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首页> 外文期刊>Sao Paulo Medical Journal >Prevalence of high-grade squamous intraepithelial lesions and cervical cancer among patients with unsatisfactory colposcopic examination, without visible lesion
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Prevalence of high-grade squamous intraepithelial lesions and cervical cancer among patients with unsatisfactory colposcopic examination, without visible lesion

机译：阴道镜检查不满意，无可见病变的患者中高度鳞状上皮内病变和宫颈癌的患病率

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CONTEXT AND OBJECTIVE: Cervical cancer is a serious public health problem in Brazil. For patients with unsatisfactory colposcopic examinations without visible lesions, but with cervical cytological tests suggesting high-grade squamous intraepithelial lesion (HSIL), the national recommendation is to repeat cervical cytological tests after three months. Our aim was to assess the prevalence of HSIL and cancer among patients with initial cervical cytological tests suggestive of HSIL but with unsatisfactory colposcopic examinations without visible lesions, in order to contribute towards the discussion regarding a more effective clinical approach that might diminish the likelihood of patient abandonment of follow-up before appropriate diagnosis and treatment. DESIGN AND SETTING: Cross-sectional study in Colposcopy Clinic of IFF/Fiocruz. METHOD: Patients admitted between December 1989 and April 2007 with cytological diagnoses of HSIL but with unsatisfactory colposcopic examinations without visible lesions underwent cervical cone biopsy. RESULTS: Sixty-five such patients were included, comprising 33.8% with HSIL and 4.6% with cancer, confirmed histologically. The other patients presented low-grade squamous intraepithelial lesion (26.1%), glandular dysplasia (1.5%) and absence of disease (33.8%). CONCLUSION: The observed prevalence of cancer and HSIL does not seem to be enough to justify immediate referral for cone biopsies to investigate the cervical canal in these cases. The findings suggest that the recommendation of repeated cytological tests following an initial one with HSIL, among patients with unsatisfactory colposcopic examinations without visible lesions, is appropriate in our setting. Efforts are needed to ensure adherence to follow-up protocols in order to reduce the chances of losses.
机译：背景与目的：宫颈癌是巴西的一个严重的公共卫生问题。对于阴道镜检查不满意，无明显病变但宫颈细胞学检查提示高度鳞状上皮内病变（HSIL）的患者，国家建议在三个月后重复进行宫颈细胞学检查。我们的目的是通过初步的宫颈细胞学检查提示HSIL但阴道镜检查结果不令人满意但无可见病灶的患者评估HSIL和癌症的患病率，从而有助于就可能减少患者可能性的更有效的临床方法进行讨论在适当的诊断和治疗前放弃随访。设计与设置：IFF / Fiocruz阴道镜诊所的横断面研究。方法：1989年12月至2007年4月间接受HSIL细胞学诊断但阴道镜检查不满意，无可见病变的患者进行了宫颈锥切活检。结果：经组织学证实，包括65例此类患者，其中HSIL占33.8％，癌症占4.6％。其他患者表现为低度鳞状上皮内病变（26.1％），腺体发育异常（1.5％）和无疾病（33.8％）。结论：观察到的癌症和HSIL患病率似乎不足以证明在这些情况下应立即转诊进行锥穿刺活检以调查宫颈管。研究结果表明，对于阴道镜检查不满意且无明显病变的患者，建议在初次HSIL筛查后重复进行细胞学检查。需要努力确保遵守后续协议，以减少损失的机会。

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