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Abstract(s)
Introdução: O Cancro do Colo do Ătero Ă© o 2Âș cancro mais frequente, no sexo feminino (nos grupos etĂĄrios dos 40-50 anos), e representa, aproximadamente, 10% de todas as neoplasias nas mulheres. A nĂvel nacional, atinge 13 a 14 mulheres por cada 100 000, com cerca de 1 000 novos casos anuais e Ă© responsĂĄvel pela morte de, aproximadamente, 350 mulheres/ano. A persistĂȘncia da infecção pelo HPV de alto risco constitui o principal factor epidemiolĂłgico para o cancro do colo do Ăștero, no entanto, apenas um pequeno nĂșmero de mulheres infectadas desenvolve a doença. A infecção do colo uterino, por este tipo de vĂrus, constitui um factor necessĂĄrio, mas nĂŁo suficiente para a sua carcinogĂ©nese. Ă necessĂĄria a acção de co-factores para o desenvolvimento da neoplasia intra-epitelial e do carcinoma invasivo.
Objectivo: AtravĂ©s da avaliação de caracterĂsticas das mulheres e de factores de risco associados, determinar a influĂȘncia da flora vaginal no desenvolvimento de neoplasia intra-epitelial do colo do Ăștero.
Material e MĂ©todos: Avaliaram-se, retrospectivamente, os processos clĂnicos de todas as doentes referenciadas Ă Unidade de Patologia Cervical do Serviço de ObstetrĂcia e Ginecologia do CHCB, CovilhĂŁ, por alteração citolĂłgica do colo do Ăștero sugestiva de Inflamação, ASC-US e LSIL, de 01 de Janeiro a 31/12/2010. Para anĂĄlise, foram excluĂdas mulheres grĂĄvidas, na menopausa e com sinais clĂnicos de infecção vulvo-vaginal. Foram seleccionados 62 processos clĂnicos, nos quais foi avaliada a idade da menarca, idade das primeiras relaçÔes sexuais, o nĂșmero de parceiros sexuais, os mĂ©todos contraceptivos utilizados, Ă data da consulta, o nĂșmero de gestaçÔes, o resultado da citologia do colo do Ăștero colhida no Centro de SaĂșde, a impressĂŁo colposcĂłpica, o resultado da biĂłpsia, a anĂĄlise microbiolĂłgica do exsudado vaginal e o tratamento realizado no CHCB.
Utilizou-se SPSS versĂŁo 17.0.
Resultados: A amostra era constituĂda por 62 mulheres, com idades compreendidas entre 19 e 52 anos (mĂ©dia = 35,89; desvio padrĂŁo=8,361). A idade mĂnima da menarca foi 9 e a mĂĄxima 17 anos (mĂ©dia=12,84; desvio padrĂŁo=1,652). Relativamente Ă s citologias realizadas, no Centro de SaĂșde, 77,4% tinham resultado de ASC-US/LSIL e 22,6% inflamatĂłrio. A maioria das mulheres era assintomĂĄtica (75,8% vs 24,2%). A idade da PRS mais frequentemente relatada foi 18 anos, seguindo-se os 19 anos e, em relação ao nĂșmero de parceiros sexuais, 43,5% tiveram um parceiro e 56,5% mais do que um. Como mĂ©todo anticoncepcional, 74,2% das mulheres usavam estroprogestativo e 25,8% usavam um mĂ©todo nĂŁo-hormonal. Na amostra analisada 22,6% das mulheres nĂŁo tinham filhos, enquanto 77,4% tinham. Quanto ao consumo de tabaco, 67,7% das mulheres negaram ter hĂĄbitos tabĂĄgicos. Na colposcopia, 6,5% das mulheres apresentavam LAG e 93,5% apresentavam LBG e, na biĂłpsia, 74% apresentavam diagnĂłstico histolĂłgico de CIN 1 e 26% sem displasia. O HPV estava presente em 58,1% das amostras e ausente em 41,9%.
Conclusão: no presente estudo, 21% das doentes foram referenciadas por resultado citológico de Inflamação, 53,2% por LSIL e 25,8% por ASC-US. Microbiologicamente, em 16,1% de todas as doentes foram encontrados muitos Lactobacilos, em 27,4% alguns, 17,7% raros e 38,7 ausentes, o que nos sugere que o resultado do estudo histológico pode ser influenciado pelo estado da flora vaginal. Encontraram-se associaçÔes entre o diagnóstico histológico de CIN 1 e algumas variåveis estudadas.
Introduction: Cervical Cancer is the 2nd most common cancer in females (in age groups of 40-50 years-old) and represents approximately 10% of all cancers in women. In this country, it affects 13 to 14 women per 100,000 with about 1000 new cases annually and is responsible for approximately 350 deaths per year. Persistent infection with high risk HPV is the major epidemiological factor for cervical cancer, however only a small number of infected women develop the disease. . The infection of the cervix by this type of virus is a necessary factor, but not sufficient for its carcinogenicity. The influence of co-factors is necessary for the development of intraepithelial neoplasia and invasive carcinoma. Objective: Through the evaluation of characteristics of women and associated risk factors, determine the influence of vaginal flora in the development of cervical intraepithelial cancer. Methods: Retrospectively, we assessed the clinical files of all patients referred to the Cervical Pathology Unit of the Department of Obstetrics and Gynecology in CHCB, CovilhĂŁ, by altered cervical cytology suggestive of inflammation, ASC-US and LSIL, from January 1rst 2010 to 31/12/2010. For analysis, we excluded pregnant women, in menopause and with clinical signs of vulvovaginal infection. We selected 62 clinical cases in which we revised the age at menarche, age of first intercourse, number of sexual partners, type of contraceptive method used at the time of consultation, number of pregnancies, the results of cervical cytology harvested at the Center for Health, the colposcopic impression, the biopsy results, the microbiological analysis of the vaginal swab and the treatment performed in CHCB. It was used SPSS version 17.0. Results: The sample included 62 women, aged between 19 and 52 years (mean = 35,89; SD = 8,361). The minimum age at menarche was 9 and the maximum 17 years (mean = 12,84; SD = 1,652). Regarding the results of cytology performed at the Health Center, 77.4% were the result ofASC-US/LSIL and 22.6% inflammatory. Most women were asymptomatic (75,8% vs 24,2%). The age of the first intercourse most frequently reported was 18 years, followed by 19 years, and concerning the number of sexual partners, 43,5% had one partner and 56,5% had more than one. As contraceptive methods, 74,2% of women used hormonal (estrogen and progesterone) and 25,8% used a non-hormonal method. In the sample 22,6% of women had no children, while 77,4% had. As for tobacco, 67,7% of women denied smoking. At colposcopy, 6,5% of women had High Grade Lesions and 93,5% had Low Grade Lesions. At biopsy, 74% had CIN 1 and 26% without dysplasia. HPV was present in 58,1% of samples and absent in 41,9%. Conclusion: In this study, 21% of patients were referred because cytological results of inflammation, 53,2% for LSIL and 25,8% for ASC-US. Microbiologically, in 16,1% of all patients were found many Lactobacilli, some in 27.4%, rare in 17.7% and absent in 38,7%, which suggests that the result of histological study may be influenced by the conditions of the vaginal flora. Associations were found between the histological diagnosis of CIN 1 and some of the variables that were analysed.
Introduction: Cervical Cancer is the 2nd most common cancer in females (in age groups of 40-50 years-old) and represents approximately 10% of all cancers in women. In this country, it affects 13 to 14 women per 100,000 with about 1000 new cases annually and is responsible for approximately 350 deaths per year. Persistent infection with high risk HPV is the major epidemiological factor for cervical cancer, however only a small number of infected women develop the disease. . The infection of the cervix by this type of virus is a necessary factor, but not sufficient for its carcinogenicity. The influence of co-factors is necessary for the development of intraepithelial neoplasia and invasive carcinoma. Objective: Through the evaluation of characteristics of women and associated risk factors, determine the influence of vaginal flora in the development of cervical intraepithelial cancer. Methods: Retrospectively, we assessed the clinical files of all patients referred to the Cervical Pathology Unit of the Department of Obstetrics and Gynecology in CHCB, CovilhĂŁ, by altered cervical cytology suggestive of inflammation, ASC-US and LSIL, from January 1rst 2010 to 31/12/2010. For analysis, we excluded pregnant women, in menopause and with clinical signs of vulvovaginal infection. We selected 62 clinical cases in which we revised the age at menarche, age of first intercourse, number of sexual partners, type of contraceptive method used at the time of consultation, number of pregnancies, the results of cervical cytology harvested at the Center for Health, the colposcopic impression, the biopsy results, the microbiological analysis of the vaginal swab and the treatment performed in CHCB. It was used SPSS version 17.0. Results: The sample included 62 women, aged between 19 and 52 years (mean = 35,89; SD = 8,361). The minimum age at menarche was 9 and the maximum 17 years (mean = 12,84; SD = 1,652). Regarding the results of cytology performed at the Health Center, 77.4% were the result ofASC-US/LSIL and 22.6% inflammatory. Most women were asymptomatic (75,8% vs 24,2%). The age of the first intercourse most frequently reported was 18 years, followed by 19 years, and concerning the number of sexual partners, 43,5% had one partner and 56,5% had more than one. As contraceptive methods, 74,2% of women used hormonal (estrogen and progesterone) and 25,8% used a non-hormonal method. In the sample 22,6% of women had no children, while 77,4% had. As for tobacco, 67,7% of women denied smoking. At colposcopy, 6,5% of women had High Grade Lesions and 93,5% had Low Grade Lesions. At biopsy, 74% had CIN 1 and 26% without dysplasia. HPV was present in 58,1% of samples and absent in 41,9%. Conclusion: In this study, 21% of patients were referred because cytological results of inflammation, 53,2% for LSIL and 25,8% for ASC-US. Microbiologically, in 16,1% of all patients were found many Lactobacilli, some in 27.4%, rare in 17.7% and absent in 38,7%, which suggests that the result of histological study may be influenced by the conditions of the vaginal flora. Associations were found between the histological diagnosis of CIN 1 and some of the variables that were analysed.
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Keywords
Neoplasia intra-epitelial do colo do Ăștero - Flora vaginal Neoplasia do colo do Ăștero - Flora vaginal. Flora vaginal Cancro do colo do Ăștero
Citation
Publisher
Universidade da Beira Interior