Cervix uteri/pathology Archives - Revista Brasileira de Ginecologia e Obstetrícia

  • Artigos Originais

    Breast and cervical cancer in patients with systemic lupus erythematosus

    Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(8):367-371

    Summary

    Artigos Originais

    Breast and cervical cancer in patients with systemic lupus erythematosus

    Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(8):367-371

    DOI 10.1590/SO100-720320140005052

    Views8

    PURPOSE:

    To study the incidence of tumors in a Brazilian sample of women with systemic lupus erythematosus.

    METHODS:

    This is a retrospective study of 395 medical charts from women with systemic lupus erythematosus diagnosed by the presence of at least 4 of the American College of Rheumatology classification criteria for the diagnosis of this disease and followed for the last 10 years in a rheumatology outpatient clinic. Demographic data (age and ethnicity of patients), data on disease duration, use of immunomodulators and on the presence of neoplasms were listed. Results are presented in frequency and contingency tables. The incidence rate of malignancies in women with lupus was compared with that of the general population for the same demographic region for the past ten years, using data published by the Brazilian National Cancer Institute (INCA). Association studies were carried out by the Fisher and χ tests, when the data were nominal, and by Mann-Whitney test, when numeric. The level of significance was set at 5%.

    RESULTS:

    Twenty-two cases of malignant tumors were identified during these 10 years of follow-up (22 cases/395 or 5.5% of the sample), being the most common those of the uterine cervix (10 cases/395 or 2.5% of the sample) and breast cancer (9 cases/395 or 2.2% of the sample). The presence of tumors was associated with disease duration (p=0.006) and was not influenced by treatment with methotrexate (p=0.1), azathioprine (p=0.9), cyclophosphamide (p=0.6) and glucocorticoids (p=0.3). Breast and uterine cervix tumors were more common in systemic lupus erythematosus women than in the general population (p<0.0001 for both).

    CONCLUSION:

    A high prevalence of malignant tumors was found in this sample, with tumors being more common in patients with longer disease duration. The most frequent tumors affected the breast and uterus at a higher incidence than in the general population. The presence of tumors was not influenced by the use of glucocorticoids or immunosuppressors.

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    Breast and cervical cancer in patients with systemic lupus erythematosus
  • 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

    Views5

    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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