Citologia E Histopatologia De Pacientes Assistidas Em Um Centro De Saúde Da Mulher

Abstract

; CARVALHO, M. A. M. de.; PESSOA, G. T.; FERRAZ, M. S.; PINTO, L. S. S. Citologia e histopatologia de pacientes assistidas em um centro de saúde da mulher. Arq. Ciênc. Saúde Unipar, Umuarama, v. 18 n. 1, p. 3-7, jan./ abr. 2014 RESUMO: O carcinoma de colo do útero é o segundo mais frequente em mulheres no Brasil, tendo acometido mais de 18.000 mulheres no ano de 2008. O presente estudo objetivou analisar e correlacionar os resultados obtidos nos laudos citológicos e histopatológicos, conforme a faixa etária das pacientes. Para tanto, metodologicamente foi realizado um estudo observacional transversal retrospectivo por meio de 106 prontuários de pacientes que apresentavam laudos citopatológicos e histopatológicos com atipias cervicais atendidas no período de janeiro de 2007 a dezembro de 2008 no Centro de Saúde da Mulher em Piripiri, Piauí, Brasil. Foram obtidos os seguintes resultados: quanto ao exame citológico os resultados mais frequentes foram os de ASCH e ASC/AG, correspondendo a respectivamente, 39,6% e 30%. Houve maior número de pacientes com laudo de ASC/AG e ASCH no intervalo de 25 a 34 anos, correspondendo a respectivamente, 13,2% e 17,9% destas lesões. Na histopatologia, 44 casos (41,5%) foram considerados LSIL, 53 casos (50%) foram diagnosticados com HSIL e 7 casos (6,6%) foram considerados como neoplasia maligna invasiva. Sendo assim, este estudo confirma a acuidade diagnóstica dos exames citológicos e histopatológicos, tendo em vista o grande número de lesões observadas, especialmente em pacientes jovens, destaca-se a importância de orientar práticas sexuais seguras, melhor controle na frequência de rastreamento e seguimento clínico destas pacientes. PALAVRAS-CHAVE: Citologia; Histopatologia; Prevenção do câncer do colo do útero. CYTOLOGY AND HISTOPATHOLOGY OF PATIENTS ASSISTED IN A WOMAN HEALTH CENTERABSTRACT: Cervical carcinoma is the second most common carcinomas among women in Brazil, having involved over 18,000 women in 2008. Analyze and correlate the most frequent cervical lesions observed in cytological and histological examinations. A cross -sectional observational study was retrospectively performed with 106 patients from a Woman Health Center in Piripiri, Piaui, Brazil, from January 2007 to December 2008, who presented atypical cytopathologic and histopathologic cervical findings. The cytologic results were more frequent in ASC and ASCH/AG, representing 39.6% and 30%, respectively. There was a greater number of patients with report of ASC/ AG and ASCH in the range of 25 to 34, representing respectively 13.2% and 17.9% of these lesions. Histopathologically, 44 cases (41.5%) were considered LSIL, 53 cases (50%) were diagnosed as HSIL and 7 cases (6.6%) were considered invasive malignancy. This study confirms the diagnostic accuracy of Pap smears, colposcopy and histopathology exams. Given the large number of lesions, especially in young patients, it highlights the importance of guidelines for safe sex practices, better control in the screening frequency and follow-up for these patients....

Description of Referrals for Colposcopy in a Hospital in Brazil

“…[13][14][15] A sensitivity of 70.5% and specificity of 77.8% was found for cytology, demonstrating its value as a screening test for these types of lesions. The PPV of 75.7% is in line with what was observed in the literature searched in a cross-sectional observational study 16 performed in a Women Health Center in the state of Piauí, Brazil, with a PPV index for cytology ranging from 62.2% to 85%.…”

“…A total of 4 cases of AIS were found in the study, and 5 cases of invasive malignant neoplasia; 4 (44.4%) of these lesions were found in patients aged between 45 and 54 years old and 4 in (36.4%) patients aged ≥ 65 years old. In the literature, 16 similar results were found, observing higher risk before 64 years old and falling after 65 years old. From the 22 (8.6%) adolescents and young adults < 25 years old, 17 (7.8%) underwent biopsy, and only 2 cases of HSIL were confirmed by histology, corresponding to 0.9% of the total cases.…”

“…These findings are in line with the data obtained in the study by Joseph et al, 14 where all surgical pathology reports of cervical colposcopic biopsies, cone biopsies, and hysterectomy specimens of 772 consecutive patients were correlated with cytology results, in which ASC-H cases there was a wide alteration in histopathology, in addition to finding a cancer occurrence above the expected. According to the Carvalho et al, 16 who made a comparative evaluation of the positive cytology, colposcopy and histopathology, this evidences a tendency of cytology to underestimate the lesions, since we consider histology as the gold standard. This can occur due to errors in the sampling, collection and interpretation of the material.…”

Alterações citopatológicas do colo uterino em mulheres atendidas na 8ª Regional de Saúde do Paraná no ano de 2014

“…Já em pesquisa semelhante realizada por Carvalho et. 20 , em 106 pacientes as alterações que prevaleceram foi ASC-H (39,6%) e ASC-US/AGUS (30,0%).…”

Prevalência da coinfecção entre Papilomavírus Humano (HPV) e Chlamydia trachomatis em mulheres

“…Assim, verificou-se que em um estudo bem semelhante a este o maior quantitativo está para as infecções por HPV, sendo que a Chlamydia como coinfecção apresentou variações de acordo com o método de diagnóstico empregado (18).…”