Navegando por Palavras-chave "Colpocitologia"
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- ItemAcesso aberto (Open Access)Avaliação dos Métodos Empregados no Programa Nacional de Combate ao Câncer do Colo Uterino do Ministério da Saúde(Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, 2001-05-01) Roberto Neto, Alfredo [UNIFESP]; Ribalta, Julisa Chamorro Lascasas [UNIFESP]; Focchi, José [UNIFESP]; Baracat, Edmund Chada [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Purpose: to evaluate a populational sample of the screening proposed by the National Program of Uterine Cervical Cancer Control (PNCC), regarding the following issues: frequency of unsatisfactory cytologic results, cytologic frequency of atypical squamous or glandular cells of undetermined significance (ASCUS, AGCUS), low- or high-grade squamous intraepithelial lesions (SIL), comparing the cytologic results with anatomicopathological results of colposcopically directed biopsies. Methods: through the written, broadcasting television and oral midia, women between 35 and 49 years were requested to have a preventive cytopathological test, to be collected by the authorized public health or other institutions accredited by SUS. The slides were analyzed by the program-authorized laboratories and all those patients from the populational sample from the municipality of Naviraí in the State of Mato Grosso do Sul with cellular alterations were submitted to colposcopy and directed biopsy. Results: the frequency of cytologic alterations of the ASCUS, AGCUS and SIL types was 3.3%, an index that is close to that predicted by the PNCC (4%); the percentage of samples that were unsatisfactory for evaluation was high (12.5%); among the ASCUS, AGCUS or low grade-SIL patients, 27.3% presented intraepithelial lesions of a high grade in the anatomicopathological study; while patients with cytology compatible with high grade-SIL, the directed biopsy revealed that 12.5% presented low-grade intraepithelial lesions. Conclusions: the choice of oncological cytology as the only method for the screening in the program allowed high indexes of false-negatives (27.3%) and of false-positives (12.5%). In the screening of cervical neoplasms, colposcopy has shown to be an important and indispensable method to guide the therapeutical management to be adopted.
- ItemAcesso aberto (Open Access)Relação entre diagnóstico citopatológico de neoplasia intra-epitelial cervical e índices de células CD4+ e de carga viral em pacientes HIV-soropositivas(Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, 2004-03-01) Coelho, Raquel Autran [UNIFESP]; Facundo, [UNIFESP]; Nogueira, Aline Leite [UNIFESP]; Sakano, Célia Regina Souza Bezerra [UNIFESP]; Ribalta, Julisa Chamorro Lascasas [UNIFESP]; Baracat, Edmund Chada [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)PURPOSE: to correlate the type of cervical lesion diagnosed by Pap smear with CD4 cell counts and HIV-RNA viral load in HIV-positive patients. METHODS: one hundred and fifteen HIV patients were evaluated retrospectively in the present study, during the period from January 2002 to April 2003, at a university hospital. Eighty-three patients presented cervical intraepithelial neoplasia (CIN) in Pap smear, in comparison with thirty-two with no lesions. Patients were divided into three groups, according to CD4 counts: CD4 more than 500 cells/mm³, between 200 and 500 cells/mm³, and less than 200 cells/mm³, and other three groups, according to HIV viral load: less than 10,000 HIV-RNA copies/mL, between 10,000 and 100,000 HIV-RNA copies/mL, or more than 100,000 HIV-RNA copies/mL. Correlation was investigated by the Fisher test. RESULTS: of the eighty-three patients with CIN, 73% presented CD4 counts less than 500 cells/mm³. In all CD4 groups, more than 50% of the patients presented CIN. According to the viral load, 71.7% of the patients with less than 10,000 HIV-RNA copies/mL presented CIN I, compared with 11.3% that showed CIN III. In the group with higher viral load (>100.000 HIV-RNA copies/mL), 61.5% showed CIN I and 30.8% presented CIN III. CONCLUSION: association between viral load and CIN was established (p=0.013), which was not observed with CD4 cell counts and CIN. Concomitant cervicovaginal infection was considered a potential confounding factor.
- ItemAcesso aberto (Open Access)Resultado da cirurgia com alça de alta freqüência e localização colposcópica da área com atipia ectocervical(Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, 2001-07-01) Cardoso, Maria Silvana [UNIFESP]; Ribalta, Julisa Chamorro Lascasas [UNIFESP]; Taha, Nabiha Saadi Abrahão [UNIFESP]; Focchi, José [UNIFESP]; Baracat, Edmund Chada [UNIFESP]; Lima, Geraldo Rodrigues [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Purpose: to evaluate the histopathologic results of cone specimens of patients undergoing loop electrosurgical excision procedure (LEEP) and their relationship with the localization of the lesion. Methods: in a retrospective study, 134 clinical reports of patients with abnormal findings of cervical cytology and/or biopsy undergoing LEEP were reviewed. The colposcopic findings were divided into three groups according to the localization of the lesion. Group I (n = 36): patients with ectocervical lesions and fully visible squamocolumnar junction; Group II (n = 50): patients with lesions at the ectocervix and endocervix, and Group III (n = 48): patients with unsatisfactory colposcopy. Results: the mean age in Group I was 33 years and there were 8.3% positive margins. In Group II the mean age was 39 years, with 36% positive margins. Group III had a mean age of 48 years and presented 29.2% positive margins. The percentage of residual disease was 4.2% in Group I, 31.6% in Group II and 35.5% in Group III. Conclusion: patients with lesions at the endocervical canal showed a higher rate of positive margins. Patients with high-grade cervical intraepithelial neoplasia at the endocervical canal and older than 40 years have a greater chance of showing positive margins and residual disease, therefore requiring stricter cytologic and colposcopic follow-up.