首页> 外文期刊>Revista Brasileira de Ginecologia e Obstetrícia >Desempenho da citologia convencional e da colposcopia para o diagnóstico de neoplasias cervicais escamosas e glandulares
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Desempenho da citologia convencional e da colposcopia para o diagnóstico de neoplasias cervicais escamosas e glandulares

机译:常规细胞学和阴道镜检查在诊断鳞状和腺宫颈癌中的作用

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Objective To estimate the cytological and colposcopic performances for the diagnosis of cervical neoplasias. Methods Cross-sectional retrospective study with data from patients’ charts. The participants underwent colposcopy, guided biopsies, and excision when needed. The cytological and colposcopic categorization followed the Bethesda System and the international colposcopic terminologies. The cytology and colposcopy performances were evaluated by sensitivity (SE), specificity (SP), positive predictive value (PPV), and negative predictive value (NPV) analyses with 95% confidence interval (95% CI). Results From 1,571 participants, a total of 1,154 (73.4%) were diagnosed with cervical squamous intraepithelial neoplasia grade 2 or worse (CIN 2+), 114 (7.2%) with adenocarcinoma in situ or worse (AIS+), 615 (39.2%) presented atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion or worse (ASC-H+) cytology, and 934 (59.4%) presented major or suspicious for invasion colposcopic abnormalities. The SE, SP, PPV, and NPV of ASC-H+ for diagnoses of CIN 2+ and AIS+ were, respectively: 44% (95% CI: 41-47) and 72% (95% CI: 67-76), 79% (95% CI: 77-81) and 79% (95% CI: 75-83), 88% (95% CI: 87-90) and 55% (95% CI: 50-60), and 28% (95% CI: 26-31) and 88% (95% CI: 85-91). The SE, SP, PPV, and NPV of major or suspicious for invasion colposcopic abnormalities for diagnoses of CIN 2+ and AIS+were, respectively: 62% (95% CI: 60-65) and 86% (95% CI: 83-89), 59% (95% CI: 57-62) and 59% (95% CI: 55-64), 85% (95% CI: 83-87) and 44% (95% CI: 40-49), and 29% (95% CI: 27-32) and 92% (95% CI: 89-94). Conclusion The SE analyses results of ASC-H+ and major or suspicious for invasion colposcopic abnormalities were higher for diagnoses of glandular neoplasias. These results confirm the role of cytology in identifying women at risk who will have their final diagnoses settled by colposcopy and histology.
机译:目的探讨细胞学和阴道镜检查对宫颈癌的诊断价值。方法横断面回顾性研究采用患者图表中的数据。参与者进行阴道镜检查,活检和必要时切除。细胞学和阴道镜分类遵循贝塞斯达系统和国际阴道镜术语。通过敏感性(SE),特异性(SP),阳性预测值(PPV)和阴性预测值(NPV)分析(95%置信区间(95%CI))评估细胞学和阴道镜检查性能。结果从1,571名参与者中,共诊断出1,154名(73.4%)宫颈鳞状上皮内瘤变2级或更严重(CIN 2 +),114名(7.2%)原位或更严重腺癌(AIS +),615名(39.2%)表现为非典型鳞状上皮细胞,不能排除高度鳞状上皮内病变或较差的(ASC-H +)细胞学检查,934(59.4%)表现为主要或可疑的侵袭性阴道镜异常。诊断CIN 2+和AIS +的ASC-H +的SE,SP,PPV和NPV分别为:44%(95%CI:41-47)和72%(95%CI:67-76),79 %(95%CI:75-83)和79%(95%CI:75-83),88%(95%CI:87-90)和55%(95%CI:50-60)和28% (95%CI:26-31)和88%(95%CI:85-91)。对于诊断CIN 2+和AIS +的严重或可疑侵入性阴道镜异常的SE,SP,PPV和NPV分别为:62%(95%CI:60-65)和86%(95%CI:83) -89),59%(95%CI:57-62)和59%(95%CI:55-64),85%(95%CI:83-87)和44%(95%CI:40-49) )和29%(95%CI:27-32)和92%(95%CI:89-94)。结论SE分析ASC-H +的结果,对侵袭性阴道镜异常有重大或可疑诊断腺瘤的诊断率较高。这些结果证实了细胞学在识别处于危险中的妇女中的作用,这些妇女将通过阴道镜和组织学确定最终诊断。

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