RESUMO
To address the feasibility of implementing a lung cancer screening program in liver transplant recipients (LTR) targeted to detect early-stage lung cancer one hundred twenty-four LTR (89% male, 59.8+/-8.8 y old), who entered the lung cancer screening program at our hospital were reviewed. The results of the diagnostic algorithm using low-dose CT and F-18-fluorodeoxyglycose positron emission tomography (FDG-PET) were analyzed. Lung cancer was detected in 12 LTR (9.7%), most of which corresponded to the non-small cell subtype. Two of the 12 lung cancers were detected in the baseline study (prevalence of 1.6%), whereas 10 patients were diagnosed with lung cancer in the follow-up (incidence of 8.1%). Considering all cancers, 10 of 12 (83.3%) were diagnosed at stage I, one cancer was diagnosed at stage IIIA, and another one at stage IV. The sensitivity, specificity, diagnostic accuracy, and positive and negative predictive values of F-18-fluorodeoxyglycose positron emission tomography to detect malignancy in our cohort were 81.8%,100%, 99.3%, 100%, and 99.3%, respectively. A carefully followed multidisciplinary lung cancer screening algorithm in LTR that includes F-18-fluorodeoxyglycose positron emission tomography and low-dose CT allows lung cancer to be diagnosed at an early stage while reducing unnecessary invasive procedures.
Assuntos
Transplante de Fígado , Neoplasias Pulmonares , Humanos , Masculino , Feminino , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/epidemiologia , Neoplasias Pulmonares/cirurgia , Fluordesoxiglucose F18 , Detecção Precoce de Câncer/métodos , Transplante de Fígado/efeitos adversos , Compostos Radiofarmacêuticos , Tomografia por Emissão de Pósitrons , Tomografia Computadorizada por Raios X , Estudos RetrospectivosRESUMO
OBJECTIVE: Cervical carcinoma (CC) is the second cause of death among women aged 15 and 44 in Spain. CC is linked to hig-risk human papillomavirus (HR-HPV) infection and its prevalence varies according age and geographical region. The awereness of the latter is essential for public health prevention efforts. The aim was to study the age related in HR-HPV genotypes in cytologies with squamous intraepithelial lesion (SIL). METHODS: From a total of 67,935 ginecologic cytologies over a four-year period, we selected cytologic specimens with SIL. We used the Cervista® test to detect HR-HPV DNA. Women were classified into two groups under 35 and over 35 years old. Proportions were estimated with confidence intervals at 95% (95% CI). RESULTS: HR-HPV prevalence was 59,7%; 64,6% in women under 35 years old. HR-HPV species alpha 9 type 16 (HR-HPV 16) and alpha 5 type 51 (HR-HPV 51) were the most prevalent (60,9% and 51,7%). High-grade squamous intraepithelial lesions (H-SIL) were twice as high in women under 35 years (6,5 vs. 3,7%). 88,8% of H-SIL was associated HR-HPV 16, which increases the probability of H-SIL against Low-grade squamous intraepithelial lesions (L-SIL) regardless of age. CONCLUSIONS: In our population HR-HPV 16 was associated to H-SIL whereas HR-HPV specie alpha 7 type 18 and HR-HPV 51 to L-SIL regardless of age. The high prevalence of HR-HPV 51 in Navrra´s population (51,7%), suggests that local vaccination programs be re-assessed.
El cáncer de cuello uterino (CCU)es la segunda causa de muerte en España en mujeres entre 15 y 44 años. Esta ligado íntimamente a la infección por el virus del papiloma humano de alto riesgo (VPH-AR). La prevalencia del VPH-AR incrementa según la gravedad de la lesión, grupo etario y región geográfica cuyo conocimiento es esencial para el desarrollo de estrategias de prevención. El objetivo fue determinar la influencia de la edad de las mujeres (menores o mayores de 35 años) en relación con la especie de VPH-AR presente y la lesión escamosa intraepitelial (LEI).
Assuntos
Alphapapillomavirus/classificação , Infecções por Papillomavirus/epidemiologia , Lesões Intraepiteliais Escamosas Cervicais/virologia , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Alphapapillomavirus/isolamento & purificação , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/diagnóstico , Prevalência , Fatores de Risco , Espanha/epidemiologia , Lesões Intraepiteliais Escamosas Cervicais/patologia , Neoplasias do Colo do Útero/diagnóstico , Adulto JovemRESUMO
Fundamento: El cáncer de cuello uterino (CCU) es la segunda causa de muerte en España en mujeres entre 15 y 44 años. Esta ligado íntimamente a la infección por el virus del papiloma humano de alto riesgo (VPH-AR). La prevalencia del VPH-AR incrementa según la gravedad de la lesión, grupo etario y región geográfica cuyo conocimiento es esencial para el desarrollo de estrategias de prevención. El objetivo fue determinar la influencia de la edad de las mujeres (menores o mayores de 35 años) en relación con la especie de VPH-AR presente y la lesión escamosa intraepitelial (LEI). Material: Estudio observacional transversal de las citologías líquidas ginecológicas con LEI recibidas en el Hospital de Navarra entre 2010 y 2014 (67.935). A todas ellas se les realizó la detección del VPH-AR (Cervista®- Hologic). Las mujeres se clasificaron en menores de 35 e igual o mayores de 35 años. Se estimó la proporción e intervalo de confianza al 95% (IC95%). Resultados: La prevalencia de VPH-AR fue del 59,7%, el 64,6% en mujeres menores de 35 años. Las especies de VPH-AR alfa 9 del subtipo 16 (VPH-AR 16) y alfa 5 del subtipo 51 (VPH-AR 51) fueron los más frecuentes (60,9% y 51,7%). En las mujeres mayores de 35 años la prevalencia de lesiones escamosas de alto grado (H-SIL) fue 6,5 % y en las de menor edad 3,7%. El 88,8% de las H-SIL estaban asociadas a VPH-AR 16. La presencia de VPH-AR 16 quintuplica la probabilidad de H-SIL frente a LEI de bajo grado independientemente de la edad. Conclusiones: El VPH-AR 16 se asoció a H-SIL mientras que las especies de VPH-AR alfa 7 del subtipo 18 y VPH-AR 51 se asociaron a LEI de bajo grado independientemente de la edad. La alta prevalencia de VPH-AR en la Comunidad de Navarra puede ser relevante en la futura planificación de las estrategias de vacunación en nuestro entorno (AU)
Background: Cervical carcinoma (CC) is the second cause of death among women aged 15 and 44 in Spain. CC is linked to hig-risk human papillomavirus (HR-HPV) infection and its prevalence varies according age and geographical region. The awereness of the latter is essential for public health prevention efforts. The aim was to study the age related in HR-HPV genotypes in cytologies with squamous intraepithelial lesion (SIL). Methods: From a total of 67,935 ginecologic cytologies over a four-year period, we selected cytologic specimens with SIL. We used the Cervista® test to detect HR-HPV DNA. Women were classified into two groups under 35 and over 35 years old. Proportions were estimated with confidence intervals at 95% (95% CI). Results: HR-HPV prevalence was 59,7%; 64,6% in women under 35 years old. HR-HPV species alpha 9 type 16 (HR-HPV 16) and alpha 5 type 51 (HR-HPV 51) were the most prevalent (60,9% and 51,7%). High-grade squamous intraepithelial lesions (H-SIL) were twice as high in women under 35 years (6,5 vs. 3,7%). 88,8% of H-SIL was associated HR-HPV 16, which increases the probability of H-SIL against Low-grade squamous intraepithelial lesions (L-SIL) regardless of age. Conclusions: In our population HR-HPV 16 was associated to H-SIL whereas HR-HPV specie alpha 7 type 18 and HR-HPV 51 to L-SIL regardless of age. The high prevalence of HR-HPV 51 in Navarra´s population (51,7%), suggests that local vaccination programs be re-assessed (AU)
