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[PMID]:29350503
[Au] Autor:Golubovic M; Lopicic M; Terzic N; Durovic M; Mugosa B; Mijovic G
[Ti] Título:Presence of histopathological premalignant lesions and infection caused by high-risk genotypes of human papillomavirus in patients with suspicious cytological and colposcopy results: A prospective study.
[So] Source:Vojnosanit Pregl;74(1):24-30, 2017 Jan.
[Is] ISSN:0042-8450
[Cp] País de publicação:Serbia
[La] Idioma:eng
[Ab] Resumo:Background/Aim: In patients with premalignant cervical lesions, human papillomavirus (HPV) infection, at any moment, may be spontaneously eliminated, or may persist or transform cervical epithelium from a lower to a higher degree. Due to that, it is necessary to wisely select the patients who are at high risk of cancer development. The aim of the study was to establish the interdependence between a suspicious Papanicolaou (Pap) test and colposcopy with the infection caused by high-risk genotypes of human papillomavirus and the presence of premalignant cervical lesions. Methods: This prospective study used cytological, colposcopy, real-time polymerase chain reaction (PCR) of high-risk genotypes of human papillomavirus and histopathological analysis of cervical biopsy specimen. Out of 2,578 female patients sent to cytological analyses in Clinical Center of Montenegro, during 2012, 2013 and 2014, the study included 80 women who had to submit their biopsy specimens due to a suspicious Pap test and atypical colposcopy results. Results: In the group of 80 (3.1%; n = 80/2,578) of the selected female patients with suspicious Pap test and colposcopy, 2/3 or 56 (70%) of them had cervicitis, and 1/3 or 24 (30%) had cervical intraepithelial neoplasia. The most common type in cervical intraepithelial neoplasia was HPV16 in 8 female patients, ie 61.53% out of the number of infected, or 33.33% out of the total number of premalignant lesions Conclusion: Patients with suspicious Papanicolaou test, colposcopy results and infection which is caused by high-risk HPV infection (HPV 16 in particular) often have premalignant cervical lesions. In these cases, histopathological confirmation of lesions is mandatory, since it serves as a definitive diagnostic procedure.
[Mh] Termos MeSH primário: Células Escamosas Atípicas do Colo do Útero/patologia
Neoplasia Intraepitelial Cervical/patologia
Colposcopia
DNA Viral/genética
Testes de DNA para Papilomavírus Humano
Teste de Papanicolaou
Papillomaviridae/genética
Infecções por Papillomavirus/virologia
Lesões Pré-Cancerosas/patologia
Lesões Intraepiteliais Escamosas Cervicais/patologia
Neoplasias do Colo do Útero/patologia
Esfregaço Vaginal
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Células Escamosas Atípicas do Colo do Útero/virologia
Biópsia
Neoplasia Intraepitelial Cervical/virologia
Criança
Pré-Escolar
Feminino
Genótipo
Seres Humanos
Lactente
Meia-Idade
Estadiamento de Neoplasias
Infecções por Papillomavirus/patologia
Lesões Pré-Cancerosas/virologia
Valor Preditivo dos Testes
Estudos Prospectivos
Reação em Cadeia da Polimerase em Tempo Real
Lesões Intraepiteliais Escamosas Cervicais/virologia
Neoplasias do Colo do Útero/virologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (DNA, Viral)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180213
[Lr] Data última revisão:
180213
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180120
[St] Status:MEDLINE
[do] DOI:10.2298/VSP150205143G


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[PMID]:29179267
[Au] Autor:Wu Y; Zhao J; Hu J; Wu XW; Zhu LR
[Ad] Endereço:Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China.
[Ti] Título:[Significance of p16/Ki-67 double immunocytochemical staining in cervical cytology ASCUS, LSIL, and ASC-H].
[So] Source:Zhonghua Fu Chan Ke Za Zhi;52(11):734-739, 2017 Nov 25.
[Is] ISSN:0529-567X
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:To investigate the application value of p16/cell proliferation associated nuclear antigen (Ki-67) double-staining and human papillomavirus mRNA in the cytological screening. Two hundred and fifty-one cases who suffered from atypical squamous cell of undetermined significance (ASCUS), low-grade squamous intraepithelial lesion (LSIL), atypical squamous cell-cannot exclude high-grade squamous intraepithelial lesion (ASC-H) in ThinPrep cytologic test (TCT) were collected in Peking University First Hospital between October 2015 and March 2016. And p16/Ki-67 double-staining and hybrid capture â…¡ (HC-â…¡) detection were performed on the cervical cells. The result was compared with the pathological result of colposcope guided biopsy. All statistical analysis was completed by Stata 12.0 statistical software analysis. The results of diagnostic tests were described by using the sensitivity, specificity, positive predictive value,negative predictive value, and the area under the receiver operating characteristic (ROC) curve. (1) One hundred and eight cases of liquid based cytology diagnosis of ASCUS patients, the positive rate of p16/Ki-67 was 13.9% (15/108), 102 cases of liquid based cytology diagnosis of LSIL patients, the positive rate of p16/Ki-67 was 21.6% (22/102), 41 cases of liquid based cytology diagnosis of ASC-H patients, the positive rate of p16/Ki-67 was 39.0% (16/41), compared amongthree groups, the difference was statistically significant (χ(2)=78.516, 0.05); cervical exfoliated cells p16/Ki-67 expression rate was 13.0%(28/215) in cervical low-grade lesions [cervical intraepithelial neoplasia (CIN) â… ], which was 69.4%(25/36) in high level lesions (CIN â…¡-â…¢), the difference was statistically significant (χ(2)=7.932, 0.05). (2) The specificity of p16/Ki-67 detection and diagnosis were higher than those of HC-â…¡ in ASCUS, LSIL, and ASC-H (89.8% vs 71.4%, 83.3% vs 15.6%, 88.9% vs 40.7%; all 0.05), meanwhile, the positive predictive value of p16/Ki-67 detection and diagnosis exceed those of HC-â…¡ in ASCUS, LSIL, and ASC-H (33.3% vs 26.3%, 31.8% vs 12.6%, 81.3% vs 38.5%; all 0.05). Moreover, the ROC curve of p16/Ki-67 were bigger than those of HC-â…¡ in ASCUS, LSIL, and ASC-H (0.799 vs 0.696, 0.708 vs 0.531, 0.909 vs 0.561; all 0.05). For patients with cytological diagnosis of ASCUS, LSIL, and ASC-H, p16/Ki-67 double staining method could be used as an effective method to assist in the diagnosis of high-grade cervical lesions, and the screening efficiency is superior to that of high-rist HPV.
[Mh] Termos MeSH primário: Células Escamosas Atípicas do Colo do Útero/patologia
Neoplasia Intraepitelial Cervical/patologia
Inibidor p16 de Quinase Dependente de Ciclina/metabolismo
Antígeno Ki-67/metabolismo
Lesões Intraepiteliais Escamosas Cervicais/patologia
Neoplasias do Colo do Útero/patologia
Esfregaço Vaginal
[Mh] Termos MeSH secundário: Células Escamosas Atípicas do Colo do Útero/metabolismo
Biópsia
Proliferação Celular
Neoplasia Intraepitelial Cervical/metabolismo
Colposcopia
Citodiagnóstico
Feminino
Seres Humanos
Teste de Papanicolaou
Papillomaviridae
Infecções por Papillomavirus
Gravidez
Curva ROC
Sensibilidade e Especificidade
Lesões Intraepiteliais Escamosas Cervicais/metabolismo
Coloração e Rotulagem
Neoplasias do Colo do Útero/metabolismo
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Cyclin-Dependent Kinase Inhibitor p16); 0 (Ki-67 Antigen)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180111
[Lr] Data última revisão:
180111
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171128
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.0529-567X.2017.11.004


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[PMID]:29065127
[Au] Autor:Wang J; Andrae B; Sundström K; Ploner A; Ström P; Elfström KM; Dillner J; Sparén P
[Ad] Endereço:Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
[Ti] Título:Effectiveness of cervical screening after age 60 years according to screening history: Nationwide cohort study in Sweden.
[So] Source:PLoS Med;14(10):e1002414, 2017 Oct.
[Is] ISSN:1549-1676
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The relatively high incidence of cervical cancer in women at older ages is a continuing concern in countries with long-established cervical screening. Controversy remains on when and how to cease screening. Existing population-based studies on the effectiveness of cervical screening at older ages have not considered women's screening history. We performed a nationwide cohort study to investigate the incidence of cervical cancer after age 60 years and its association with cervical screening at age 61-65, stratified by screening history at age 51-60. METHODS AND FINDINGS: Using the Total Population Register, we identified 569,132 women born between 1 January 1919 and 31 December 1945, resident in Sweden since age 51. Women's cytological screening records, cervical cancer occurrence, and FIGO stage (for those diagnosed with cancer) were retrieved from national registers and medical charts. We calculated the cumulative incidence of cervical cancer from age 61 to age 80 using a survival function considering competing risk, and estimated the hazard ratio (HR) of cervical cancer in relation to screening status at age 61-65 from Cox models, adjusted for birth cohort and level of education, conditioning on women's screening history in their 50s. In women unscreened in their 50s, the cumulative incidence up to age 80 was 5.0 per 1,000 women, and screening at age 61-65 was associated with a lower risk for cervical cancer (HR = 0.42, 95% CI 0.24-0.72), corresponding to a decrease of 3.3 cancer cases per 1,000 women. A higher cumulative incidence and similarly statistically significant risk decrease was seen for women with abnormal smears in their 50s. In women adequately or inadequately screened with only normal results between age 51 and age 60, the cumulative incidence of cervical cancer from age 61 to 80 was 1.6 and 2.5 per 1,000 women, respectively, and further screening at age 61-65 was not associated with statistically significant decreases of cervical cancer risk up to age 80, but with fewer cancer cases of advanced stages at age 61-65. Adjustment for potential lifestyle confounders was limited. CONCLUSIONS: In this study, cervical screening with cytology at age 61-65 was associated with a statistically significant reduction of subsequent cervical cancer risk for women who were unscreened, or screened with abnormalities, in their 50s. In women screened with normal results in their 50s, the risk for future cancer was not sizeable, and the risk reduction associated with continued screening appeared limited. These findings should inform the current debate regarding age and criteria to discontinue cervical screening.
[Mh] Termos MeSH primário: Adenocarcinoma/diagnóstico
Carcinoma de Células Escamosas/diagnóstico
Lesões Intraepiteliais Escamosas Cervicais/diagnóstico
Neoplasias do Colo do Útero/diagnóstico
[Mh] Termos MeSH secundário: Adenocarcinoma/epidemiologia
Adenocarcinoma/patologia
Fatores Etários
Idoso
Células Escamosas Atípicas do Colo do Útero/patologia
Carcinoma de Células Escamosas/epidemiologia
Carcinoma de Células Escamosas/patologia
Estudos de Coortes
Detecção Precoce de Câncer
Feminino
Seres Humanos
Incidência
Meia-Idade
Teste de Papanicolaou
Modelos de Riscos Proporcionais
Lesões Intraepiteliais Escamosas Cervicais/epidemiologia
Lesões Intraepiteliais Escamosas Cervicais/patologia
Suécia/epidemiologia
Neoplasias do Colo do Útero/epidemiologia
Neoplasias do Colo do Útero/patologia
Esfregaço Vaginal
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171110
[Lr] Data última revisão:
171110
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171025
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pmed.1002414


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[PMID]:29045515
[Au] Autor:Tewari D; Novak-Weekley S; Hong C; Aslam S; Behrens CM
[Ad] Endereço:Kaiser Permanente Southern California, Orange County Women's Health Services, Irvine.
[Ti] Título:Performance of the cobas HPV Test for the Triage of Atypical Squamous Cells of Undetermined Significance Cytology in Cervical Specimens Collected in SurePath.
[So] Source:Am J Clin Pathol;148(5):450-457, 2017 Nov 02.
[Is] ISSN:1943-7722
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Objectives: Determine performance of the cobas human papillomavirus (HPV) test for triage of atypical squamous cells of undetermined significance (ASC-US) in SurePath. Methods: Women presenting for routine screening had cervical specimens collected in SurePath and specimen transport medium (STM); those with ASC-US cytology underwent colposcopy. Performance of cobas HPV in SurePath specimens that had undergone a preanalytic procedure to reverse possible cross-linking of HPV DNA was compared with Hybrid Capture 2 (hc2) specimens in STM. Results: Among 856 women, HPV prevalence was 45.8%; HPV 16 and HPV 18 prevalences were lower than expected in the 21- to 29-year-old group in this highly vaccinated population. cobas HPV performance in SurePath was comparable to hc2 in STM. Sensitivity and specificity for detection of cervical intraepithelial neoplasia grade 3 or worse were 87.5% (95% confidence interval [CI], 71.9%-95.2%) and 55.5% (95% CI, 52.1%-58.9%) for cobas and 85.3% (95% CI, 69.9%-93.6%) and 54.7% (95% CI, 51.4%-57.9%) for hc2. Sensitivity was negatively affected by random biopsies performed at colposcopy; comparable sensitivities were achieved in the nonvaccinated and vaccinated populations with disease determined by directed biopsy only. Conclusions: Performance of cobas HPV for ASC-US triage in pretreated SurePath specimens meets criteria for validation. Preliminary data indicate reliable performance of HPV testing in a highly vaccinated population.
[Mh] Termos MeSH primário: Células Escamosas Atípicas do Colo do Útero/virologia
Citodiagnóstico/métodos
Infecções por Papillomavirus/diagnóstico
Fixação de Tecidos/métodos
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Meia-Idade
Papillomaviridae
Infecções por Papillomavirus/complicações
Infecções por Papillomavirus/epidemiologia
Prevalência
Sensibilidade e Especificidade
Triagem/métodos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171019
[St] Status:MEDLINE
[do] DOI:10.1093/ajcp/aqx091


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[PMID]:28990460
[Au] Autor:Upendram P; Sahni S; Mohiuddin K; Poornima S; Gourishankar B; Kumar Vattam K; Boddala P; Jayashankar E; Mohiuddin S; Kamineni V; Mohan V; Houldsworth J; Hasan Q
[Ad] Endereço:1 Department of Genetics and Molecular Medicine, Kamineni Hospitals, Hyderabad, India.
[Ti] Título:Amplification of specific chromosomal regions assessed by fluorescent in situ hybridization on Pap smears to be added as screening tool for identifying women at risk of progressing to cervical cancer.
[So] Source:Tumour Biol;39(10):1010428317698363, 2017 Oct.
[Is] ISSN:1423-0380
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Cervical carcinoma is a frequent malignancy in developing countries despite being a preventable disease. For the first time, four screening tests were used simultaneously for identifying women with a risk of developing cervical cancer, to help clinicians and policy makers to implement the best strategy for reducing the burden of this disease. Women visiting a hospital in India were enrolled after institutional ethics clearance and informed consent. Visual inspection using acetic acid and Pap smear tests were performed on 2683 women, and 104 had abnormal cytology: atypical squamous cells of undetermined significance (n = 29), low-grade squamous intraepithelial lesion (n = 41), high-grade squamous intraepithelial lesion (n = 17), and squamous cell carcinoma (n = 17). These and 96 samples, with normal cytology, were subjected to high-risk human papilloma virus testing and fluorescent in situ hybridization evaluation. Women with abnormal cytology were followed for 5 years and evaluated with colposcopy-guided biopsy. Three accepted methods of screening and one novel fluorescent in situ hybridization assay were carried out in 200 cases. Cutoffs for fluorescent in situ hybridization were established. The screening methods had 88%-96% negative predictive value, while positive predictive value was low (20%) for visual inspection using acetic acid, 47% for fluorescent in situ hybridization, 56% for high-risk human papilloma virus, and 73% for combined high-risk human papilloma virus and fluorescent in situ hybridization. Combined high-risk human papilloma virus and fluorescent in situ hybridization had 94% sensitivity, specificity, and negative predictive value, suggesting that simultaneous screening with these two tests is appropriate for identifying women progressing to cervical cancer and not visual inspection using acetic acid, which has low positive predictive value and Pap cytology which requires to be repeated. Policy makers and clinicians can assess feasibility of incorporating this screening strategy to prevent cervical cancer.
[Mh] Termos MeSH primário: Detecção Precoce de Câncer/métodos
Neoplasias do Colo do Útero/diagnóstico
[Mh] Termos MeSH secundário: Células Escamosas Atípicas do Colo do Útero/virologia
Carcinoma de Células Escamosas/diagnóstico
Carcinoma de Células Escamosas/virologia
Neoplasia Intraepitelial Cervical/diagnóstico
Neoplasia Intraepitelial Cervical/virologia
Feminino
Seres Humanos
Hibridização in Situ Fluorescente/métodos
Índia
Teste de Papanicolaou/métodos
Infecções por Papillomavirus/complicações
Infecções por Papillomavirus/diagnóstico
Sensibilidade e Especificidade
Lesões Intraepiteliais Escamosas Cervicais/diagnóstico
Lesões Intraepiteliais Escamosas Cervicais/virologia
Esfregaço Vaginal/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171017
[Lr] Data última revisão:
171017
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171010
[St] Status:MEDLINE
[do] DOI:10.1177/1010428317698363


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[PMID]:28926579
[Au] Autor:Canfell K; Caruana M; Gebski V; Darlington-Brown J; Heley S; Brotherton J; Gertig D; Jennett CJ; Farnsworth A; Tan J; Wrede CD; Castle PE; Saville M
[Ad] Endereço:Cancer Research Division, Cancer Council New South Wales, Sydney, New South Wales, Australia.
[Ti] Título:Cervical screening with primary HPV testing or cytology in a population of women in which those aged 33 years or younger had previously been offered HPV vaccination: Results of the Compass pilot randomised trial.
[So] Source:PLoS Med;14(9):e1002388, 2017 Sep.
[Is] ISSN:1549-1676
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Using primary human papillomavirus (HPV) testing for cervical screening increases detection of high-grade cervical intraepithelial neoplastic lesions and invasive cancer (cervical intraepithelial neoplasia grade 2+ [CIN2+]) compared to cytology, but no evaluation has been conducted in a population previously offered HPV vaccination. We aimed to assess colposcopy referral and CIN2+ detection rates for HPV-screened versus cytology-screened women in Australia's HPV-vaccinated population (by 2014, resident women ≤33 years had been age-eligible for HPV vaccination, with 3-dose uptake across age cohorts being about 50%-77%). METHODS AND FINDINGS: Compass is an open-label randomised trial of 5-yearly HPV screening versus 2.5-yearly liquid-based cytology (LBC) screening. In the first phase, consenting women aged 25-64 years presenting for routine screening at 47 primary practices in Victoria, Australia, provided a cervical sample and were randomised at a central laboratory at a 1:2:2 allocation to (i) image-read LBC screening with HPV triage of low-grade cytology ('LBC screening'), (ii) HPV screening with those HPV16/18 positive referred to colposcopy and with LBC triage for other oncogenic (OHR) types ('HPV+LBC triage'), or (iii) HPV screening with those HPV16/18 positive referred to colposcopy and with dual-stained cytology triage for OHR types ('HPV+DS triage'). A total of 5,006 eligible women were recruited from 29 October 2013 to 7 November 2014 (recruitment rate 58%); of these, 22% were in the group age-eligible for vaccination. Data on 4,995 participants were analysed after 11 withdrawals; 998 were assigned to, and 995 analysed (99.7%) in, the LBC-screened group; 1,996 assigned to and 1,992 analysed (99.8%) in the HPV+LBC triage group; and 2,012 assigned to and 2,008 analysed (99.8%) in the HPV+DS triage group. No serious trial-related adverse events were reported. The main outcomes were colposcopy referral and detected CIN2+ rates at baseline screening, assessed on an intention-to-treat basis after follow-up of the subgroup of triage-negative women in each arm referred to 12 months of surveillance, and after a further 6 months of follow-up for histological outcomes (dataset closed 31 August 2016). Analysis was adjusted for whether women had been age-eligible for HPV vaccination or not. For the LBC-screened group, the overall referral and detected CIN2+ rates were 27/995 (2.7% [95% CI 1.8%-3.9%]) and 1/995 (0.1% [95% CI 0.0%-0.6%]), respectively; for HPV+LBC triage, these were 75/1,992 (3.8% [95% CI 3.0%-4.7%]) and 20/1,992 (1.0% [95% CI 0.6%-1.5%]); and for HPV+DS triage, these were 79/2,008 (3.9% [95% CI 3.1%-4.9%]) and 24/2,008 (1.2% [95% CI 0.8%-1.6%]) (p = 0.09 for difference in referral rate in LBC versus all HPV-screened women; p = 0.003 for difference in CIN2+ detection rate in LBC versus all HPV-screened women, with p = 0.62 between HPV screening groups). Limitations include that the study population involved a relatively low risk group in a previously well-screened and treated population, that individual women's vaccination status was unknown, and that long-term follow-up data on disease detection in screen-negative women are not yet available. CONCLUSIONS: In this study, primary HPV screening was associated with significantly increased detection of high-grade precancerous cervical lesions compared to cytology, in a population where high vaccine uptake was reported in women aged 33 years or younger who were offered vaccination. It had been predicted that increased disease detection might be associated with a transient increase in colposcopy referral rates in the first round of HPV screening, possibly dampened by HPV vaccine effect; in this study, although the point estimates for referral rates in women in each HPV-screened group were 41%-44% higher than in cytology-screened women, the difference in referral rate between cytology- and HPV-screened women was not significant. These findings provide initial support for the implementation of primary HPV screening in vaccinated populations. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12613001207707.
[Mh] Termos MeSH primário: Neoplasia Intraepitelial Cervical/diagnóstico
Colo do Útero/patologia
Detecção Precoce de Câncer/métodos
Papillomavirus Humano 16/isolamento & purificação
Papillomavirus Humano 18/isolamento & purificação
Encaminhamento e Consulta/estatística & dados numéricos
Neoplasias do Colo do Útero/diagnóstico
[Mh] Termos MeSH secundário: Adulto
Células Escamosas Atípicas do Colo do Útero/patologia
Células Escamosas Atípicas do Colo do Útero/virologia
Biópsia/métodos
Neoplasia Intraepitelial Cervical/patologia
Neoplasia Intraepitelial Cervical/virologia
Colposcopia
Feminino
Seres Humanos
Meia-Idade
Vacinas contra Papillomavirus
Projetos Piloto
Lesões Intraepiteliais Escamosas Cervicais/diagnóstico
Lesões Intraepiteliais Escamosas Cervicais/patologia
Lesões Intraepiteliais Escamosas Cervicais/virologia
Triagem
Neoplasias do Colo do Útero/patologia
Neoplasias do Colo do Útero/virologia
Vacinação
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Papillomavirus Vaccines)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170928
[Lr] Data última revisão:
170928
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170920
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pmed.1002388


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[PMID]:28807115
[Au] Autor:Duvall MJ; Maxon JA; Lehman JS
[Ad] Endereço:Department of Family Medicine, Mayo Clinic, Rochester, Minnesota.
[Ti] Título:Correlation between HPV status via in situ hybridization testing on genital squamous papillomas and risk for cervical dysplasia or other anogenital HPV-related complications: A case-control study.
[So] Source:J Am Acad Dermatol;77(3):579-580, 2017 09.
[Is] ISSN:1097-6787
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Doenças do Ânus/virologia
Neoplasia Intraepitelial Cervical/virologia
Condiloma Acuminado/virologia
Neoplasias dos Genitais Femininos/virologia
Papiloma/virologia
Infecções por Papillomavirus/virologia
[Mh] Termos MeSH secundário: Células Escamosas Atípicas do Colo do Útero/virologia
Estudos de Casos e Controles
Feminino
Neoplasias dos Genitais Femininos/patologia
Seres Humanos
Hibridização In Situ
Meia-Idade
Teste de Papanicolaou
Papiloma/patologia
Infecções por Papillomavirus/genética
Estudos Retrospectivos
Lesões Intraepiteliais Escamosas Cervicais/virologia
Esfregaço Vaginal
[Pt] Tipo de publicação:LETTER
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170918
[Lr] Data última revisão:
170918
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170816
[St] Status:MEDLINE


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[PMID]:28655061
[Au] Autor:Cuzick J; Myers O; Lee JH; Shi Y; Gage JC; Hunt WC; Robertson M; Wheeler CM; New Mexico HPV Pap Registry Steering Committee
[Ad] Endereço:Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, England.
[Ti] Título:Outcomes in Women With Cytology Showing Atypical Squamous Cells of Undetermined Significance With vs Without Human Papillomavirus Testing.
[So] Source:JAMA Oncol;3(10):1327-1334, 2017 Oct 01.
[Is] ISSN:2374-2445
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Little is known about the long-term yield of high-grade cervical intraepithelial neoplasia (CIN) and the influence on biopsy and treatment rates of human papillomavirus (HPV) triage of cytology showing atypical squamous cells of undetermined significance (hereafter ASC-US cytology). Objective: To examine 5-year outcomes after ASC-US cytology with vs without HPV testing. Design, Setting, and Participants: In this observational study, all cervical cytology and HPV testing reports from January 1, 2007, to December 31, 2012, were obtained for women throughout New Mexico and linked to pathology reports. The dates of the analysis were May 4, 2015, to January 13, 2017. Main Outcomes and Measures: Influence of HPV testing on disease yield, time to histologically confirmed disease, and biopsy or loop electrosurgical excision procedure rates. Results: A total of 457 317 women (mean [SD] age, 39.8 [12.5] years) with a screening test were recorded between 2008 and 2012, and 20 677 (4.5%) of the first cytology results per woman were reported as ASC-US. CIN grade 3 or more severe (CIN3+) lesions were detected in 2.49% of women with HPV testing vs 2.15% of women without HPV testing (P = .23). Time to CIN3+ detection was much shorter in those with HPV testing vs those without testing (median, 103 vs 393 days; P < .001). CIN grade 1 was detected in 11.6% of women with HPV testing vs 6.6% without testing (relative risk, 1.76; 95% CI, 1.56-2.00; P < .001). Loop electrosurgical excision procedure rates within 5 years were 20.0% higher in those who underwent HPV testing, resulting in more CIN2+ and CIN3+ detection. Conclusions and Relevance: Human papillomavirus testing led to faster and more complete diagnosis of cervical disease, but 55.8% more biopsies and 20.0% more loop electrosurgical excision procedures were performed. In those tested, virtually all high-grade disease occurred in the 43.1% of women who were HPV positive, allowing clinical resources to be focused on women who need them most. These data provide essential information for cervical screening guidelines and public health policy.
[Mh] Termos MeSH primário: Células Escamosas Atípicas do Colo do Útero/patologia
Neoplasia Intraepitelial Cervical/patologia
Papillomaviridae/isolamento & purificação
Infecções por Papillomavirus/diagnóstico
Neoplasias do Colo do Útero/patologia
[Mh] Termos MeSH secundário: Adulto
Biópsia/estatística & dados numéricos
Neoplasia Intraepitelial Cervical/cirurgia
Neoplasia Intraepitelial Cervical/virologia
Detecção Precoce de Câncer
Eletrocirurgia/estatística & dados numéricos
Feminino
Seres Humanos
Meia-Idade
Gradação de Tumores
Infecções por Papillomavirus/cirurgia
Prognóstico
Resultado do Tratamento
Neoplasias do Colo do Útero/cirurgia
Neoplasias do Colo do Útero/virologia
Esfregaço Vaginal
Adulto Jovem
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171019
[Lr] Data última revisão:
171019
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170628
[St] Status:MEDLINE
[do] DOI:10.1001/jamaoncol.2017.1040


  9 / 144 MEDLINE  
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[PMID]:28498639
[Au] Autor:Guo M; Khanna A; Wang J; Dawlett MA; Kologinczak TL; Lyons GR; Bassett RL; Sneige N; Gong Y; Bevers TB
[Ad] Endereço:Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
[Ti] Título:Three-year risk of high-grade CIN for women aged 30 years or older who undergo baseline Pap cytology and HPV co-screening.
[So] Source:Cancer;125(8):644-651, 2017 Aug.
[Is] ISSN:1097-0142
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Papanicolaou (Pap) cytology and high-risk human papillomavirus (HPV) DNA cotesting for women aged ≥30 years are recommended for the prevention of cervical cancer. The objective of the current study was to evaluate the efficacy of this cotesting for predicting the risk of high-grade cervical intraepithelial neoplasia 3 (CIN3) during a 3-year follow-up period. METHODS: A retrospective database search identified women aged ≥30 years who had baseline HPV and Pap cytology cotesting results in 2007 or 2008 and for whom 3-year follow-up results were available. The cumulative 3-year risks of developing CIN-3 were calculated. RESULTS: The 3-year follow-up data after baseline Pap/HPV cotesting were available for 1986 women (mean age, 53 years). Of the 1668 women who had a baseline Pap-negative (Pap-)/HPV- cotesting result, 1561 (93.6%) had a follow-up Pap cytology result that was negative for intraepithelial lesions or malignancy. Of the 1530 women who had follow-up Pap/HPV cotesting, 1504 (98.3%) had a Pap-/HPV- result. The 3-year cumulative risk of developing CIN-3 was found to be highest for women with a baseline Pap-positive (Pap+)/HPV+ cotesting result (12.5%); the risk of CIN-3 was lower in those with a Pap-/HPV+ result (1.5%; P = .0032) or a Pap-/HPV- result (0.06%; P<.0001). The 3-year cumulative risk of CIN-3 was found to be significantly greater for women with an HPV+ result (4.8%) compared with those with an HPV- result (0.06%; P<.0001). CONCLUSIONS: Pap cytology and HPV cotesting are valuable for stratifying CIN-3 risk. Pap cytology and HPV co-screening at a 3-year screening interval appears to carry a low risk of CIN-3 for women who have a baseline Pap-/HPV- cotesting result. Cancer Cytopathol 2017;125:644-51. © 2017 American Cancer Society.
[Mh] Termos MeSH primário: Neoplasia Intraepitelial Cervical/epidemiologia
Infecções por Papillomavirus/epidemiologia
Lesões Intraepiteliais Escamosas Cervicais/epidemiologia
Neoplasias do Colo do Útero/epidemiologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Células Escamosas Atípicas do Colo do Útero/patologia
Neoplasia Intraepitelial Cervical/diagnóstico
Neoplasia Intraepitelial Cervical/patologia
Bases de Dados Factuais
Detecção Precoce de Câncer
Feminino
Testes de DNA para Papilomavírus Humano
Seres Humanos
Meia-Idade
Gradação de Tumores
Teste de Papanicolaou
Infecções por Papillomavirus/diagnóstico
Estudos Retrospectivos
Medição de Risco
Lesões Intraepiteliais Escamosas Cervicais/diagnóstico
Lesões Intraepiteliais Escamosas Cervicais/patologia
Neoplasias do Colo do Útero/diagnóstico
Neoplasias do Colo do Útero/patologia
Esfregaço Vaginal
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170918
[Lr] Data última revisão:
170918
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170513
[St] Status:MEDLINE
[do] DOI:10.1002/cncy.21877


  10 / 144 MEDLINE  
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[PMID]:28445270
[Au] Autor:Hu SY; Zhang WH; Li SM; Li N; Huang MN; Pan QJ; Zhang X; Han Y; Zhao FH; Chen W; Qiao YL
[Ad] Endereço:aDepartment of Cancer Epidemiology bDepartment of Gynecological Oncology cDepartment of Cytology dDepartment of Pathology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
[Ti] Título:Pooled analysis on the necessity of random 4-quadrant cervical biopsies and endocervical curettage in women with positive screening but negative colposcopy.
[So] Source:Medicine (Baltimore);96(17):e6689, 2017 Apr.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Controversy remains over whether random cervical biopsies and endocervical curettage (ECC) should be used in women with positive screening but negative colposcopy. Our paper aims to determine the indications for random biopsies and ECC among these screened positive women.Three thousand two hundred thirteen women with any positive screening test result but negative colposcopy, who received random 4-quadrant biopsies, were pooled from 17 population-based cervical cancer screening studies done in China from 1999 to 2008. The detection rates of cervical intraepithelial neoplasia grade 2 or worse (CIN2+) and CIN grade 3 or worse (CIN3+) stratified by cytology and high-risk human papillomavirus (HR-HPV) status were assessed, as well as the false negative rates for CIN2+ and CIN3+ by random biopsies without ECC.Compared with women with negative cytology and positive HR-HPV, those with atypical squamous cells of undetermined significance/low-grade squamous intraepithelial lesion (ASC-US/LSIL) and negative HR-HPV had the equivalent lower risks of CIN2+ and CIN3+, but ascending risks were observed in the groups of ASC-US/LSIL and positive HR-HPV, and atypical glandular cells/atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion/high-grade squamous intraepithelial lesion or worse (AGC/ASC-H/HSIL+). If random biopsies were only taken without ECC, 9.3% of CIN2+ and 18.5% of CIN3+ would have been missed.For women with any positive screening but negative colposcopy, in areas with good cytological infrastructure, it was necessary to perform random biopsies plus ECC on those with cytological ASC-US/LSIL and positive HR-HPV, AGC, ASC-H, or HSIL+. In contrast, those with other results should be followed up.
[Mh] Termos MeSH primário: Biópsia
Colo do Útero/patologia
Colposcopia
Dilatação e Curetagem
Detecção Precoce de Câncer
Neoplasias do Colo do Útero/diagnóstico
[Mh] Termos MeSH secundário: Adulto
Células Escamosas Atípicas do Colo do Útero/patologia
Neoplasia Intraepitelial Cervical/diagnóstico
Neoplasia Intraepitelial Cervical/patologia
Feminino
Seres Humanos
Meia-Idade
Papillomaviridae
Infecções por Papillomavirus/diagnóstico
Infecções por Papillomavirus/patologia
Neoplasias do Colo do Útero/patologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170602
[Lr] Data última revisão:
170602
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170427
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000006689



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