Cervix Archives - Revista Brasileira de Ginecologia e Obstetrícia

  • Trabalhos Originais

    Behavioral factors and changes in the number of Langerhans’ cells

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(4):289-294
    07-20-2004

    Summary

    Trabalhos Originais

    Behavioral factors and changes in the number of Langerhans’ cells

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(4):289-294
    07-20-2004

    DOI 10.1590/S0100-72032004000400004

    Views91

    OBJECTIVE: to study the relationship of biobehavioral factors, such as age, menarche, number of gestations, and age of first sexual intercourse, with changes in Langerhans'cells in women with negative hybrid capture for HPV. METHODS: thirty women referred due to abnormal cervical cytology or premalignant cervical lesions were studied and underwent colposcopy, guided biopsy and histopathological exams. The Langerhans' cells were identified by immunohistochemical (S100+) exams. Langerhans' cells visualized in brown color were counted using the software Cytoviewer. The nonparametric Wilcoxon rank-sum test was employed for statistical analysis. RESULTS: the number of Langerhans' cells in women who had menarche after 13 years old presented statistically significant difference (173.34 cell/mm²) compared to the group whose menarche occurred before 13 (271.41 cell/mm²). The age at the first sexual intercourse was associated with the low number of Langerhans' cells, 127.15 cell/mm² and 250.14 cell/mm², respectively, for the beginning of the sexual activity up to 17 years old and after 17 (p=0.03). Previous cauterizations of the uterine cervix have been related to a lower number of Langerhans' cells in the epithelium, with the average 120.30 cell/mm² as compared to 236.06 cell/mm² for those women who never underwent that procedure (p=0.05). Other factors such as the patient's age and the number of gestations showed no statistically significant differences in the density of Langerhans' cells. CONCLUSIONS: the present study reports the association of biobehavioral factors with decrease in the number of Langerhans' cell.

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    This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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    Evaluation of cervical slides previously diagnosed as ASCUS: interassay and interobserver comparison

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(3):233-240
    07-05-2004

    Summary

    Trabalhos Originais

    Evaluation of cervical slides previously diagnosed as ASCUS: interassay and interobserver comparison

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(3):233-240
    07-05-2004

    DOI 10.1590/S0100-72032004000300010

    Views85

    OBJECTIVE: to evaluate the existence of intra and intercytophathologists disagreement in the analysis of cervical slides previously diagnosed as atypical skin cells with undetermined significance (ASCUS), and the degree of this disagreement. METHODS: a transversal study of 50 cervical slides of Pap smears previously diagnosed as ASCUS, collected in November 2000 in Contagem town. They were analyzed and classified by four cytopathologists according to the first Bethesda system review of 1991 (normal, atrophic alteration, inflammatory alteration, suggestive of LoSIL, suggestive of HiSIL, suggestive of invasive carcinoma and others). After the first analysis, the slides were renumbered in a random order and sent to the same cytophathologists for a new exam. The Kappa test and the weighted Kappa were used in the analysis of the results. RESULTS: there was a high degree of disagreement between the different analyses of the same cytopathologist, varying from 7.8 to 74.4% according to the Kappa test. When a weight of 20% was settled for each degree of disagreement, these values increased from 16.1% for the cytopathologist A to 81.08% for the cytopathologist B. Concerning the comparative analyses made by different examiners the Kappa test values obtained varied from 50.6% to 63.4% in the normal and weighted versions, respectively. CONCLUSIONS: this study confirms the existence of subjectivity in the analysis of the ASCUS category and imprecision in the analysis criteria by the same examiner.

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    This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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    Human papillomavirus typing and physical state by in situ hybridization in uterine cervix intraepithelial lesions

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(1):59-64
    04-23-2004

    Summary

    Trabalhos Originais

    Human papillomavirus typing and physical state by in situ hybridization in uterine cervix intraepithelial lesions

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(1):59-64
    04-23-2004

    DOI 10.1590/S0100-72032004000100009

    Views66

    PURPOSE: to carry out a molecular study (in situ hybridization) on patients who present intraepithelial lesions of the uterine cervix, and to assess the frequency and the physical state of the human papillomavirus (HPV). METHODS: histological sections of biopsies of the uterine cervix from 84 patients were evaluated by in situ hybridization, with a broad-spectrum probe, which allows the identification of the HPV types 6, 11, 16, 18, 31, 33, 35, 39, 42, 45, and 56 and with specific probes for HPV types 6, 11, 16, 18, 31, and 33. The physical patterns of HPV DNA found were: episomal, when the entire nucleus stains with biotin (brown); integrated - one or two brown points in the hybridized nucleus, or mixed, associating both patterns. Of the 84 patients evaluated, 31 (36.9%) had low-grade squamous intraepithelial lesions (LSIL), and 53 (63.1%) had high-grade squamous intraepithelial lesions (HSIL) on histological examination. Fisher's exact test was used for the statistical analysis. RESULTS: considering all the cases, 46 (54.7%) were positive for HPV DNA with the broad-spectrum probe. Regarding typing, HPV-16 was the most frequent in HSIL (12 cases - 22.6% - p<0.05). The frequencies of the other HPV types did not show statistically significant differences between the LSIL and HSIL cases. By physical condition assessment of the HPV DNA, the percentage of the episomal (most common in LSIL) and integrated patterns showed no significant differences between the two groups; the mixed HSIL type prevailed when compared to LSIL: 26.4 and 3.2%, respectively (p<0.01). The physical condition of the HPV DNA, integrated in the host cell, was more frequent in the most severe cases. CONCLUSIONS: HPV-16 was the most frequent in HSIL cases. The frequencies of the other HPV types did not show statistically significant differences between the LSIL and HSIL cases. The physical condition of the HPV DNA, integrated in the host cell, was more frequent in the more severe cases.

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    This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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    Evaluation of the Intensity and the Extension of Thermal Alterations Produced by High Frequency Surgery in the Uterine Cervix

    Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(1):47-51
    06-27-2001

    Summary

    Trabalhos Originais

    Evaluation of the Intensity and the Extension of Thermal Alterations Produced by High Frequency Surgery in the Uterine Cervix

    Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(1):47-51
    06-27-2001

    DOI 10.1590/S0100-72032001000100007

    Views60

    Purpose: to evaluate the incidence of thermal damage to the specimens excised through large loop excision of the transformation zone (LLETZ) and to determine qualitatively and quantitatively the thermal injury to the ectocervical and endocervical epithelia as well as the influence of the menstrual phase on such process. Methods: we performed a prospective study of 100 patients with high-grade squamous intraepithelial lesions (HGSIL). Thermal damage was subdivided into three grades according to Messing et al¹. Results: thermal injury occurred in all the cases, however, through statistical analysis we found that in 91% of the cases it was insignificant, thus leading to a precise histological evaluation, hence to measure the thermal injury was unnecessary. The grade and extent of thermal damage in excised specimens using LLETZ had no relation to the menstrual phase. The extension of thermal tissue alteration in the endocervical epithelia was 271,6 mu while the extension in ectocervical epithelia was 254,8 mu, showing that the extension of thermal damage is significantly higher in endocervical epithelia. Of the one hundred patients, 80 were in menacme and 20 in menopause correlating the grade and extension of thermal damage with the menstrual state. Conclusion: there was no significant difference in both qualitative and quantitative evaluations. There is no need to measure the thermal damage.

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    This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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    Angiogenesis in Squamous Cervical Neoplasia: Comparative Study of two Endothelial Cells

    Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(5):313-319
    06-26-2001

    Summary

    Trabalhos Originais

    Angiogenesis in Squamous Cervical Neoplasia: Comparative Study of two Endothelial Cells

    Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(5):313-319
    06-26-2001

    DOI 10.1590/S0100-72032001000500007

    Views95

    Purpose: to compare the efficiency of anti-factor VIII and anti-CD34 antibodies as vascular makers in cervical cancer, in cervical intraepithelial neoplasia and in normal cervix. Methods: using an immunohistochemical method, factor VIII-related antigen and leukocyte antigen CD34, we performed microvascular counts in 18 squamous cell carcinomas, in 15 cervical high-grade intraepithelial neoplasia, in 15 low-grade intraepithelial lesions and in 10 normal cervices. Using light microscopy we counted microvessels per 400X field in the most active areas of neovascularization with higher microvessel density in each case. Results: the average of microvessels stained with anti-CD34 in invasive carcinoma, high-grade intraepithelial lesions, low-grade intraepithelial lesions and in the normal cervices was 154, 134, 112 and 93, respectively. When we used anti-factor VIII the average was 56, 44, 33 and 30 vessels, following the same order. High-grade intraepithelial lesions and invasive carcinomas showed greater means number of vessels than normal tissue. Conclusions: the use of anti-CD34 allowed the detection of a greater number of vessels when compared to anti-factor VIII. However, we could observe that anti-factor VIII staining was able to significantly discriminate high-grade from low-grade lesions.

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    This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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