RESUMO
The history of the previous and the later Papanicolaou smears results with diagnosis of atypical squamous cells (ASC) and its correlation with respective biopsies was retrospectively analyzed. The previous and the later exams which resulted as diagnoses of ASC by cytologic test were investigated, and also the examinations periodicity. Of 60 selected cases of ASC with correlated biopsy results, 57 had the first cytologic diagnosis of ASC-US (undetermined significance) and 3 had ASC-H (cannot exclude high grade lesion) diagnosis. Of 57 cases, 30 (52.6%) were negative on biopsy, 16 (28.1%) had a diagnosis of NIC 1, and 11 (19.3%) presented diagnose discrepancies above 2 degrees. Among ASC-H (100%) all the cases were diagnosed as NIC 1 on biopsy. Of 60 cases, 44 (73.3%) cases who had previous examinations results, 14 (23.3%) were positive. Among patients who had the later cytology exams, 53 (88.3%) had cytologic examinations after being biopsied, and 10 (16.7%) were positive. Concerning the examinations periodicity, 26 (43.3%) were examined 1- year interval, 29(48.3%) at 1 to 3-year interval, and one (1.7%) at a period longer than three years. According to the observed findings the ASC diagnoses were frequently associated with reactional morphologic changes, showing the relevance in carrying out the cyto-histological correlation, since performing cytological follow up only it shoul
No presente estudo foi avaliada a história de realização dos exames citológicos (EC) prévios e posteriores com diagnóstico citológico de células escamosas atípicas (ASC) e sua correlação com os resultados de exames de biópsias. Para tanto, foi realizado o estudo retrospectivo, de 60 casos de EC cérvico-vaginais com diagnóstico de ASC e biópsias correlatas, os exames prévios e posteriores de ASC e a periodicidade de exames realizados. Das 60 análises selecionadas, 57 apresentaram diagnóstico citológico anterior de ASC-US (possivelmente não neoplásico), 30 (52,6%) foram negativos no exame de biópsia, 16 (28,1%) de NIC 1, 11 (19,3%) com diagnósticos discrepantes acima de 2 graus; 3 (100%) casos de ASC-H(não se pode afastar lesão de alto grau) foram NIC 1 na biópsia. Dentre os 60 casos, 44 (73,3%) que tiveram exames anteriores, 14 (23,3%) eram positivos; 53 (88,3%) que fizeram EC posteriores à biópsia, 10 (16,7%) eram positivos. Quanto à periodicidade dos exames, 26 (43,3%) realizaram o exame com intervalo de até 1 ano, 29 (48,3%) de 1 a 3 anos, 1 (1,7%) em intervalo maior que 3 anos. De acordo com os achados observados neste estudo, os diagnósticos citológicos de ASC, quando comparado com os exames da biópsia, estavam mais frequentemente associados às alterações morfológicas reacionais. Estes dados mostram o valioso papel da correlação cito-histológica, uma vez que a execução apen
RESUMO
The retrospective study on cervico-vaginal smears analyzed by Papanicolaou (Pap) test at Instituto Adolfo Lutz Division of Pathology, during the period from 2003 to 2008, was carried out. The diagnoses of pre-neoplasic and neoplasic lesions on Pap smears were analyzed, according to the age groups distribution. Of the 222,024 analysed samples, 3,674 (1.65%) were classified as unsatisfactory, 206,439 (92.98%) were negative and 11,911 (5.36%) presented abnormal cytology diagnoses. Of those with abnormal cytology, 6,437 (54.04%) were classified as ASC-US, 210 (1.76%) as ASC-H, 3,264 (27.40%) as LSIL, 1,279 (10.74%) as HSIL, 131(1.10%) as SCC and 552 (4.63%) as AGC-US, 23 (0.19%) as AGC-H, 7 (0.06%) as AIS, and 8(0.07%) were diagnosed as ADENOCA. The distribution of the squamous and glandular intraepithelial lesions diagnosis in the age group ranging at 5-year intervals, showed the major frequency of LSIL among younger women (15-25 years of age), and the diagnoses of ASC-US, ASC-H, AGC-US, HSIL, SCC and ADENOCA among >50 year- old women. The glandular variations as AGC-H and AIS occurred in women at of 30-34 and 45-49 age groups. Two (0.16%) women with HSIL were under 14 years of age, and 51 (3.99%) were from 15 to 19 years old. This study emphasizes the relevance in implementing the educational campaigns, the patients screening and follow-up protocols for assuring the improvem
No presente estudo foi realizado o levantamento retrospectivo de diagnóstico citopatológico das lesões pré-neoplásicas e neoplásicas pela método de Papanicolaou e sua distribuição por faixa etária das mulheres atendidas no período de 2003a 2008. Das 222.024 amostras analisadas, 3.674 (1,65%) foram classificadas como insatisfatórias, 206.439 (92,98%) foram negativas e 11.911 (5,36%) apresentaram algum tipo de atipias nucleares. Dentre as alterações epiteliais atípicas, 6.437(54,04%) foram de ASC-US e 210 (1,76%) de ASC-H; 3.264 (27,40%) de LSIL; 1.279 (10,74%) de HSIL; 131 (1,10%) de SCC; 552 (4,63%) por AGC-US e 23 (0,19%) de AGC-H; 7 (0,06%) de AIS e 8 (0,07%) de ADENOCA. Quanto à ocorrência e distribuição dos diagnósticos de lesões intraepiteliais escamosas e glandulares, de acordo com a faixa etária em intervalos de 5 anos, foi observada maior frequência de diagnóstico de LSIL entre as mulheres mais jovens (15-25 anos)e os diagnósticos de ASC-US, ASC-H, AGC-US, HSIL, SCC e ADENOCA nas mulheres >50 anos de idade. As alterações glandulares, como AGC-H e AIS, ocorreram em mulheres na faixa etária entre 30-34 e 45-49 anos. Foram detectados dois (0,16%) casos de HSIL em pacientes 14 anos e em 51 (3,99%) pacientes na faixa entre 15-19 anos. Os dados da presente avaliação enfatiza a importância de campanhas orientativas, rastreamento e seguimento das pacientes para garantir