2013, Number 2
<< Back Next >>
Med Sur 2013; 20 (2)
Certeza diagnóstica de la colposcopia, citología e histología de las lesiones intraepiteliales del cérvix
Sánchez NMF, Olivares MAK, Contreras CNA, Díaz SMM
Language: Spanish
References: 16
Page: 95-99
PDF size: 128.08 Kb.
ABSTRACT
Introduction. Cervical cancer is the second most common cancer
in Latin American women and the second cause of death. In Mexico in
the past decade, 48.761 deaths were reported from this reason.
Infection with human papillomavirus causes the appearance of
cervical cancer, since it has identified in 99.7% of cervical carcinomas.
Objective. Determine the diagnostic accuracy of cytology,
colposcopy and histology for the detection of cervical intraepithelial
lesions.
Material and methods. Descriptive, retrospective and
analytical study in a sample of 673 patients treated at the pathology
service at the Women’s Hospital, Ministry of Health from January 1st
2010 until December 31st 2011. The sensitivity, specificity, positive
predictive value, negative predictive value and diagnostic accuracy
were calculated.
Results. The cytology-histology, sensitivity 39%,
specificity 70%, positive predictive value 86%, negative predictive
value 18%. Colposcopy and histology, sensitivity 99%, specificity
43%, positive predictive value 89.9% and negative predictive value
90%, diagnostic accuracy 44% for cytology and colposcopy 89%.
Conclusions. There is not a single diagnostic method (cytology,
colposcopy, including guided biopsy), which promotes an accurate
diagnosis of intraepithelial lesions, but a correlation greater than
90% is well accepted.
REFERENCES
Alonso P, Lazcano EC, Hernández M. Cáncer cervicouterino. Diagnóstico, prevención y control. 1a. Ed. Panamericana; 2000, p. 203-20.
Secretaría de Salud. Compendio del Registro Histopatológico de Neoplasias en México. Morbilidad y Mortalidad. 1a. Ed. 1996, p. 35-7.
Joseph MG, Cragg F, Wright VC, Kontozoglou TE, Downing P, Marks FR. Cyto-histological correlates in a colposcopic clinic: a 1-year prospective study. Diagn Cytopathol 1991; 5: 477-81.
Rivera J, Vázquez VM, Ilizaliturri S. Correlación colpo-cito-histológica de lesiones intraepiteliales en el diagnóstico temprano de cáncer cervicouterino (CaCu) en 2,722 casos. Enfermedades del tracto genital inferior 2007; 1: 45-6.
Lazcano EC, Buiatti E, Nájera P, Alonso P, Hernández M. Evaluation model of the mexican national program for early cervical cancer detection and proposals for a new approach. Cancer1998; 9: 241-51.
Renshaw AA, DiNisco SA, Minter LJ, Cibas ES. A more accurate measure of the false-negative rate of Papanicolaou smear screening is obtained by determining the false-negative rate of the rescreening process. Cancer 1997; 81: 272-6.
Olivares K, Alonso P. Citología Cervical. Gaceta Mexicana de Oncología 2006(5); 4: 94-8.
Chase D, Kalouyan M, DiSaia P. Colposcopy to evaluate abnormal cervical cytology in 2008. Am Jour of Obst & Gynecol 2009: 472-80.
Palma PD, Rossi PG, Collina G, Buccoliero AM, Ghiringhello B, Lestani M, Onnis G, et al. The Risk of False-Positive Histology According to the Reason for Colposcopy Referral in Cervical Cancer Screening. Am J Clin Pathol 2008; 129: 75-80.
Velázquez N, Sánchez LF, Lares EF, Cisneros V, Milla H, Arreola F, Navarrete JA, et al. Comparación de la utilidad diagnóstica entre la inspección visual con ácido acético y citología cervical. Ginecol Obstet Mex 2010; 78: 261-7.
Warren J, Gullett H, King V. Cervical Cancer Screening and Updated Pap Guidelines. Prim Care Clin Office Prac 2009: 131-49.
Renshaw AA, Josep MG, Joste NE, Crum CP, Cibas ES. Cytologic/ histologic correlation for quality control in cervicovaginal cytology. Experience with 1582 paired cases. Am J Clin Pathol 1995; 103: 32-4.
Tritz DM, Weeks JA, Spires SE, Sattich M. Etiologies for noncorrelating cervical cytologies and biopsies. Am J Clin Pathol 1995; 103: 594-7. Órgano de Difusión de la Sociedad de Médicos Revista de Investigación
Gupta S, Sodhani P. Why is high grade squamous intraepithelial neoplasia underdiagnosed on cytology in a quarter of cases? Analysis of smear characteristics in discrepant cases. Indian J Cancer 2004; 41: 104-8.
Mitchell MF, Schottenfeld D, Tortolero G, Cantor SB, Richards R. Colposcopy for the diagnosis of squamous intraepithelial lesions: a meta-analysis. Obstet Gynecol 1998; 91: 626-31.
Dos Santos I. Epidemiología del Cáncer: Principios y Métodos. Agencia Internacional de Investigación sobre el Cáncer. Organización Mundial de la Salud. Francia: 1999.