Cell biology Archives - Revista Brasileira de Ginecologia e Obstetrícia

  • Artigos Originais

    Abnormal vaginal secretion: sensitivity, specificity and concordance between clinical and cytological diagnosis

    Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(5):222-228

    Summary

    Artigos Originais

    Abnormal vaginal secretion: sensitivity, specificity and concordance between clinical and cytological diagnosis

    Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(5):222-228

    DOI 10.1590/SO100-720320150005183

    Views1

    PURPOSE:

    To estimate the prevalence of bacterial vaginosis (BV), candidiasis and
    trichomoniasis and compare the findings of physical examination of the vaginal
    secretion with the microbiological diagnosis obtained by cytology study of a
    vaginal smear using the Papanicolaou method.

    METHODS:

    A cross-sectional study of 302 women aged 20 to 87 years, interviewed and
    submitted to a gynecology test for the evaluation of vaginal secretion and
    collection of a cytology smear, from June 2012 to May 2013. Sensitivity analyses
    were carried out and specificity, positive predictive value (PPV) and negative
    predictive value (NPV) with their respective 95%CI were determined to assess the
    accuracy of the characteristics of vaginal secretion in relation to the
    microbiological diagnosis of the cytology smear . The kappa index (k) was used to
    assess the degree of agreement between the clinical features of vaginal secretion
    and the microbiological findings obtained by cytology.

    RESULTS

    The prevalence of BV, candidiasis and trichomoniasis was 25.5, 9.3 and 2.0%,
    respectively. The sensitivity, specificity, PPV and NPV of the clinical
    characteristics of vaginal secretion for the cytological diagnosis of BV were 74,
    78.6, 54.3 and 89.9%, respectively. The sensitivity, specificity, PPV and the NPV
    of the clinical characteristics of vaginal secretion for the cytological diagnosis
    of candidiasis were 46.4, 86.2, 25.5 and 94%, respectively. The correlation
    between the clinical evaluation of vaginal secretion and the microbiological
    diagnosis of BV, candidiasis and trichomoniasis, assessed by the kappa index, was
    0.47, 0.23 and 0.28, respectively.

    CONCLUSION

    The most common cause of abnormal vaginal secretion was BV. The clinical
    evaluation of vaginal secretion presented amoderate to weak agreement with the
    microbiological diagnosis, indicating the need for complementary investigation of
    the clinical findings of abnormal vaginal secretion.

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  • Artigos Originais

    Cytological smears of women diagnosed with adenocarcinoma of the uterine cervix

    Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(1):40-45

    Summary

    Artigos Originais

    Cytological smears of women diagnosed with adenocarcinoma of the uterine cervix

    Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(1):40-45

    DOI 10.1590/S0100-72032014000100009

    Views1

    PURPOSE:

    To analyze the cytological findings of women with cervical adenocarcinoma, taking
    into account the patient's history in the year prior to diagnosis and the
    histopathological aspects of the lesions.

    METHODS:

    A retrospective comparative study was conducted using data from women with
    cervical adenocarcinoma or squamous carcinoma detected between 2002 and 2008. The
    cytological reports were synthesized according to the Bethesda System revised in
    2001 and were compared to the histopathological findings of cervical
    adenocarcinoma and squamous carcinoma. The distributions of cytological findings
    were calculated, as well as the global agreement and chance-corrected agreement
    using the Cohen's Kappa Coefficient. For this purpose, the cytological findings
    were grouped according to the epithelial origin, forming the glandular cell and
    squamous cell groups, with the histopathologically confirmed tumor types
    (adenocarcinoma versus squamous carcinoma) being used as the gold
    standard.

    RESULTS:

    A total of 284 cases of cervical cancer were diagnosed during the study period.
    The effectively studied cases were 27 and 54 patients with adenocarcinoma and
    squamous carcinoma, respectively. The adenocarcinoma group represented 9.5% of the
    total cases diagnosed, and 56.0% of the women in this group were younger than 50
    years. Cervical cytology was collected on average 92 days before the cancer
    diagnosis (range: 19 days to 310 days). In 41.6% of cases the cytological results
    were consistent with glandular alterations such as adenocarcinoma cells or
    atypical glandular cells. The global agreement and Cohen's Kappa Coefficient were
    73.7 and 48.7%, suggesting substantial and moderate agreement, respectively.

    CONCLUSIONS:

    In this population, the cytological smears had an important role in screening
    women with adenocarcinoma, although some of them were referred to clarify the
    clinical symptoms. The agreement between cytological and histopathological
    findings was moderate.

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