Epidemiological data from the Quality Assurance Unit (QAU) of the Cervical Cancer Screening Program of Paraná is discussed. Slides (65,753) reviewed by the QAU, from October 1997 to July 1999, were analyzed. Relations between agreement rate, diagnostic categories, and age groups were tested. The overall agreement rate was 97.04% (kappa +/- 95%, confidence interval = 0.888 +/- 0.003). Low-grade squamous intraepithelial lesion (LSIL) showed its peak prevalence in patients < or = 19 yr (8.3%). High-grade squamous intraepithelial lesion (HSIL) was more common in women between 40 and 49 yr (5.0%). Squamous-cell carcinoma (SCC) was almost exclusively seen in women > or = 40 yr. The lowest agreement rates were seen in adenocarcinoma (54.5%; kappa = 0.667) and LSIL cases (76.3%, kappa = 0.822), and in women < or = 19 yr (95.8%). It was concluded that constant monitoring to assess specific errors allows directed measures. The 10% rescreening model of quality assurance proved to be effective in a low resources setting with a positive overall financial impact.
RESUMO -Tumores derivados do plexo coróide são neoplasias raras do sistema nervoso central que acometem principalmente crianças. Este estudo apresenta uma série de 38 pacientes com tumores de origem neuroectodérmica, dentre os quais 24 possuem diagnóstico histológico e/ou imunoistoquímico de Carcinoma do Plexo Coróide (CPC). Destes, 16 eram do gênero masculino. O local predominantemente acometido foi o ventrículo lateral esquerdo. As manifestações clínicas mais freqüentes foram hidrocefalia, hipertensão intracraniana e crises convulsivas. Todos os pacientes foram submetidos a tratamento cirúrgico. Houve um óbito no per-operatório e outro no pós-operatório imediato. Nove pacientes tiveram recidiva, evoluindo a óbito em tempo médio de 12,3 meses. Sete estão vivos. Os demais casos não apresentavam dados disponíveis. Em Curitiba, o CPC tem uma alta prevalência em relação a outros tumores do plexo coróide, podendo estar relacionado a algum agente patogênico.PALAVRAS-CHAVE: neoplasias do sistema nervoso central, tumores do plexo coróide, carcinoma do plexo coróide.
Choroid plexus tumours: epidemiologic comparative study of 24 casesABSTRACT -Tumours derived from choroid plexus are rare central nervous system neoplasms affecting mainly children. This study presents a series of 38 patients with neuroectodermal tumours. Twenty four of them had the histological and/or immunohistochemical diagnosis of choroid plexus carcinoma (CPC). Sixteen of these patients were male. The left lateral ventricle was affected in most cases. Main clinical features were: hydrocephalus, intracranial hypertension and convulsion. All the patients were treated by surgery. There were 2 deaths due to surgical complications. Nine patients had recurrence, dying in a intermediate time of 12.3 months and 7 patients remain alive. The other cases did not present available data. CPC is very prevalent in Curitiba when compared to other choroid plexus tumours and it might be related to some pathogenic agent.KEY WORDS: central nervous system tumours, choroid plexus tumours, choroid plexus carcinoma.Os tumores do plexo coróide são neoplasias do sistema nervoso central (SNC) originários do epitélio de revestimento dos ventrículos cerebrais, que tipicamente acometem crianças. Correspondem a 0,4 a 0,6% de todos os tumores intracranianos e 2 a 4% dos que acometem crianças. As formas malignas são ainda mais infreqüentes, ocorrendo na razão de 1:5 em relação aos papilomas 1 . Os carcinomas do plexo coróide (CPC) são tumores de comportamento biológico singular e desfavorável, o que torna o seu prognóstico bastante desfavorável. Manifestam-se tipicamente na primeira década de vida (80% dos casos) e correspondem a 8,1% de todos os tumores do plexo coróide. O número relativamente pequeno de casos descritos na literatura, associado à falta de dados epidemiológicos relevantes e às controvérsias acerca de sua classificação clínica e anatomopatológica, torna difícil o estabelecimento de uma conduta terapêutica padronizada no manejo desta entidade 2 . Como a cura acaba sendo...
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