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macedo_mhha_me_botfm.pdf: 349266 bytes, checksum: 7d77758a26025e4bc84c18172c4da334 (MD5) / Fundação de Ensino e Pesquisa em Ciências da Saúde (FEPECS) / O presente estudo avaliou 99 pacientes com diagnóstico colpocitológico de células escamosas atípicas de significado indeterminado (ASC), no Distrito Federal (DF). No ano do estudo, foram realizadas 101.948 colpocitologias oncóticas (CO) na rede de saúde publica do DF. Destas, 1.454 correspondiam a células escamosas atípicas de significado indeterminado, possivelmente não neoplásicas (ASC-US) e 324 a células escamosas atípicas de significado indeterminado, quando não se pode excluir lesão intraepitelial de alto grau (ASC-H). Foram incluídas no estudo 99 pacientes com citologias de interesse, e realizadas biópsias de colo uterino cujos resultados histológicos revelaram 77 normais e 22 alterados com neoplasia intraepitelial de grau moderado ou maior (NIC2+), e colhidas novas colpocitologias. As novas colpocitologias foram analisadas na central de Citopatologia do DF, as colposcopias foram realizadas por um único observador, e os estudos histológicos por um mesmo patologista. Foram feitas 99 biópsias com os seguintes resultados: 77 normais e 22 com alterações evidenciando neoplasia intraepitelial de alto grau. Entre as colpocitologias iniciais com diagnóstico de ASC-H 50% apresentaram NIC2+ à histologia. A colposcopia mostrou sensibilidade e especificidade de 63,6% e 87,0% (IC 95%), respectivamente. Os valores preditivos positivos foram 6,66%, 26,30% e 9,09% (IC de 95% ) para a primeira colpocitologia, para a segunda colpocitologia e colposcopia. Os valores preditivos negativos foram, para os mesmos métodos diagnósticos 98,74%, 98,43% e 99,15%. Os fatores associados a presença de lesão NIC2+ foram tabagismo, estado civil, número de parceiros, uso de anticoncepcional hormonal, e início da vida sexual ativa entre 13 e 16 anos. Os resultados histológicos de ASC, tanto ASC-US como ASC-H... / The current study evaluated 99 patients diagnosed with vaginal smear atypical squamous cells (ASC) of underdetermined significance in the Federal District (FD). During the year of studies, 101,948 oncotic colpocytologies (OC) were undertaken in public service in the FD. Of these, 1,454 corresponded to atypical squamous cells of underdetermined significance, possible non-neoplasia (ASC-US), and 324 corresponded to atypical squamous cells of underdetermined significance when high grade intraepithelial neoplasia cannot be excluded (ASC-H). Patients with cytology interest were called. 99 biopsies were undertaken whose histological results revealed 77 normal and 22 altered with moderate or higher grade cervical intraepithelial neoplasia (NIC2+) and a new colpocytology was taken. The new colpocytologies were analyzed at the Cytology Central of the FD, the colposcopies and hystologies were carried out by a single observer, but different. Ninety-nine biopsies were done with the following results: 77 normal and 22 with changes showing high-grade intraepithelial neoplasia (NIC2+). Among the initial colpocytology with a diagnosis of ASC-H, 50% showed NIC2+ at histology. Colposcopy showed a sensitivity and specificity of 63.6% and 87.0% (95%), respectively. Positive predictive values were 6.66%, 26.30% and 9.09% (IC of 95%) for the first colpocytology, for the second colpocytology and colposcopy. The negative predictive values were, for the same diagnostic methods 98.74%, 98.43% and 99.15%. Factors associated with lesion NIC2+ were smoking, marital status, number of partners, use of hormonal contraceptive and beginning of sexual activity between 13 and 16 years old. The histological results both of ASC-US, and ASC-H comprise a wide variety of diagnoses ranging from normal to severe lesions as carcinomas. This finding... (Complete abstract click electronic access below)
| Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.unesp.br:11449/99211 |
| Date | 31 August 2011 |
| Creators | Macedo, Mirian Helena Hoeschl Abreu [UNESP] |
| Contributors | Universidade Estadual Paulista (UNESP), Silva Filho, Agnaldo Lopes da [UNESP], Magalhães, Isis Maria Quesado Soares [UNESP] |
| Publisher | Universidade Estadual Paulista (UNESP) |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Format | 60 f. |
| Source | Aleph, reponame:Repositório Institucional da UNESP, instname:Universidade Estadual Paulista, instacron:UNESP |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | -1, -1, -1 |
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