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Desempenho das Amostras do Canal Cervical e do Fundo de Saco no Diagnóstico da Neoplasia do Colo Uterino Performance of Cervical Canal and Vaginal Cul-de-sac Samples for the Diagnosis of Cervical Neoplasia

Authors: Luiz Carlos Zeferino; Jamira Machado Ramos Catharino; Marco Aurelio Salvino de Araujo; Luiz Carlos Borges da Silva; Silvia Regina Vedoato; Júlia Kawamura Tambascia; Edson Zangiacomi Martinez;

Desempenho das Amostras do Canal Cervical e do Fundo de Saco no Diagnóstico da Neoplasia do Colo Uterino Performance of Cervical Canal and Vaginal Cul-de-sac Samples for the Diagnosis of Cervical Neoplasia

Abstract

Objetivos: comparar o desempenho das amostras do canal cervical e fundo de saco vaginal para o exame colpocitológico no diagnóstico da neoplasia do colo uterino. Métodos: foram constituídos três grupos seqüenciais: grupo 1) 10.048 mulheres com amostras da ectocérvice e fundo de saco, utilizando espátula de Ayre; grupo 2) 3.847 mulheres com amostras da ectocérvice, fundo de saco e canal cervical, utilizando espátula de Ayre e escova cytobrush; grupo 3) 4.059 mulheres com amostras da ectocérvice e canal cervical, utilizando espátula de Ayre e escova cytobrush. A metodologia estatística utilizou análise de variância (ANOVA) e comparação de proporções. Resultados: os percentuais de exames alterados dos grupos 2 (2,6%) e 3 (2,4%), incluindo todas as lesões escamosas e glandulares, foram significativamente maiores que no grupo 1 (2%). Os percentuais de diagnóstico da lesão intra-epitelial escamosa de baixo grau (LIE-BG) não foram estatisticamente diferentes entre os três grupos (1,27; 1,25 e 1,07%). Por outro lado, os percentuais de diagnóstico da lesão intra-epitelial escamosa de alto grau (LIE-AG) foram significativamente maiores nos grupos 2 (0,81%) e 3 (0,77%) do que no grupo 1 (0,54%). A diferença entre os percentuais dos grupos 2 e 3 não foi estatisticamente significante. Conclusões: a amostra do canal cervical melhora o desempenho do exame colpocitológico para o diagnóstico da lesão intra-epitelial escamosa de alto grau, ao passo que a amostra de fundo de saco não interfere significativamente nos percentuais de diagnóstico das lesões intra-epiteliais.Purpose: to compare the performance of cervical canal and vaginal cul-de-sac samples for colpocytology testing, in order to diagnose cervical neoplasia. Methods: three sequential groups were constituted: group 1 - 10,048 women with ectocervix and cul-de-sac samples collected with the use of an Ayre spatula; group 2 - 3,847 women with ectocervix, cul-de-sac and cervical canal samples taken with an Ayre spatula and a cytobrush, and group 3 -- 4,059 women with ectocervix and cervical canal samples, using an Ayre spatula and a cytobrush. ANOVA (analysis of variance) and comparison of proportions were utilized for the statistical analysis. Results: the rates of abnormal tests in groups 2 (2.6%) and 3 (2.4%), including all squamous and glandular lesions, were significantly higher than in group 1 (2.0%). The diagnosis rates of low-grade squamous intraepithelial lesion (LGSIL) were not statistically different between the three groups (1.27, 1.25 and 1.07%). On the other hand, the diagnosis rates of high-grade squamous intraepithelial lesion (HGSIL) were statistically higher in groups 2 (0.81%) and 3 (0.77%) than in group 1 (0.54%). The difference between the rates of the second and the third groups did not present any statistical significance. Conclusions: the cervical canal sampling improves the performance of cytologic testing for the diagnosis of HGSIL, while cul-de-sac sampling does not change significantly the performance in diagnosing cervical neoplasia.

Keywords

Cervical neoplasia, Screening, RG1-991, Colo do útero: lesões pré-neoplásicas, Gynecology and obstetrics, Câncer: rastreamento, Cytology, Colpocitologia

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
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