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You searched for:"João Norberto Stávale"
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Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(3):213-219
DOI 10.1590/S0100-72032004000300007
OBJECTIVE: to evaluate the effectiveness of the hygroscopic dilator in the colposcopic examination of the endocervical canal in patients with high-grade lesion in the cytopathology and unsatisfactory colposcopy. METHODS: prospective study, including 62 patients with unsatisfactory colposcopic examination and cytology compatible with high-grade intraepithelial lesion. The patients were submitted to dilation of the endocervical canal by means of a hygroscopic dilator. After dilation, the new colposcopic findings were recorded, and then conization was made through loop electrosurgical excision procedure. The incidence of neoplasic involvement of surgical margins was compared between patients with examinations modified toward satisfactory results and those that remained with unsatisfactory colposcopy. In order to compare the incidence of involved margins and the incidence of residual disease, two retrospective control-groups were used: the GinSat group (n = 35): patients with unsatisfactory colposcopy; GSat group (n = 38): patients with satisfactory colposcopy and endocervical atypy. RESULTS: 80.6% of the cases presented satisfactory colposcopic vision after dilation. 80.4% of those presented disease-free resection margins. The incidence of disease-free resection margins in patients with persistent unsatisfactory colposcopy after dilation was 36.3%. Affected surgical margins occurred in 28% of the group that had undergone dilation, 28.5% of the cases in GinSat group, and 31.5% in the Gsat group. Follow-up showed the incidence of residual disease in 7.5% of the patients under dilation, 28.5% in the GinSat group and 28.9% in the GSat group. CONCLUSION: the use of hygroscopic dilation improved visualization of lesions of difficult access to the colposcopic examination, thus permitting reduction in the percentage of residual neoplasic disease in patients with unsatisfactory colposcopy treated with loop electrosurgical excision procedure.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(3):213-219
DOI 10.1590/S0100-72032004000300007
OBJECTIVE: to evaluate the effectiveness of the hygroscopic dilator in the colposcopic examination of the endocervical canal in patients with high-grade lesion in the cytopathology and unsatisfactory colposcopy. METHODS: prospective study, including 62 patients with unsatisfactory colposcopic examination and cytology compatible with high-grade intraepithelial lesion. The patients were submitted to dilation of the endocervical canal by means of a hygroscopic dilator. After dilation, the new colposcopic findings were recorded, and then conization was made through loop electrosurgical excision procedure. The incidence of neoplasic involvement of surgical margins was compared between patients with examinations modified toward satisfactory results and those that remained with unsatisfactory colposcopy. In order to compare the incidence of involved margins and the incidence of residual disease, two retrospective control-groups were used: the GinSat group (n = 35): patients with unsatisfactory colposcopy; GSat group (n = 38): patients with satisfactory colposcopy and endocervical atypy. RESULTS: 80.6% of the cases presented satisfactory colposcopic vision after dilation. 80.4% of those presented disease-free resection margins. The incidence of disease-free resection margins in patients with persistent unsatisfactory colposcopy after dilation was 36.3%. Affected surgical margins occurred in 28% of the group that had undergone dilation, 28.5% of the cases in GinSat group, and 31.5% in the Gsat group. Follow-up showed the incidence of residual disease in 7.5% of the patients under dilation, 28.5% in the GinSat group and 28.9% in the GSat group. CONCLUSION: the use of hygroscopic dilation improved visualization of lesions of difficult access to the colposcopic examination, thus permitting reduction in the percentage of residual neoplasic disease in patients with unsatisfactory colposcopy treated with loop electrosurgical excision procedure.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(6):339-345
DOI 10.1590/S0100-72032000000600004
Purpose: to quantify the vessels and epithelial proliferation, applying immunohistochemical staining with anti-CD34 as well as anti-PCNA markers, in intra-epithelial neoplasia of the uterine cervix. Methods: in the present study, 16 patients with CIN III, 16 with CIN II, 21 with CIN I and 11 with normal cervix (control group) were investigated. Slide analysis was performed at the same time by two observers, in 10 consecutive sites using 100X and 400X magnification, both in the highest vascularization (CD34) and proliferative activity sites (PCNA). Results: the means obtained with the use of anti-PCNA in intraepithelial neoplasias were: 78.2% (CIN III), 52.1% (CIN II), 33.3% (CIN I) and 4.6% (control group), while 199.1 vessels (CIN III), 162.0 vessels (CIN II), 111.7 vessels (CIN I) and 124.4 vessels (control group) were quantified using anti-CD34 as a vascular marker. Conclusion: the results showed that both markers, anti-PCNA and anti-CD34, are useful for investigating proliferative and angiogenic activity, respectively. However, anti-PCNA showed better and more accurate results than anti-CD34 in differentiating intraepithelial neoplasias.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(6):339-345
DOI 10.1590/S0100-72032000000600004
Purpose: to quantify the vessels and epithelial proliferation, applying immunohistochemical staining with anti-CD34 as well as anti-PCNA markers, in intra-epithelial neoplasia of the uterine cervix. Methods: in the present study, 16 patients with CIN III, 16 with CIN II, 21 with CIN I and 11 with normal cervix (control group) were investigated. Slide analysis was performed at the same time by two observers, in 10 consecutive sites using 100X and 400X magnification, both in the highest vascularization (CD34) and proliferative activity sites (PCNA). Results: the means obtained with the use of anti-PCNA in intraepithelial neoplasias were: 78.2% (CIN III), 52.1% (CIN II), 33.3% (CIN I) and 4.6% (control group), while 199.1 vessels (CIN III), 162.0 vessels (CIN II), 111.7 vessels (CIN I) and 124.4 vessels (control group) were quantified using anti-CD34 as a vascular marker. Conclusion: the results showed that both markers, anti-PCNA and anti-CD34, are useful for investigating proliferative and angiogenic activity, respectively. However, anti-PCNA showed better and more accurate results than anti-CD34 in differentiating intraepithelial neoplasias.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(1):47-51
DOI 10.1590/S0100-72032001000100007
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.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(1):47-51
DOI 10.1590/S0100-72032001000100007
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.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(5):313-319
DOI 10.1590/S0100-72032001000500007
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.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(5):313-319
DOI 10.1590/S0100-72032001000500007
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.
