Accuracy of endocervical cytological tests in diagnosing preinvasive lesions of the cervical canal in patients with type 3 transformation zone: a retrospective observational study
ABSTRACT BACKGROUND: Cervical cancer screening in Brazil is done using Pap smears. Women who are most likely to have a preinvasive lesion or cervical cancer are immediately referred for colposcopy. OBJECTIVE: The aim of this study was to evaluate the diagnostic performance of endocervical cytolo...
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| Format: | Article |
| Language: | English |
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Associação Paulista de Medicina
2020-04-01
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| Series: | São Paulo Medical Journal |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802020000100047&tlng=en |
| _version_ | 1819259339684184064 |
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| author | Paula Moskovics Jordão Fábio Bastos Russomano Gabriella Tostes Gerbauld Cecília Vianna de Andrade Clarice Fraga Esteves Maciel Osorio |
| author_facet | Paula Moskovics Jordão Fábio Bastos Russomano Gabriella Tostes Gerbauld Cecília Vianna de Andrade Clarice Fraga Esteves Maciel Osorio |
| author_sort | Paula Moskovics Jordão |
| collection | DOAJ |
| description | ABSTRACT BACKGROUND: Cervical cancer screening in Brazil is done using Pap smears. Women who are most likely to have a preinvasive lesion or cervical cancer are immediately referred for colposcopy. OBJECTIVE: The aim of this study was to evaluate the diagnostic performance of endocervical cytological tests in diagnosing preinvasive cervical lesions in women with initial high-grade squamous intraepithelial lesions (HSIL), or atypical squamous cells in which high-grade lesions could not be ruled out (ASC-H), or atypical glandular cells (AGC), and whose colposcopy did not show any abnormalities, with no fully visible transformation zone (types 2 and 3). DESIGN AND SETTING: Retrospective observational study conducted in Rio de Janeiro, Brazil. METHODS: Data from women who came to the cervical pathology outpatient clinic between January 2012 and April 2017 were analyzed. The results from endocervical cytological tests were compared with the final diagnosis, which was obtained through examination of a surgical specimen or, among women who did not undergo an excisional procedure, after cytological and colposcopic follow-up for two years. RESULTS: We included 78 women. The sensitivity of endocervical cytological tests was 72.7%; specificity 98.5%; positive and negative predictive values 88.9% and 95.6%, respectively; and positive and negative likelihood ratios 48.7 and 0.28. CONCLUSION: Endocervical cytological tests are simple, inexpensive and noninvasive, and form a reliable method for determining management among patients with HSIL, ASC-H and AGC cytological findings and negative colposcopic findings without visualization of the squamocolumnar junction. |
| first_indexed | 2024-12-23T19:08:27Z |
| format | Article |
| id | doaj.art-a844ba14774f49459fa21aa90a246c24 |
| institution | Directory Open Access Journal |
| issn | 1806-9460 |
| language | English |
| last_indexed | 2024-12-23T19:08:27Z |
| publishDate | 2020-04-01 |
| publisher | Associação Paulista de Medicina |
| record_format | Article |
| series | São Paulo Medical Journal |
| spelling | doaj.art-a844ba14774f49459fa21aa90a246c242022-12-21T17:34:33ZengAssociação Paulista de MedicinaSão Paulo Medical Journal1806-94602020-04-011381475310.1590/1516-3180.2019.0435.r1.19112019Accuracy of endocervical cytological tests in diagnosing preinvasive lesions of the cervical canal in patients with type 3 transformation zone: a retrospective observational studyPaula Moskovics Jordãohttps://orcid.org/0000-0002-1761-0636Fábio Bastos Russomanohttps://orcid.org/0000-0001-7510-0485Gabriella Tostes Gerbauldhttps://orcid.org/0000-0003-1510-442XCecília Vianna de Andradehttps://orcid.org/0000-0001-7980-4367Clarice Fraga Esteves Maciel Osoriohttps://orcid.org/0000-0002-0817-4123ABSTRACT BACKGROUND: Cervical cancer screening in Brazil is done using Pap smears. Women who are most likely to have a preinvasive lesion or cervical cancer are immediately referred for colposcopy. OBJECTIVE: The aim of this study was to evaluate the diagnostic performance of endocervical cytological tests in diagnosing preinvasive cervical lesions in women with initial high-grade squamous intraepithelial lesions (HSIL), or atypical squamous cells in which high-grade lesions could not be ruled out (ASC-H), or atypical glandular cells (AGC), and whose colposcopy did not show any abnormalities, with no fully visible transformation zone (types 2 and 3). DESIGN AND SETTING: Retrospective observational study conducted in Rio de Janeiro, Brazil. METHODS: Data from women who came to the cervical pathology outpatient clinic between January 2012 and April 2017 were analyzed. The results from endocervical cytological tests were compared with the final diagnosis, which was obtained through examination of a surgical specimen or, among women who did not undergo an excisional procedure, after cytological and colposcopic follow-up for two years. RESULTS: We included 78 women. The sensitivity of endocervical cytological tests was 72.7%; specificity 98.5%; positive and negative predictive values 88.9% and 95.6%, respectively; and positive and negative likelihood ratios 48.7 and 0.28. CONCLUSION: Endocervical cytological tests are simple, inexpensive and noninvasive, and form a reliable method for determining management among patients with HSIL, ASC-H and AGC cytological findings and negative colposcopic findings without visualization of the squamocolumnar junction.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802020000100047&tlng=enSensitivity and specificityMass screeningPathologyColposcopyUterine cervical neoplasmsEndocervical lesionsEndocervical brushingType 3 transformation zone |
| spellingShingle | Paula Moskovics Jordão Fábio Bastos Russomano Gabriella Tostes Gerbauld Cecília Vianna de Andrade Clarice Fraga Esteves Maciel Osorio Accuracy of endocervical cytological tests in diagnosing preinvasive lesions of the cervical canal in patients with type 3 transformation zone: a retrospective observational study São Paulo Medical Journal Sensitivity and specificity Mass screening Pathology Colposcopy Uterine cervical neoplasms Endocervical lesions Endocervical brushing Type 3 transformation zone |
| title | Accuracy of endocervical cytological tests in diagnosing preinvasive lesions of the cervical canal in patients with type 3 transformation zone: a retrospective observational study |
| title_full | Accuracy of endocervical cytological tests in diagnosing preinvasive lesions of the cervical canal in patients with type 3 transformation zone: a retrospective observational study |
| title_fullStr | Accuracy of endocervical cytological tests in diagnosing preinvasive lesions of the cervical canal in patients with type 3 transformation zone: a retrospective observational study |
| title_full_unstemmed | Accuracy of endocervical cytological tests in diagnosing preinvasive lesions of the cervical canal in patients with type 3 transformation zone: a retrospective observational study |
| title_short | Accuracy of endocervical cytological tests in diagnosing preinvasive lesions of the cervical canal in patients with type 3 transformation zone: a retrospective observational study |
| title_sort | accuracy of endocervical cytological tests in diagnosing preinvasive lesions of the cervical canal in patients with type 3 transformation zone a retrospective observational study |
| topic | Sensitivity and specificity Mass screening Pathology Colposcopy Uterine cervical neoplasms Endocervical lesions Endocervical brushing Type 3 transformation zone |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802020000100047&tlng=en |
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