Citologia de base líqüida associada à captura de híbridos para DNAHPV pode otimizar a qualidade diagnóstica do método de Papanicolaou?
Palavras-chave:
método de Papanicolaou, ASCUS, captura de híbridos, citologia de base líquida, reflex testing
Resumo
A associação da citologia de base liquida (BL) e o teste de Captura de Híbridos II (HC2) para DNA HPVpoderão otimizar o diagnóstico citológico, sobretudo os de origem indeterminada (ASCUS/AGUS).Avaliamos as amostras colhidas com o sistema DNA-CITOLIQ® (DIGENE-Brasil) para citologia de BL eHC2, de pacientes atendidas no Hospital Leonor Mendes de Barros. Foram realizados 842 exames decitologia de BL e HC2, onde 64 (7,6%) amostras apresentaram atipias de significado indeterminado (ASCUS/AGUS) de citologia na BL. O HC2 para DNA HPV de alto risco foi positiva em 16 (25%) amostras de ASCUSe quatro (6,2%) de atipia glandular (AGUS). De 748 amostras, 88,8% foram citologicamente negativas edestas 97 (11,5%) foram positivas para HPV de alto risco. Essas alterações estão associadas à infecçãopelo HPV e , portanto, colocam a paciente em um grupo com conduta diferenciada da população normal.Adicionalmente, os casos com resultados negativos no exame citológico, que nos testes de DNA HPVforam positivos, demonstraram a elevada sensibilidade das técnicas biomoleculares em relação à morfologia.Concluímos que a citologia de BL associada ao HC2, pode melhorar a sensibilidade do método dePapanicolaou.Referências
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cytology smear study and conventional papanicolaou smears: A
metaanalysis of prospective studies comparing cytologic diagnosis
and sample adequacy. Am J Obstet Gynecol , 185: 308-317, 2001.
2. Biscotti, CV et al. Thin-layer Pap test vs. Conventioanl pap smear.
Analysis of 400 split-samples. J Reprod Med , 47: 9-13, 2002.
3. Bishop JW. Comparison of the CytoRich system with conventional
cervical cytology. Preliminary data on 2032 cases from a clinical trial
site. 41: 15-23, 1997.
4. Bishop, JW et al. Multicenter masked evaluation of Autocyte PREP
thin layer with matched conventional smears. Including initial biopsy
results. Acta cytol ,42: 189-197, 1998.
5. Bolick, DR; Hellman, DJ. Laboratory implementation and efficacy
assessment of the ThinPrep cervical cancer screening system. Acta
Cytol, 42: 209-213, 1998.
6. Castle, PE et al. Absolute risk of a subsequent abnormal Pap among
oncogenic human papillomavirus DNA-positive, cytologically negative
women. Cancer, 95: 2145-2151, 2002.
7. Cohn, DE; Herzog, TJ New innovations in cervical cancer screening.
Gynecologic Surgery and Oncology , 44: 538-549, 2001.
8. FDA News. FDA approves expanded use of HPV test. http://
www.fda.gov/bbs/topics/news/2003/new00890.html.
9. Ferenczy, A; Franco, E. Cervical-cancer screening beyond the year
2000. Lancet-Oncology , 2: 27-32, 2001.
10. Hessling JI et al. Effectiveness of thin layer preparations vs.
Conventional pap smear in a blinded, split-sample study. Extended
cytologic evaluation. J Reprod Med , 46: 880-886, 2001.
11. Manos, MM et al. Identifying women with cervical neoplasia using
human papillomavirus DNA testing for equivocal Papanicolaou results.
JAMA, 281: 1605-1610, 1999.
12. Marino, JF; Fremont-Smith, M. Direct-to-vial experience with
AutoCyte PREP in a small New England regional cytology practice.
J Reprod Med, 46: 353-358, 2001.
13. McCrory, D et al. Evaluation of cervical cytology. Evidence Report/
Technology Assessment Number 5. Duke University, 290-97-0014;
Agency for Health Care Policy and Research, 99-E010. Rockville,
MD: Agency for Health Care Policy and Research, 1999.
14. Minge, L et al. Autocyte Prep System vs conventional cervical cytology.
Comparison based on 2,156 cases. J Reprod Med, 45: 179-184, 2000.
15. Monsonego, J et al. Liquid-based cytology for primary cervical cancer
screening: a multi-center study. Br J Cancer, 84: 360-366, 2001.
16. Petry, KU et al. Inclusion of HPV testing in routine cervical cancer
screening for women above 29 years in Germany: results for 8,466
patients. Br J Cancer, 88: 1570-1577, 2003.
17. Saslow, D et al. American cancer society guideline for the early detection
of cervical neoplasia and cancer. CA Cancer J Clin , 52: 342-362, 2002.
18. Solomon, D et al. The 2001 Bethesda System. Terminology for
reporting results of cervical cytology. JAMA , 287: 2114-2119, 2002.
19. Sulik, SM et al. Are flui-based cytologies superior to the conventional
Papanicolaou test?. A systematic review. J Fam Pract , 50: 1040-
1046, 2001.
20. Quddus, MR et al. Utility of HPV DNA Detection in thin-layer, liquidbased
tests with atypical squamous metaplasia. Acta Cytol, 46: 808-
812, 2002.
21. Vassilakos, P et al. CytoRich liquid-based cervical cytologic test.
Screening results in a routine cytopathology service. Acta Cytol, 42:
198-202, 1998.
22. Vassilakos, P et al. Biopsy-based comparison of liquid-based, thin
layer preparations to conventional Pap smears. J Reprod Med, 45:
11-16, 2000.
23. Wright Jr, TC et al. 2001 Consensus guidelines for the management
of women with cervical cytological abnormalities. JAMA , 287:
2120-2129, 2000.
cytology smear study and conventional papanicolaou smears: A
metaanalysis of prospective studies comparing cytologic diagnosis
and sample adequacy. Am J Obstet Gynecol , 185: 308-317, 2001.
2. Biscotti, CV et al. Thin-layer Pap test vs. Conventioanl pap smear.
Analysis of 400 split-samples. J Reprod Med , 47: 9-13, 2002.
3. Bishop JW. Comparison of the CytoRich system with conventional
cervical cytology. Preliminary data on 2032 cases from a clinical trial
site. 41: 15-23, 1997.
4. Bishop, JW et al. Multicenter masked evaluation of Autocyte PREP
thin layer with matched conventional smears. Including initial biopsy
results. Acta cytol ,42: 189-197, 1998.
5. Bolick, DR; Hellman, DJ. Laboratory implementation and efficacy
assessment of the ThinPrep cervical cancer screening system. Acta
Cytol, 42: 209-213, 1998.
6. Castle, PE et al. Absolute risk of a subsequent abnormal Pap among
oncogenic human papillomavirus DNA-positive, cytologically negative
women. Cancer, 95: 2145-2151, 2002.
7. Cohn, DE; Herzog, TJ New innovations in cervical cancer screening.
Gynecologic Surgery and Oncology , 44: 538-549, 2001.
8. FDA News. FDA approves expanded use of HPV test. http://
www.fda.gov/bbs/topics/news/2003/new00890.html.
9. Ferenczy, A; Franco, E. Cervical-cancer screening beyond the year
2000. Lancet-Oncology , 2: 27-32, 2001.
10. Hessling JI et al. Effectiveness of thin layer preparations vs.
Conventional pap smear in a blinded, split-sample study. Extended
cytologic evaluation. J Reprod Med , 46: 880-886, 2001.
11. Manos, MM et al. Identifying women with cervical neoplasia using
human papillomavirus DNA testing for equivocal Papanicolaou results.
JAMA, 281: 1605-1610, 1999.
12. Marino, JF; Fremont-Smith, M. Direct-to-vial experience with
AutoCyte PREP in a small New England regional cytology practice.
J Reprod Med, 46: 353-358, 2001.
13. McCrory, D et al. Evaluation of cervical cytology. Evidence Report/
Technology Assessment Number 5. Duke University, 290-97-0014;
Agency for Health Care Policy and Research, 99-E010. Rockville,
MD: Agency for Health Care Policy and Research, 1999.
14. Minge, L et al. Autocyte Prep System vs conventional cervical cytology.
Comparison based on 2,156 cases. J Reprod Med, 45: 179-184, 2000.
15. Monsonego, J et al. Liquid-based cytology for primary cervical cancer
screening: a multi-center study. Br J Cancer, 84: 360-366, 2001.
16. Petry, KU et al. Inclusion of HPV testing in routine cervical cancer
screening for women above 29 years in Germany: results for 8,466
patients. Br J Cancer, 88: 1570-1577, 2003.
17. Saslow, D et al. American cancer society guideline for the early detection
of cervical neoplasia and cancer. CA Cancer J Clin , 52: 342-362, 2002.
18. Solomon, D et al. The 2001 Bethesda System. Terminology for
reporting results of cervical cytology. JAMA , 287: 2114-2119, 2002.
19. Sulik, SM et al. Are flui-based cytologies superior to the conventional
Papanicolaou test?. A systematic review. J Fam Pract , 50: 1040-
1046, 2001.
20. Quddus, MR et al. Utility of HPV DNA Detection in thin-layer, liquidbased
tests with atypical squamous metaplasia. Acta Cytol, 46: 808-
812, 2002.
21. Vassilakos, P et al. CytoRich liquid-based cervical cytologic test.
Screening results in a routine cytopathology service. Acta Cytol, 42:
198-202, 1998.
22. Vassilakos, P et al. Biopsy-based comparison of liquid-based, thin
layer preparations to conventional Pap smears. J Reprod Med, 45:
11-16, 2000.
23. Wright Jr, TC et al. 2001 Consensus guidelines for the management
of women with cervical cytological abnormalities. JAMA , 287:
2120-2129, 2000.
Publicado
2004-12-30
Como Citar
UTAGAWA, M. L., PEREIRA, S. M. M., LONGATTO FILHO, A., MARTINS, C. R.-, AGUIAR, L. S., PITTOLI, J. Érika, DI LORETO, C., MAEDA, M. Y. S., MARTINS, L., GALVANE, J. O., & SYRJÄNEN, K. (2004). Citologia de base líqüida associada à captura de híbridos para DNAHPV pode otimizar a qualidade diagnóstica do método de Papanicolaou?. Revista Do Instituto Adolfo Lutz, 63(1), 100-103. https://doi.org/10.18241/rial.v63i1.34801
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