Artículos de revistas
High-grade Squamous Intraepithelial Lesion In Women Aged <30 Years Has A Prevalence Pattern Resembling Low-grade Squamous Intraepithelial Lesion
Registro en:
Cancer Cytopathology. , v. 121, n. 10, p. 576 - 581, 2013.
19346638
10.1002/cncy.21312
2-s2.0-84891548057
Autor
Vale D.B.
Westin M.C.
Zeferino L.C.
Institución
Resumen
BACKGROUND: Cervical cytology is the cervical cancer screening test for women aged <30 years because of the low specificity of human papillomavirus tests in this age group. The Bethesda System classifies cervical intraepithelial neoplasia grade 2 (CIN 2) and grade 3 (CIN 3) as high-grade intraepithelial lesions (HSIL). In this study, the authors subclassified cytologic HSIL as suggestive of CIN 2 (HSIL-CIN 2) or CIN 3 (HSIL-CIN 3) and evaluated whether there was a correlation between these findings and age for screened and unscreened women. METHODS: The study included 2,002,472 cervical smears collected from women who had at least 1 previous test (screened) and 217,826 previously untested women (unscreened). The laboratory has been using the Bethesda System since 1998 with the subcategorization of HSIL-CIN 2 and HSIL-CIN 3. RESULTS: For unscreened women, the prevalence of low-grade intraepithelial lesion (LSIL) and HSIL-CIN 2 decreased with age, whereas the prevalence of HSIL-CIN 3 increased. The prevalence of HSIL-CIN 2 was greater than that of HSIL-CIN 3 for women up to age 29 years (prevalence ratio [PR], 4.73; 95% confidence interval [CI], 3.90-5.75) and lower for the groups ages 30 to 49 years (PR, 0.66; 95% CI, 0.50-0.87) and ≥50 years (PR, 0.21; 95% CI, 0.12-0.36). For screened women, the prevalence of HSIL-CIN 2 also was greater in the group aged ≤29 years (PR, 2.72; 95% CI, 2.49- 2.97). CONCLUSIONS: The prevalence pattern of HSIL suggestive of CIN 2 resembled the pattern observed in LSIL and was more prevalent than HSIL suggestive of CIN 3 in younger women. The impact of screening was less evident when HSIL was suggestive of CIN 2. A conservative approach for younger women who have HSIL is important for management guidance. © 2013 American Cancer Society. 121 10 576 581 Solomon, D., Davey, D., Kurman, R., The 2001 bethesda system: Terminology for reporting results of cervical cytology (2002) JAMA., 287, pp. 2114-2119 Monteiro, D.L., Trajano, A.J., Russomano, F.B., Silva, K.S., Prognosis of intraepithelial cervical lesion during adolescence in up to 2 years of follow-up (2010) J Pediatr Adolesc Gynecol., 23, pp. 230-236 Elit, L., Levine, M.N., Julian, J.A., Expectant management versus immediate treatment for low-grade cervical intraepithelial neoplasia: A randomized trial in canada and brazil (2011) Cancer Cytopathol., 117, pp. 1438-1445 Moscicki, A.B., Cox, J.T., Practice improvement in cervical screening and management (picsm): Symposium on management of cervical abnormalities in adolescents and young women (2010) J Low Genit Tract Dis., 14, pp. 73-80 Kjaer, S.K., Frederiksen, K., Munk, C., Iftner, T., Long-term absolute risk of cervical intraepithelial neoplasia grade 3 or worse after human papillomavirus infection: Role of persistence (2010) J Natl Cancer Inst., 102, pp. 1478-1488 Herbert, A., The impact of cytological cervical screening and its changing role in the future (2010) Cytopathology., 21, pp. 355-358 Dehn, D., Torkko, K.C., Shroyer, K.R., Human papillomavirus testing and molecular markers of cervical dysplasia and carcinoma (2007) Cancer Cytopathol., 111, pp. 1-14 Brown, C.A., Bogers, J., Sahebali, S., Depuydt, C.E., De Prins, F., Malinowski, D.P., Role of protein biomarkers in the detection of highgrade disease in cervical cancer screening programs [serial online] (2012) J Oncol, 2012, p. 289315 Hwang, S.J., Shroyer, K.R., Biomarkers of cervical dysplasia and carcinoma [serial online] (2012) J Oncol, 2012, p. 507286 Abreu, A.L., Souza, R.P., Gimenes, F., Consolaro, M.E., A review of methods for detect human papillomavirus infection [serial online] (2012) Virol J., 9, p. 262 Llewellyn, H., Observer variation, dysplasia grading, and hpv typing: A review (2000) Am J Clin Pathol., 114 (SUPPL.), pp. S21-S35 Crum, C.P., Symposium part 1: Should the bethesda system terminology be used in diagnostic surgical pathology? (2003) Point Int J Gynecol Pathol., 22, pp. 5-12 Mollers, M., Goot Hein, J., Vriend Henrike, J., Prevalence, incidence and persistence of hpv infections in a large cohort of sexually active young women in the netherlands (2013) Vaccine., 31, pp. 394-401 Arbyn, M., Kyrgiou, M., Simoens, C., Perinatal mortality and other severe adverse pregnancy outcomes associated with treatment of cervical intraepithelial neoplasia: Meta-analysis [serial online] (2008) BMJ., 337, pp. a1284 (2012) Diretrizes Brasileiras Para o Rastreamento do Cancer do Colo do Utero., , http:www1.inca.gov.br=inca=Arquivos= Diretrizes_rastreamento_cancer_colo_utero.pdf, Instituto Nacional de Cancer. Available at: Accessed December 18 Castle, P.E., Schiffman, M., Wheeler, C.M., Solomon, D., Evidence for frequent regression of cervical intraepithelial neoplasia-grade 2 (2009) Obstet Gynecol., 113, pp. 18-25 Peto, J., Gilham, C., Fletcher, O., Matthews, F.E., The cervical cancer epidemic that screening has prevented in the uk (2004) Lancet., 364, pp. 249-256 Kohli, M., Ferko, N., Martin, A., Estimating the long-term impact of a prophylactic human papillomavirus 16=18 vaccine on the burden of cervical cancer in the uk (2007) Br J Cancer., 96, pp. 143-150 Freitas, R.A., Carvasan, G.A., Morais, S.S., Zeferino, L.C., Excessive pap smears due to opportunistic cervical cancer screening (2008) Eur J Gynaecol Oncol., 29, pp. 479-482 Vale, D.B., Morais, S.S., Pimenta, A.L., Zeferino, L.C., Assessment of the cervical cancer screening in the family health strategy in amparo, sao paulo state, brazil (2010) Cad Saude Publica., 26, pp. 383-390 Sasieni, P., Castanon, A., Cuzick, J., Effectiveness of cervical screening with age: Population based case-control study of prospectively recorded data [serial online] (2009) BMJ., 339, pp. b2968 McCredie, M.R., Sharples, K.J., Paul, C., Natural history of cervical neoplasia and risk of invasive cancer in women with cervical intraepithelial neoplasia 3: A retrospective cohort study (2008) Lancet Oncol., 9, pp. 425-434 Ostor, A.G., Natural history of cervical intraepithelial neoplasia: A critical review (1993) Int J Gynecol Pathol., 12, pp. 186-192 Vooijs, G.P., Benign proliferative reactions intraepithelial neoplasia and invasive cancer of the uterine cervix (1991) Comprehensive Cytopathology, pp. 153-230. , In: Bibbo M, ed. Philadelphia: WB Saunders Company; Coleman, D.V., Evans, D.M.D., (1999) Biopsy Pathology and Cytology of the Cervix, , 2nd ed. London United Kingdom: Arnold; Dufloth, R.M., Messias-Silva, S.M., Andrade, L.A., Di Loreto, C., Munhoz, D.M., Zeferino, L.C., Nuclear alterations of cells and atypical metaplastic cells in cervical smears are predictive criteria of highgrade cervical intraepithelial neoplasia (2005) Eur J Gynaecol Oncol., 26, pp. 186-190 Blanks, R.G., Kelly, R.S., Comparison of cytology and histology results in english cervical screening laboratories before and after liquidbased cytology conversion: Do the data provide evidence for a single category of high-grade dyskaryosis? (2010) Cytopathology., 21, pp. 368-373 Ronco, G., Giorgi-Rossi, P., Carozzi, F., Efficacy of human papillomavirus testing for the detection of invasive cervical cancers and cervical intraepithelial neoplasia: A randomised controlled trial (2010) Lancet Oncol., 11, pp. 249-257 Zhao, C., Chen, X., Onisko, A., Kanbour, A., Austin, R.M., Follow-up outcomes for a large cohort of us women with negative imaged liquid-based cytology findings and positive high risk human papillomavirus test results (2011) Gynecol Oncol., 122, pp. 291-296