II, NIC III e CA. A técnica de reação de cadeia de polimerase em tempo real (RT-PCR, na sigla em inglês) foi realizada para avaliar a expressão gênica do receptor de interferon (IFNR) 1, IFNR2, IFN-α, 2′-5′- oligoadenilato sintetase (2′5′OAS), supressor de sinalização de citocina (SOCS)1, SOCS3, transdutor de sinal e ativador de transcrição 1 (STAT1) e fator regulador de interferon 9 (IRF9) das 128 biópsias. Das 128 amostras, 46 foram avaliadas por citometria de fluxo para IFNAR1, IFNAR2, STAT1, IRF7 e IFN-α em células de sangue periférico. Resultados Pacientes com NIC II e III (63 amostras) tiveram baixa expressão local de IFNR1 mas não de IFNR2. Pacientes com algum grau de lesão apresentaram alta expressão de SOCS1 e SOCS3. Sistemicamente, os pacientes com NIC II e III (20 amostras) tiveram um aumento significativo de IFNR1, IFNR2, STAT1, IRF7 e IFN-α em linfócitos T auxiliares, citotóxicos e monócitos. Conclusão Pacientes com lesões de alto grau apresentam expressão sistêmica aumentada de IFN-α e suas vias de ativação em linfócitos T auxiliares e citotóxicos, bem como em monócitos, devido à exacerbação da resposta imune nesses pacientes. Este fenômeno não é acompanhado pela resolução da lesão devido a um defeito na via de ativação do IFN-α que é revelado pela baixa expressão local de IFNR1 e alta expressão local de SOCS1 e SOCS3.


Subject(s)
Humans , Female , Uterine Cervical Neoplasms/genetics , Cervical Intraepithelial Neoplasia/genetics , Interferon-alpha , Suppressor of Cytokine Signaling Proteins/metabolism
5.
Rev. Ciênc. Méd. Biol. (Impr.) ; 20(2): 229-234, set 29, 2021. tab
Article in English | LILACS | ID: biblio-1354390

ABSTRACT

Introduction: the prevalence of cervical and anal human papillomavirus (HPV) infection in women infected with human immunodeficiency virus (HIV) is high. However, little is known about the differences in the susceptibility of these infections and related lesions. The aim of this study was to describe the association between the prevalence of cervical and anal HPV infection and HPV-related lesions in HIV-positive women. Methods: this study included 88 HIV-positive women attending an outpatient clinic in a university hospital. Ectocervical, endocervical, and anal samples were collected for colpocytology and anal cytology. A polymerase chain reaction-based technique was used to detect HPV deoxyribonucleic acid in endocervical and anal swab samples. Results: the cervical and anal HPV positivity rates were 35.21% and 78.8%, respectively. The presence of HPV-related lesions on colpocytology was associated with anal HPV positivity (P = 0.027). The ratio between cervical HPV infection and cervical HPV-related lesions was 2.5. The ratio between anal HPV infection and anal HPV-related lesions was 4.3. Overall, 30% had concomitant HPV DNA in the cervix and anus. Conclusion: there are differences in the susceptibility of infections and related lesions between the cervix and anus. Despite a higher incidence of anal HPV, the progression to HPV-related lesion does not occur via the same manner in the cervix and anus. Moreover, cervical HPV-related lesions in HIV-positive women may serve as a cue for anal preventive strategies, and further investigations in these women may be useful.


Introdução: as infecções cervicais e anais pelo papilomavírus humano (HPV) em mulheres infectadas com o vírus da imunodeficiência umana (HIV) são muito prevalentes. Entretanto, pouco se sabe sobre as diferenças na suscetibilidade entre essas infecções e as lesões HPV-relacionadas. Objetivo: descrever a associação entre as prevalências de infecção cervical e anal pelo HPV e lesões relacionadas em mulheres HIV-positivas. Metodologia: este estudo incluiu 88 mulheres HIV-positivas atendidas em ambulatório de hospital universitário. Amostras ectocervicais, endocervicais e anais foram coletadas para colpocitologia e citologia anal. Uma técnica baseada na reação em cadeia da polimerase foi usada para detectar o ácido desoxirribonucléico (DNA) do HPV em amostras de swabs endocervical e anal. Resultado: as taxas de positividade do HPV cervical e anal foram de 35,21% e 78,8%, respectivamente. As lesões relacionadas ao HPV na colpocitologia foram associadas à positividade anal para o HPV (P = 0,027). A proporção entre infecção cervical por HPV e lesões cervicais relacionadas foi de 2,5. A proporção entre a infecção anal por HPV e as lesões anais relacionadas foi de 4,3. 30% tinham DNA-HPV concomitante no colo do útero e ânus. Conclusão: existem diferenças na suscetibilidade de infecções e de lesões relacionadas entre o colo e o ânus. Apesar de maior incidência de HPV anal, a progressão para lesões relacionadas não ocorre da mesma forma no colo e no ânus. Além disso, lesões cervicais relacionadas ao HPV em mulheres HIV positivas podem servir como pista para estratégias preventivas anais. Investigações adicionais podem ser úteis.


Subject(s)
Humans , Female , Anus Neoplasms , HIV , Cervical Intraepithelial Neoplasia , Alphapapillomavirus , Cross-Sectional Studies
6.
Diagn. tratamento ; 26(2): 49-57, abr.-jun. 2021. tab, ilus
Article in Portuguese | LILACS | ID: biblio-1280724

ABSTRACT

Contexto e objetivo: No mundo, aproximadamente 20 milhões de mulheres encontram-se infectadas pelo papilomavírus humano (HPV). Esta infecção pode ser assintomática ou causar papilomas verrucosos benignos, neoplasias intraepiteliais cervicais (NICs) de baixo ou alto grau, carcinoma cervical, vaginal e anal. Os tratamentos atuais para as NICs ainda são muito invasivos e destrutivos. Sendo assim, existe a necessidade do desenvolvimento de modalidades menos agressivas. A terapia fotodinâmica (TFD) atende a esses pedidos, induzindo a morte seletiva de células infectadas pelo vírus. Este artigo tem o objetivo de analisar a redução da carga viral de HPV em pacientes com lesões intraepiteliais cervicais de alto grau (LIEAG) antes e após a TFD. Métodos: Foram incluídas 28 pacientes portadoras de NICs de alto grau que realizaram tratamento com 2,5 g de creme contendo o pró-fármaco ácido 5-metil aminolevulínico (MAL) a 20%, por aproximadamente 10 horas, com posterior aplicação da luz de LED com comprimento de onda de 630 nm e irradiância de 120 mW/cm2, por 25 minutos, entregando uma dose total de 180 J/cm2, em duas sessões. As pacientes foram avaliadas por meio de captura híbrida antes e após a TFD. Resultados: Após análise criteriosa, observou-se redução significativa da carga viral dos HPVs de alta oncogenicidade após a TFD (P = 0,0334) nas pacientes com LIEAG. O mesmo não foi observado em relação aos HPVs de baixo grau oncogênico (P = 0,4038). Conclusão: A TFD parece ser eficaz e promissora na diminuição da carga viral em pacientes com LIEAG induzidos por subtipos de HPV de alto grau oncogênico.


Subject(s)
Papillomaviridae , Photochemotherapy , Cervical Intraepithelial Neoplasia , Squamous Intraepithelial Lesions , Aminolevulinic Acid , Infections
7.
Rev. bras. ginecol. obstet ; 42(6): 340-348, June 2020. tab, graf
Article in English | LILACS | ID: biblio-1137843

ABSTRACT

Abstract Objective To evaluate the performance of the hybrid capture 2 (HC2) high-risk papillomavirus (hrHPV) assay and cytological test in women with previous abnormalities, to detect cervical intraepithelial neoplasia grade 2 or worse (≥ CIN 2). Methods A cytological test and HC2 (Qiagen, Gaithersburg, Maryland, EUA) for hrHPV were conducted in 359 liquid-based (Sure Path, Becton Dickinson, TriPath Imaging, Burlington, NC, USA) samples collected from women from the Vale do Ribeira Region, during July 2013 and September 2015 with previous cytology classified as atypical squamous cells of undetermined significance (ASC-US), low-grade squamous intraepithelial lesion (LSIL), atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesions (ASC-H), and atypical glandular cells (AGC). The histopathological examination was conducted in 179 women. The performance evaluations were calculated using the "exact" Clopper-Pearson 95% confidence interval (CI) test by MEDCALC (Medcalc Software Ltd, Ostend, Belgium). Results The ≥ CIN 2 frequency was 11.7% (21/179). The HC2 for hrHPV and repeat cytology to detect ≥ CIN 2 obtained, respectively, a sensitivity of 90.5% (95% CI = 69.6-98.8) and 90.5%, (95%CI = 69.6-98.8), a specificity of 65.8% (95% CI = 57.9-73.2) and 43.7% (95%CI = 35.8-51.8), a positive predictive value of 26.0% (95% CI = 21.4-31.3) and 17.6%, (95%CI = 14.9-20.6), and a negative predictive value of 98.1% (95%CI = 93.3-99.5) and 97.2% (95% CI = 90.1-99.2). Conclusion Hybrid capture 2 for hrHPV improves the performance of the detection of ≥ CIN 2, without compromising sensitivity, and provides a greater safety margin to return to the triennial screening of women undergoing follow-up due to previous abnormalities, without underlying ≥ CIN 2.


Resumo Objetivo Avaliar o desempenho da captura híbrida 2 (CH2) para papilomavírus humano de alto risco (HPVar) e repetição do exame citopatológico em mulheres com anormalidades em citologia anterior, para detectar neoplasia intraepitelial cervical grau 2 ou pior (≥ NIC 2). Métodos Foi realizado exame citopatológico e CH2 para HPVar (Qiagen, Gaithersburg, Maryland, EUA) em 359 amostras em meio líquido (Sure Path, Becton Dickinson, TriPath Imaging, Burlington, NC, USA) coletadas de mulheres da região do Vale do Ribeira, durante julho de 2013 e setembro de 2015 com citologia anterior classificada como células escamosas atípicas de significado indeterminado (ASC-US), lesão intraepitelial de baixo grau (LSIL), células escamosas atípicas, não podendo excluir lesão de alto grau (ASC-H) e células glandulares atípicas (AGC). O exame histopatológico foi realizado em 179 mulheres. As avaliações de desempenho foram calculadas usando o teste de intervalo de confiança (IC) "exato" de Clopper-Pearson de 95% pelo software MEDCALC (Medcalc Software Ltd, Ostend, Bélgica). Resultados A frequência de≥ NIC 2 foi 11,7% (21/179). A CH2 para o HPVar e a citologia de repetição para a detecção ≥ NIC 2 obteve, respectivamente, sensibilidade de 90.5% (IC 95% = 69,6-98,8) e 90,5% (IC 95% = 69,6-98,8), especificidade de 65,8% (IC 95% = 57,9-73,2) e 43,7%, (IC 95% = 35,8-51,8), valor preditivo positivo de 26,0% (IC 95% = 21,4-31,3) e 17,6%, (IC95% = 14,9-20,6), e valor preditivo negativo de 98,1% (IC 95% = 93,3-99,5) e 97,2%, (IC 95% = 90,1-99,2). Conclusão No geral, a CH2 para HPVar aprimora o desempenho para detecção de ≥ NIC 2, sem comprometer a sensibilidade e proporciona maior margem de segurança do retorno ao rastreio trienal de mulheres com anormalidades citológicas prévias, sem≥ NIC 2 subjacente.


Subject(s)
Humans , Female , Adolescent , Adult , Aged , Young Adult , Papillomaviridae/isolation & purification , Vaginal Smears , Uterine Cervical Neoplasms/diagnosis , Triage , Cervical Intraepithelial Neoplasia/diagnosis , Papillomavirus Infections/diagnosis , Atypical Squamous Cells of the Cervix/pathology , Brazil , Uterine Cervical Neoplasms/pathology , Cross-Sectional Studies , Sensitivity and Specificity , Cervical Intraepithelial Neoplasia/pathology , Papillomavirus Infections/pathology , Middle Aged
8.
Rev. bras. ginecol. obstet ; 42(3): 140-145, Mar. 2020. tab
Article in English | LILACS | ID: biblio-1098862

ABSTRACT

Abstract Objective To describe the referral for colposcopy in a Hospital in Brazil and the relative frequency of patients who benefited from it, considering the correct indications for the examination and its final diagnoses. Methods A retrospective study was performed in the colposcopy service database of the Hospital Universitário de Taubaté, Taubaté, state of São Paulo, Brazil. The frequency validated in the analysis of the medical records of women referred for clinical indication or cytological alteration, attended from March 2015 to March 2017. The population selected and analyzed included 256 results that were correlated to the cytological, clinical data and the result of the colposcopy. Results Of the women referred, 45% presented out of the age of screening according to the guidelines of cervical cancer screening, 8.6% being adolescents and young adults < 25 years old, and 36.4% of the patients being ≥ 65 years old. A total of 50% of the patients had no indication of colposcopy, that is, normal cytologies, benign changes, ectopia, cervicitis, atypical squamous cells of indeterminate significance (ASC-US) and low-grade intraepithelial lesion (LSIL) without persistence and normal clinical appearance. A total of 39.84% who underwent colposcopy had high-grade lesion or cancer results, thus benefiting from the adequate referral. Conclusion Most (60.16%) of the patients referred to the colposcopy service did not benefit from the referral for results without changes, such as negative colposcopies, histologies with no cervical intraepithelial neoplasm (CIN) or only CIN 1, or were out of the age for screening. These findings therefore demonstrate a significant number of unnecessary and inadequate referrals.


Resumo Objetivo Descrever os encaminhamentos para colposcopia em um hospital no Brasil e a frequência relativa dos pacientes que foram beneficiados, considerando as indicações corretas para o exame e seus diagnósticos finais. Métodos Foi realizado um estudo retrospectivo no banco de dados do serviço de colposcopia do Hospital Universitário de Taubaté, Taubaté, SP, Brasil. A frequência validou em análise de prontuários de mulheres encaminhadas por indicação clínica ou alteração citológica, atendidas no período de março de 2015 a março de 2017. A população selecionada e analisada incluiu 256 resultados que estavam correlacionadas aos dados citológicos, clínicos e com o resultado da colposcopia. Resultados Das mulheres encaminhadas, 45% apresentaram-se fora da idade de rastreamento conforme as diretrizes de rastreio de câncer de colo uterino, sendo que 8,6% eram adolescentes e adultas jovens < 25 anos de idade e 36,4% das pacientes tinham idade ≥ 65 anos. Um total de 50% das pacientes não possuía indicação de colposcopia, ou seja, citologias normais, de alterações benignas, ectopia, cervicite, células escamosas atípicas de significado indeterminado (ASC-US) e lesão intraepitelial escamosa de baixo grau (LSIL) sem persistência e aspecto clínico normal. Um total de 39,84% das pacientes que realizaram a colposcopia tiveram resultados de lesão de alto grau ou câncer e, dessa forma, se beneficiaram com o encaminhamento adequado. Conclusão A maioria (60,16%) das pacientes encaminhadas para o serviço de colposcopia não se beneficiou com o encaminhamento, por resultados sem alterações como colposcopias negativas, histologias com ausência de neoplasia intraepitelial cervical (NIC) ou apenas NIC 1, ou estavam fora da idade de rastreamento. Esses achados demonstram, portanto, significativo número de encaminhamentos desnecessários e inadequados.


Subject(s)
Humans , Female , Adolescent , Adult , Aged , Aged, 80 and over , Young Adult , Referral and Consultation/statistics & numerical data , Uterine Cervical Neoplasms/pathology , Cervical Intraepithelial Neoplasia/pathology , Colposcopy/statistics & numerical data , Brazil , Women's Health Services , Medical Records , Retrospective Studies , Age Factors , Hospitals , Middle Aged
9.
Rev. chil. obstet. ginecol. (En línea) ; 85(1): 74-98, feb. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1092778

ABSTRACT

El cáncer cérvico uterino (CaCu) corresponde al 10% de los cánceres femeninos, se describe prevenible y con viabilidad de curación, no obstante, con la optimización de las terapias las sobrevivientes superan los cinco años en el 70% de los casos, evidenciando efectos adversos producto principalmente del tratamiento que deterioran la calidad de vida e impactan sobre su sexualidad. OBJETIVO: Identificar efectos de la enfermedad y tratamiento que comprometen la calidad de vida sexual de la mujer con CaCu. METODOLOGÍA: Revisión de artículos originales entre los años 2010 y 2019 desde las bases de datos Pubmed, Scopus, Scielo, Google Académico, Science Direct, Elsevier, Redalyc, Springer Link, Wiley Online Library, Dialnet y Ovid, seleccionando 51 artículos de 90 en inglés, español y portugués a texto completo, que reportaran efectos físicos y psicosociales que comprometieran la calidad de vida sexual de mujeres con CaCu. RESULTADOS: La sexualidad de estas mujeres es impactada por efectos físicos, relacionadas con el estadio de la enfermedad y tratamiento como dispareunia, anorgasmia, alteraciones digestivas, urinarias, insomnio, inapetencia, linfedema y neuropatía periférica. Desde el ámbito psicosocial manifiestan efectos sobre su autoestima, depresión e inseguridad en la permanencia del vínculo de pareja. Emerge la comunicación sexual de pareja como condición categórica en el nivel de afectación de la calidad de vida sexual. CONCLUSIONES: la sexualidad de la mujer con CaCu está comprometida por efectos físicas y psicosociales secundarias principalmente al tratamiento recibido. La comunicación sexual de pareja surge como interviniente para superar estos efectos y debe considerarse en la atención profesional.


Cervical uterine cancer (CaCu) corresponds to 10% of female cancers, it is described as preventable and with viability of cure, however, with the optimization of therapies the survivors exceed five years in 70% of the cases, evidencing adverse effects mainly due to the treatment that deteriorates the quality of life and impact on their sexuality. OBJECTIVE: To identify the effects of the disease and treatment that compromises the quality of sexual life of women with CaCu. METHODOLOGY: Review of original articles between 2010 and 2019 from Pubmed, Scopus, Scielo, Google Scholar, Science Direct, Elsevier, Redalyc, Springer Link, Wiley Online Library, Dialnet, and Ovid databases, selecting 51 articles out of 90 in English, Spanish, and Portuguese in full text, which reported physical and psychosocial effects that compromises the quality of sexual life of women with CaCu. RESULTS: The sexuality of these women is impacted by physical effects, related to the stage of the disease and treatment, such as dyspareunia, anorgasmia, digestive and urinary disorders, insomnia, inappetence, lymphedema and peripheral neuropathy. From the psychosocial perspective, they show effects on their self-esteem, depression and insecurity in the permanence of the couple's relationship. Sexual communication between couples is emerging as a categorical condition in the level of affectation of the quality of sexual life. CONCLUSIONS: The sexuality of women with CaCu is compromised by physical and psychosocial effects mainly secondary to the treatment received. Couple's sexual communication emerges as an intervention to overcome these effects and should be considered in professional care.


Subject(s)
Humans , Female , Uterine Cervical Neoplasms/complications , Uterine Cervical Neoplasms/psychology , Cervical Intraepithelial Neoplasia/complications , Cervical Intraepithelial Neoplasia/psychology , Sexuality , Quality of Life , Sexual Behavior , Uterine Cervical Neoplasms/therapy , Cervical Intraepithelial Neoplasia/therapy , Sexual Health
10.
Säo Paulo med. j ; 138(1): 47-53, Jan.-Feb. 2020. tab, graf
Article in English | LILACS | ID: biblio-1099384

ABSTRACT

ABSTRACT BACKGROUND: Cervical cancer screening in Brazil is done using Pap smears. Women who are most likely to have a preinvasive lesion or cervical cancer are immediately referred for colposcopy. OBJECTIVE: The aim of this study was to evaluate the diagnostic performance of endocervical cytological tests in diagnosing preinvasive cervical lesions in women with initial high-grade squamous intraepithelial lesions (HSIL), or atypical squamous cells in which high-grade lesions could not be ruled out (ASC-H), or atypical glandular cells (AGC), and whose colposcopy did not show any abnormalities, with no fully visible transformation zone (types 2 and 3). DESIGN AND SETTING: Retrospective observational study conducted in Rio de Janeiro, Brazil. METHODS: Data from women who came to the cervical pathology outpatient clinic between January 2012 and April 2017 were analyzed. The results from endocervical cytological tests were compared with the final diagnosis, which was obtained through examination of a surgical specimen or, among women who did not undergo an excisional procedure, after cytological and colposcopic follow-up for two years. RESULTS: We included 78 women. The sensitivity of endocervical cytological tests was 72.7%; specificity 98.5%; positive and negative predictive values 88.9% and 95.6%, respectively; and positive and negative likelihood ratios 48.7 and 0.28. CONCLUSION: Endocervical cytological tests are simple, inexpensive and noninvasive, and form a reliable method for determining management among patients with HSIL, ASC-H and AGC cytological findings and negative colposcopic findings without visualization of the squamocolumnar junction.


Subject(s)
Humans , Female , Pregnancy , Uterine Cervical Neoplasms , Cervical Intraepithelial Neoplasia , Vaginal Smears , Brazil , Retrospective Studies , Colposcopy , Early Detection of Cancer
11.
Rev. saúde pública (Online) ; 54: 27, 2020. tab, graf
Article in English | LILACS | ID: biblio-1094408

ABSTRACT

ABSTRACT OBJECTIVES To determine the efficacy and safety of the use of cryotherapy, cold knife or thermocoagulation compared to Loop Electrosurgical Excision Procedure (LEEP) for the treatment of cervical intraepithelial neoplasia. METHODS Systematic review with meta-analysis of randomized controlled trials in women with cervical intraepithelial neoplasia undergoing treatment with cryotherapy, cold knife, or thermo-coagulation compared with LEEP, to estimate its efficacy and safety. The search was conducted on MEDLINE/PUBMED, Cochrane Central Register of Controlled Trials (CENTRAL) and Scopus, until September 2018. RESULTS The total of 72 studies were identified, of which only 8 studies met the inclusion criteria. The treatment of CIN with cold knife decreases the risk of residual disease compared with LEEP (RR, 0.54, 95%CI, 0.30-0.96, p = 0.04). The management of premalignant lesions with cryotherapy, compared with LEEP, increases the risk of disease recurrence by 86% (RR, 1.86, 95%CI, 1.16-2.97, p = 0.01), increases the risk of infections (RR, 1.17, 95%CI, 1.08-1.28, p < 0.001) and reduces the risk of minor bleeding by 51% (RR, 0.49, 95%CI) %, 0.40-0.59, p ≤ 0.001). CONCLUSIONS The treatment of premalignant lesions of cervical cancer with cold knife reduces the risk of residual disease. Nevertheless, cryotherapy reduces the risk of minor bleeding in the 24 hours after treatment and increases the risk of recurrence of disease and infections.


RESUMEN OBJETIVOS Evaluar la eficacia y seguridad del uso de crioterapia, cono frio o termo-coagulación en comparación con el procedimiento de escisión electroquirúrgica en asa (LEEP) para el manejo de neoplasias intraepiteliales cervicales. MÉTODOS Revisión sistemática de ensayos controlados aleatorizados en mujeres con neoplasia intraepitelial cervical en tratamiento con crioterapia, cono frio, o termo coagulación y LEEP, para estimar su eficacia y seguridad. La búsqueda se realizó en MEDLINE/PUBMED, Registro Cochrane Central de Ensayos Controlados (CENTRAL) y Scopus, hasta setiembre de 2018. RESULTADOS Se identificaron 72 estudios, ocho cumplieron los criterios de inclusión. Cono frio disminuyó el riesgo de enfermedad residual en comparación con LEEP (RR 0,54; IC del 95%, 0,30-0,96, p = 0,04). Crioterapia en comparación con LEEP incrementó el riesgo de recurrencia de enfermedad en un 86,0% (RR 1,86; IC del 95%, 1,16-2,97, p = 0,01) con un tiempo de seguimiento de seis a 24 meses, y de infecciones (RR, 1,17; IC del 95%, 1,08-1,28, p < 0,001); pero redujo el riesgo de sangrado menor en un 51,0% (RR 0,49; IC del 95%, 0,40-0,59, p ≤ 0,001). CONCLUSIONES Cono frio reduce el riesgo de enfermedad residual. Sin embargo, la crioterapia reduce el riesgo de sangrado menor en las 24 horas posteriores al tratamiento e incrementa el riesgo de recurrencia de enfermedad y de infecciones.


Subject(s)
Humans , Female , Uterine Cervical Neoplasms/surgery , Cryotherapy/methods , Cervical Intraepithelial Neoplasia/surgery , Conization/methods , Electrocoagulation/methods , Postoperative Complications , Uterine Cervical Neoplasms/pathology , Risk , Risk Factors , Cervical Intraepithelial Neoplasia/pathology , Neoplasm Recurrence, Local/surgery , Neoplasm Recurrence, Local/pathology
12.
Ann. afr. méd. (En ligne) ; 13(4): 3861-3866, 2020. tab
Article in French | AIM, AIM | ID: biblio-1259094

ABSTRACT

Contexte et objectif.Bien que le cancer du col utérin soit le deuxième cancer plus fréquent chez la femme en Afrique, le recours aux biomarqueurs immunohistochimiques reste exceptionnel en Afrique subsaharienne. La présente étude avait pour objectif de montrer l'apport des biomarqueurs p16 et Ki-67 dans le diagnostic des néoplasies intra-épithéliales du col utérin. Méthodes. C'était une étude rétrospective réalisée dans cinq laboratoires d'Anatomie Pathologique de Kinshasa. Des lames biopsiques ont été relues et reclassées par au moins deux pathologistes indépendants aux Cliniques Universitaires de Kinshasa en suivant la nomenclature de Bethesda/OMS. L'immunomarquage (p16 et Ki-67) a été réalisé avec un contrôle qualité externe en Europe. Résultats. 70 cas ont été inclus. Les 24 cas des néoplasies intra-épithéliales de haut grade (CIN2, CIN3 et CIS) étaient marquées positivement par p16 et Ki-67 alors que celles de bas grade étaient marquées positivement pour 41 cas de CIN1 et négativement pour 5 cas (3 de CIN1 et 2 de CP). Certaines lésions ont été requalifiées. L'immunomarquage était significativement associé au grade des néoplasies pour la p16 (p=0,001) et pour le Ki-67 (p=0,004). Conclusion. P16 et Ki-67 sont des biomarqueurs spécifiques et efficaces pour un diagnostic optimal des néoplasies intra-épithéliales du col utérin


Subject(s)
Cervical Intraepithelial Neoplasia , Cervix Uteri , Democratic Republic of the Congo , Genetic Diseases, Inborn
13.
Article in English | WPRIM | ID: wpr-811219

ABSTRACT

OBJECTIVE: To investigate pathologic discrepancies between colposcopy-directed biopsy (CDB) of the cervix and loop electrosurgical excision procedure (LEEP) in women with cytologic high-grade squamous intraepithelial lesions (HSILs).METHODS: We retrospectively identified 297 patients who underwent both CDB and LEEP for HSILs in cervical cytology between 2015 and 2018, and compared their pathologic results. Considering the LEEP to be the gold standard, we evaluated the diagnostic performance of CDB for identifying cervical intraepithelial neoplasia (CIN) grades 2 and 3, adenocarcinoma in situ, and cancer (HSIL+). We also performed age subgroup analyses.RESULTS: Among the study population, 90.9% (270/297) had pathologic HSIL+ using the LEEP. The diagnostic performance of CDB for identifying HSIL+ was as follows: sensitivity, 87.8%; specificity, 59.3%; balanced accuracy, 73.6%; positive predictive value, 95.6%; and negative predictive value, 32.7%. Thirty-three false negative cases of CDB included CIN2,3 (n=29) and cervical cancer (n=4). The pathologic HSIL+ rate in patients with HSIL− by CDB was 67.3% (33/49). CDB exhibited a significant difference in the diagnosis of HSIL+ compared to LEEP in all patients (p<0.001). In age subgroup analyses, age groups <35 years and 35–50 years showed good agreement with the entire data set (p=0.496 and p=0.406, respectively), while age group ≥50 years did not (p=0.036).CONCLUSION: A significant pathologic discrepancy was observed between CDB and LEEP results in women with cytologic HSILs. The diagnostic inaccuracy of CDB increased in those ≥50 years of age.


Subject(s)
Adenocarcinoma in Situ , Biopsy , Cervical Intraepithelial Neoplasia , Cervix Uteri , Colposcopy , Conization , Dataset , Diagnosis , Early Detection of Cancer , Female , Humans , Papanicolaou Test , Retrospective Studies , Sensitivity and Specificity , Squamous Intraepithelial Lesions of the Cervix , Uterine Cervical Neoplasms
16.
Rev. cuba. invest. bioméd ; 38(4): e249, oct.-dic. 2019. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1093419

ABSTRACT

Introducción: El virus de papiloma humano per se no es capaz de desarrollar todas las transformaciones neoplásicas en el cérvix uterino, de manera que factores de riesgo como los genéticos, ambientales, estilo de vida sexual y el desbalance oxidativo podrían contribuir a la enfermedad. Objetivo: Determinar el comportamiento del sistema enzimático antioxidante en mujeres con atipia de células escamosas de significado indeterminado y neoplasia intraepitelial cervical grado I. Métodos: Se conformaron tres grupos de estudio: el primero incluyó 30 mujeres con diagnóstico de atipias, el segundo se constituyó con 40 mujeres con neoplasia intraepitelial grado I y el tercero consistió en 30 mujeres con citología negativa tomadas como control, provenientes de la consulta de Patología de Cuello del Agustín Gómez Lubián de Santa Clara. Mediante métodos espectrofotométricos se determinaron los niveles de actividad enzimática superóxido dismutasa y catalasa así, como las concentraciones de glutatión reducido. Las comparaciones se realizaron con el programa SPSS, versión 18. Resultados: En el grupo de atipias aunque los tres parámetros tuvieron una tendencia a la disminución no hubo diferencias significativas con respecto al control. Mientras que el grupo de neoplasia grado I evidenció disminución significativa de los tres indicadores estudiados al ser comparados con el grupo control. Conclusiones: Se constató afectación del sistema antioxidante enzimático en el grupo de neoplasia grado I, lo cual podría considerarse un cofactor importante en la progresión de las lesiones en el cérvix uterino(AU)


Introduction: Human papillomavirus per se can not carry out all the neoplastic transformations occurring in the uterine cervix. Genetic and environmental risk factors as well as sexual behavior and oxidative imbalance may also play a role. Objective: Determine the behavior of the enzymatic antioxidant system in women with squamous cell atypia of indeterminate significance and grade I cervical intraepithelial neoplasia. Methods: Three study groups were formed. The first group included 30 women diagnosed with atypia, the second group was made up of 40 women with grade I intraepithelial neoplasia, and the third or control group consisted of 30 women with negative cytology from Agustín Gómez Lubián Cervical Pathology service in Santa Clara. Spectrophotometric methods were used to determine the levels of superoxide dismutase and catalase enzymatic activity, as well as the concentrations of reduced glutathione. Comparisons were made with the SPSS software, version 18. Results: In the atypia group the three parameters showed a decreasing tendency, but differences with respect to the control group were not significant. In the grade I neoplasia group, however, a significant reduction was found of the three study indicators when compared with the control group. Conclusions: Damage to the enzymatic antioxidant system was observed in the grade I neoplasia group. This could be considered to be an important cofactor in the progress of uterine cervix lesions(AU)


Subject(s)
Female , Papilloma , Carcinoma in Situ/prevention & control , Cervix Uteri , Cervical Intraepithelial Neoplasia/diagnosis , Cell Biology , Life Style , Antioxidants/analysis , Sexual Behavior , Case-Control Studies , Indicators and Reagents
17.
Rev. Ciênc. Méd. Biol. (Impr.) ; 18(3): 361-366, dez 20, 2019. fig
Article in Portuguese | LILACS | ID: biblio-1359168

ABSTRACT

Introdução: a reação em cadeia da polimerase (PCR) é a técnica de biologia molecular mais utilizada na detecção viral, principalmente em situações onde a quantidade de DNA disponível é pequena. O papilomavírus humano (HPV) representa um dos mais graves problemas de saúde pública e está associado ao câncer do colo do útero, especialmente em países em desenvolvimento, como o Brasil, que desde 2009 já apresentava 40 mil novos casos por ano. Objetivo: descrever a evolução da PCR e sua contribuição no diagnóstico do HPV. Metodologia: realizou-se uma revisão de literatura a partir de publicações disponíveis em base de dados eletrônicos, como Science Direct, SciELO, Pubmed, Instituto Nacional do Câncer e Ministério da Saúde do Brasil, nos últimos cinco anos. Resultados: dentre as técnicas citadas nesta revisão de literatura, todas têm alta relevância na detecção de genotipagem do HPV, embora a escolha quanto ao melhor desempenho fique a critério do pesquisador. A técnica de Nested PCR demonstra ser a mais vantajosa na detecção do vírus, pelo fato de ter uma maior sensibilidade, em comparação com as demais. Conclusão: a técnica PCR possui alta sensibilidade (90-100%) e apresenta 92,8 a 100% de especificidade, sendo padrão ouro para a detecção de DNA do HPV, em amostras citológicas do câncer de colo do útero. Assim, os dados obtidos permitem constatar que a técnica PCR, utilizada para o rastreamento do HPV, é considerada padrão ouro, tendo maior sensibilidade, especificidade e velocidade de análise, devendo ser o método de escolha para o diagnóstico eficiente do HPV.


Introduction: polymerase chain reaction (PCR) is the most widely used molecular biology technique for viral detection, especially in situations where the amount of available DNA is small. Human papillomavirus (HPV) represents one of the most serious public health problems and is associated with cervical cancer, especially in developing countries such as Brazil that has had 40,000 (forty thousand) new cases a year, since 2009. Objective: to describe the evolution of PCR and its contribution to HPV diagnosis. Methodology: a literature review was conducted from publications available in electronic databases, such as Science Direct, SciELO, Pubmed, National Cancer Institute and Ministry of Health of Brazil, in the last five years. Results: among the techniques cited in this literature review, all have high relevance in the detection of HPV genotyping, although the choice for the best performance is at the discretion of the researcher. The Nested PCR technique proves to be the most advantageous in detecting the virus because it has a higher sensitivity compared to the others. Conclusion: the PCR technique has high sensitivity (90-100%) and presents 92.8 to 100% specificity, being the gold standard for the HPV DNA detection in cytology samples of uterus cervix cancer. Thus, the data obtained show that the PCR technique used for HPV screening is considered the gold standard, having greater sensitivity, specificity and speed of analysis, and should be the method of choice for the efficient diagnosis of HPV.


Subject(s)
Humans , Female , Papillomaviridae , Uterine Neoplasms , Polymerase Chain Reaction , Cervical Intraepithelial Neoplasia , Real-Time Polymerase Chain Reaction , Database
18.
Rev. bras. anal. clin ; 51(4): 306-314, 2019/12/30. tab
Article in Portuguese | LILACS | ID: biblio-1103997

ABSTRACT

Objetivo: O objetivo desse estudo foi comparar resultados de exames colpocitológicos realizados em âmbito nacional, na região sudeste e em Minas Gerais com aqueles obtidos no município de Governador Valadares (GV). Métodos: As informações sobre exames colpocitológicos, realizados nas quatro esferas, de janeiro/2006 a dezembro/2014, foram obtidas na consulta ao Sistema de Informação do Câncer do Colo do Útero ­ Siscolo. Resultados: A taxa de exames alterados foi de 2,8%, 3,3%, 2,2% e 2,7% [Brasil, Sudeste, Minas Gerais (MG) e GV, respectivamente]. Essa taxa foi significativamente mais alta em GV quando comparada com MG e significativamente mais baixa que a da região sudeste e do Brasil. As principais alterações, em todas as esferas, foram: atipias em células escamosas de significado indeterminado possivelmente não neoplásicas, lesão intraepitelial escamosa de baixo grau e lesão intraepitelial escamosa de alto grau. As taxas de incidência de câncer do colo do útero foram: 27,03; 28,02; 16,99 e 23,16 casos por 100 mil habitantes no país, região sudeste, MG e GV, respectivamente. Governador Valadares apresentou uma taxa significativamente mais alta apenas quando comparada com dados de Minas Gerais. Conclusão: Concluindo, os exames realizados em GV mostram algumas diferenças significativas em relação às outras esferas. É necessário implementar uma política de monitoramento interno da qualidade para aumentar a sensibilidade do exame, além de maior investimento na educação continuada do profissional que faz a leitura das lâminas.


Objective: Cervical cancer is one of the leading causes of cancer death in women and can be prevented by the early detection of precursor lesions by cytological techniques. The objective of this study was to compare the results of colpocytological exams performed at national, regional and state level with those obtained at Governador Valadares (GV). Methods: Information was obtained on colpocytological exams performed in the four spheres, from January / 2006 to December / 2014, from the Cervical Cancer Information System ­ Siscolo. Results: The rate of altered exams was 2.8%, 3.3%, 2.2% and 2.7% [Brazil, Southeast, Minas Gerais (MG) and GV, respectively]. This rate was significantly higher in GV when compared to MG and significantly lower than that in the Southeast and Brazil. The main injuries in all spheres were: atypical squamous cells of undetermined significance, possibly non-neoplastic, low grade squamous intraepithelial lesion and high grade squamous intraepithelial lesion. The incidence rates of cervical cancer were: 27.03; 28.02; 16.99 and 23.16 cases per 100,000 inhabitants in the country, southeast region, MG and GV, respectively. GV showed a significantly higher rate only when compared with MG data. Conclusion: Concluding, the exams carried out in GV show some significant differences in relation to the other spheres. It is necessary to implement an internal quality monitoring policy to improve the quality of the exam, besides greater investment in the continuing education of the professional who does the scrutiny of the blades.


Subject(s)
Humans , Female , Child , Adolescent , Adult , Middle Aged , Vaginal Smears , Cervical Intraepithelial Neoplasia , Papanicolaou Test
19.
J. coloproctol. (Rio J., Impr.) ; 39(4): 297-302, Oct.-Dec. 2019. tab
Article in English | LILACS | ID: biblio-1056650

ABSTRACT

Abstract Objective: To describe the epidemiological, clinical and laboratory profiles of women with anal neoplasia associated with cervical neoplasia attending a tertiary healthcare facility in northeastern Brazil. Methods: This epidemiological, descriptive study was conducted using a database from a cross-sectional study carried out between December 2008 and January 2016. Women with a diagnosis of cervical neoplasia associated with anal neoplasia were included in the present study. Results: Of the women with cervical neoplasia, 14% were found to have an anal intraepithelial lesion or anal cancer. Median age was 33 years, 68% were non-white, and 70% were from urban regions, had little schooling and low income. Most reported having had anoreceptive (73%) and unprotected intercourse (84%). Regarding symptoms, 7% reported bleeding and 11% pruritus. Overall, 10% of the sample tested positive for the human immunodeficiency virus. Anal cytology was abnormal in 92%. High-resolution anoscopy was abnormal in all cases. Histopathology revealed three cases of invasive carcinoma and high-grade lesions in 32% of the cases. Conclusion: Women with a diagnosis of anal and cervical neoplasia are often young, non-white women, who initiated their sexual life at an early age, were exposed to unprotected anoreceptive intercourse, live in urban centers, have little schooling and a low-income level.


Resumo Objetivo: Descrever os perfis epidemiológico, clínico e laboratorial de mulheres com neoplasia anal associada à neoplasia cervical atendidas em uma unidade de saúde terciária no nordeste do Brasil. Métodos: Este estudo epidemiológico e descritivo usou um banco de dados de um estudo transversal realizado entre dezembro de 2008 e janeiro de 2016. Mulheres com diagnóstico de neoplasia cervical associada à neoplasia anal foram incluídas no presente estudo. Resultados: Das mulheres com neoplasia cervical, 14% apresentaram lesão intra-epitelial anal ou câncer anal. A mediana de idade foi de 33 anos; 68% das pacientes não eram brancas e 70% eram provenientes de regiões urbanas, com baixa escolaridade e baixa renda. A maioria relatou histórico de relações sexuais anoreceptivas (73%) e desprotegidas (84%). Quanto aos sintomas, 7% relataram sangramento e 11% prurido. No geral, 10% das pacientes apresentaram serologia positiva para o vírus da imunodeficiência humana. A citologia anal foi anormal em 92% da amostra. A anuscopia de alta resolução foi anormal em todos os casos. A histopatologia revelou três casos de carcinoma invasivo e lesões de alto grau em 32% dos casos. Conclusão: As mulheres com diagnóstico de neoplasia anal e cervical geralmente são jovens, não brancas, que iniciaram sua vida sexual em idade precoce, foram expostas a relações sexuais anoreceptivas desprotegidas, moram em centros urbanos e têm baixa escolaridade e baixo nível de renda.


Subject(s)
Humans , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , Anus Neoplasms/epidemiology , Health Profile , Carcinoma in Situ/epidemiology , Uterine Cervical Neoplasms/epidemiology , Anus Neoplasms/diagnosis , Socioeconomic Factors , Brazil , Carcinoma in Situ/diagnosis , Uterine Cervical Neoplasms/diagnosis , Cervical Intraepithelial Neoplasia/diagnosis , Cervical Intraepithelial Neoplasia/epidemiology , Tertiary Care Centers
20.
Rev. cuba. obstet. ginecol ; 45(3): e478, jul.-set. 2019. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1093653

ABSTRACT

Introducción: El cáncer cérvico uterino es la segunda neoplasia más común en mujeres en el mundo. Una buena correlación entre las pruebas de tamizaje, diagnóstico y tratamiento de las lesiones cervicales optimiza su manejo, evita procedimientos innecesarios y maximiza recursos disponibles. Objetivo: Identificar la relación entre los métodos diagnósticos de las patologías del cuello uterino. Métodos: Se realizó un estudio observacional, descriptivo, transversal y prospectivo en el Hospital Provincial Camilo Cienfuegos de Sancti Spíritus, desde septiembre de 2015 a septiembre de 2017. Se tomó una población de 1172 pacientes de la consulta de patología de cuello uterino según los criterios de la investigación. Los métodos científicos fueron: de nivel teórico, empírico-experimental y matemático-estadístico. Se asumieron las variables: edad, factores de riesgo asociados, sintomatología, citología, colposcopia y biopsia. Resultados: El grupo de edad que con mayor frecuencia se presentó estuvo comprendido entre 26 y 35 años de edad. Los principales factores de riesgo asociados fueron: edad de inicio de las relaciones sexuales antes de los 18 años, virus del papiloma humano, paridad de más de dos hijos y antecedentes familiares de alguna patología de cuello. La sintomatología destacada fue el sangramiento poscoital e intermenstrual. Los resultados de los métodos diagnósticos fueron: virus del papiloma humano y displasia leve, tanto en la citología como en la biopsia, y lesiones de bajo grado en la colposcopia. Conclusiones: La asociación entre los métodos diagnósticos estudiados mostró una buena correlación citocolposcópica y colpohistológica, con diagnóstico de confirmación principalmente ante lesiones de alto grado(AU)


Introduction: Cervical cancer is the second most common neoplasm in women in the world. Good correlation between screening tests, diagnosis and treatment of cervical lesions optimizes management, avoiding unnecessary procedures and maximizing available resources. Objective: To identify the relationship between the diagnostic methods of cervical pathologies. Methods: An observational, descriptive, cross-sectional and prospective study was conducted at Camilo Cienfuegos Provincial Hospital in Sancti Spíritus, from September 2015 to September 2017. A population of 1172 patients was taken from the cervical pathology clinic according to the research criteria. The scientific methods were theoretical, empirical-experimental and mathematical-statistical. The assumed variables were age, associated risk factors, symptomatology, cytology, colposcopy and biopsy. Results: The age group that most frequently appeared was ages between 26 and 35 years. The main associated risk factors were age of first sexual intercourse before 18 years old, human papillomavirus, parity of more than two children and family history of some cervix pathology. The outstanding symptomatology was postcoital and intermenstrual bleeding. The results of the diagnostic methods were human papillomavirus and mild dysplasia, both in cytology and biopsy, and low-grade colposcopy lesions. Conclusions: The association between the diagnostic methods studied showed good cytocolposcopic and colpohistological correlation, with confirmation diagnosis mainly in cases of high-grade lesions(AU)


Subject(s)
Humans , Female , Adolescent , Adult , Uterine Cervical Diseases/pathology , Cervical Intraepithelial Neoplasia/diagnosis , Colposcopy/methods , Epidemiology, Descriptive , Cross-Sectional Studies , Prospective Studies
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