Alaniz SA, Ortuño LM, Cruz GM, Alaniz GTL

Language: Spanish
References: 10
Page: 13-17
PDF size: 191.50 Kb.

ABSTRACT

Introduction: The detection of the early lesions precursors of uterine cervix carcinoma is carried out based on the interpretation of Papanicolaou smear.
Objective: To determine the correlation that exists betweeen cervical cytology compared with the diagnosis by either colposcopy or histology in the Low-Grade Squamous Intraepithelial Lesion (LSIL).
Material and methods: 100 patients with cytology compatible with LSIL are practiced colposcopy taking directed biopsy for histopathologic study.
Results: Average age: 37; Average onset of sexually active life: 19.25 years old; number of sexual partners: 2.57; condom use in 0.3%. 45% of the patients were smokers. Diagnosis by cytology: LSIL in 77 (77%) of the patients, inflammatory process 20 (20%), and HSIL 3 (3%). Sensibility: 88.23%; specificity 42.85%; positive predictive value (PPV): 94.93%, and negative predictive value (NPV): 23.07%. LSIL diagnosis by cytology: 85 patients (85%); inflammatory process: 13 (13%); HSIL: 2 (2%); Sensibility: 79.12%; specificity: 28.57%; PPV: 93.50%; NPV: 9.52%. The colposcopy with Reid index and diagnosis of LSIL: 92 (92%) patients; inflammatory process: 6 (6%); HSIL: 2 (2%); Sensibility: 93.47%; Specificity: 33.33%; PPV: 95.55%; NPV: 25%. The gold standard was histopathology: 100% with a diagnosis of LSIL.
Conclusion: Before an abnormal cytology, colposcopy with directed biopsy should be performed for a more accurate diagnosis. Cytology will remain a good screening test due to its usefulness to detect early cervical lesions.

REFERENCES

1. Norma Oficial Mexicana NOM-014-SSA2-1994. Para la prevención, detección, diagnóstico, tratamiento, control y vigilancia epidemiológica del cáncer cérvico uterino. Diario Oficial de la Federación. México. 02 Marzo de 1998.

2. ACOG Practice bulletin cervical cytology: Cervical cytology screening. Int J Gynecol Obstet. 2003;83:237-47.

3. ACOG Technical bulletin. Genital human papillomavirus infection. Int J Gynecol Obstet. 1994;46:339-3465.

4. Irwin K, Montaño D, Kasprzyk D, et al. Cervical cancer screening, abnormal cytology management and counseling practices in the United States. Obstet Gynecol. 2006;108:397-409.

5. Greenberg MD. Índice colposcópico de Reid. Apgar BS, Brotzman GL, Spitzer M. Colposcopia. Principios y práctica. 1.ª Edición. México: McGraw-Hill Interamericana; 2003. p. 226-39.

6. Walboomers JM, Jacobs MV, Manos MM, et al. Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. J Phatol. 1999;189:12-9.

7. Wright TC, Cox JT, Massad LS, Carlson J, Twiggs LB, Wilkinson EJ. 2001 Consensus guidelines for management of women with cervical intraepithelial neoplasia. Am J Obstet Gynecol. 2003;189:295-304.

8. González SJL, Pérez GC, Celorio AG, Chávez BJ, Ríos MFA. Correlación citológica con el sistema Bethesda y la biopsia dirigida por colposcopia. Ginec Obstet Mex. 1998;66:330-4.

9. Gage JC, Hanson VW, Abbey K, et al. Number of cervical biopsies and sensitivity of colposcopy. Obstet Gynecol. 2006;108:264-72.

10. Alaniz SA, Flores GJ, Salazar ACE. Factores para el desarrollo de la displasia leve cervical. Rev Fac Med UNAM. 2009;52:69-72.