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Type: Artigo de periódico
Title: Value Of Hpv-dna Test In Women With Cytological Diagnosis Of Atypical Glandular Cells (agc).
Author: Zeferino, Luiz Carlos
Rabelo-Santos, Silvia Helena
Villa, Luísa Lina
Sarian, Luis Otávio
Costa, Maria Cecília
do Amaral Westin, Maria Cristina
de Ângelo-Andrade, Liliana Aparecida Lucci
Derchain, Sophie
Abstract: This study analyzed whether HPV (human papillomavirus) testing contributes towards defining histological abnormalities in women with atypical glandular cells (AGC) diagnosed at cervical cytology. One hundred and eight women with conventional cervical cancer screening smears suggestive of AGC not otherwise specified (AGC-NOS) and favor neoplastic (AGC-FN) were consecutively enrolled. All women underwent colposcopic examinations and biopsy was performed according to the cytopathologic and/or colposcopic abnormalities present. All specimens were tested for high risk HPV genotypes by Roche's polymerase chain reaction reverse line blot assay. The chi-square test was used to evaluate the association between HPV findings and a diagnosis of high-grade pre-invasive or invasive disease (CIN 2 or worse) taking negative tests or CIN 1 as a reference. Odds ratios (OR) with their respective 95% confidence intervals (95%CI) were used to evaluate the magnitude of the association between HPV testing and CIN 2 or worse. Sensitivity, specificity and their respective 95% confidence intervals (95%CI), positive predictive values (PPV) and negative predictive values (NPV) were also calculated. Final diagnosis revealed a negative outcome in 80 cases (74%), cervical epithelial neoplasia 1 (CIN 1) in 13 cases (12%), CIN 2 or worse in 12 cases (11%) and glandular neoplasia in 3 (3%) cases. The overall detection rate of HPV was 21% (23/108). Neoplasia was significantly associated with positive HPV-DNA in women with AGC-NOS (OR=15.21; 95%CI: 2.64-87.50); however, there was no significant association between a histological diagnosis of neoplasia and HPV positivity in women with AGC-FN (OR=3.00; 95%CI: 0.36-24.92). The sensitivity, specificity, positive predictive value and negative predictive value of HPV-DNA testing for the detection of CIN 2 or worse in women with AGC-NOS were 71%, 86%, 29% and 97%, respectively. In women with AGC-FN, these values were 50%, 75%, 66% and 60%, respectively. HPV testing at the time of colposcopy for patients with AGC in whom no colposcopic abnormality is found may be a powerful ancillary tool for identifying women at a high risk of underlying significant cervical lesions.
Subject: Adult
Cervical Intraepithelial Neoplasia
Cervix Uteri
Dna, Viral
Middle Aged
Neoplasm Grading
Neoplasms, Glandular And Epithelial
Sensitivity And Specificity
Uterine Cervical Neoplasms
Vaginal Smears
Rights: fechado
Identifier DOI: 10.1016/j.ejogrb.2011.05.023
Date Issue: 2011
Appears in Collections:Unicamp - Artigos e Outros Documentos

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