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Patología Revista Latinoamericana

2008, Número 4

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Patol Rev Latinoam 2008; 46 (4)


Lesión premaligna escamosa del cuello uterino, un enfoque actualizado

de la Torre RFE

Idioma: Español
Referencias bibliográficas: 67
Paginas: 332-342
Archivo PDF: 686.32 Kb.


RESUMEN

La nomenclatura y concepto de las lesiones premalignas del epitelio escamoso del cuello uterino han evolucionado en los últimos 32 años, a partir de la detección del VPH en las atipias coilocíticas y lesiones displásicas reportadas por Meisels y su grupo, y Purola y Salvia. En este tiempo se ha revelado la falta de reproducibilidad del diagnóstico histopatológico y el uso heterogéneo de los criterios de clasifi cación, tanto para la histología como para citología. Entre los progresos relevantes se encuentran las clasifi caciones de Richart y el Sistema Bethesda. Con el desarrollo de la inmunohistoquímica y biología molecular se ha comprendido la patogenia y evolución de estas lesiones y han provocado la incorporación de diversos marcadores moleculares para establecer el diagnóstico histológico y citológico, desde el genoma viral hasta la alteración de proteínas celulares por la infección de VPH (p16) y marcadores de proliferación o maduración celular (Ki-67, p63 y ciclina E). Este estudio revisa la evolución conceptual y tecnológica de las nomenclaturas de lesiones intraepiteliales del cuello uterino, además de proporcionar información actualizada de los criterios de diagnóstico histológico y el uso de los marcadores moleculares.


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