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  • Original Article

    When is There no Benefit in Performing a Biopsy in the Suspicion of Intraepithelial Lesions of the Cervix?

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(3):272-279

    Summary

    Original Article

    When is There no Benefit in Performing a Biopsy in the Suspicion of Intraepithelial Lesions of the Cervix?

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(3):272-279

    DOI 10.1055/s-0042-1744212

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    Abstract

    Objective

    To evaluate whether colposcopy-directed biopsy is necessary to increase the accuracy of diagnosing cervical intraepithelial lesions in relation to colposcopy.

    Methods

    We performed a retrospective, observational study by analyzing medical records obtained fromHospital de Clínicas do Paraná fromFebruary 2008 to February 2018. Patients with results of Pap tests, colposcopy, colposcopy-directed biopsy, and surgical procedures (high-frequency surgery or cold conization) were included. Data such as quadrants involved during colposcopy and age differences were also analyzed.

    Results

    A total of 299 women were included. Colposcopy was found to have an accuracy rate of 76.25% (95% confidence interval [CI], 71.4-81.1). Among the highest-grade lesions, the accuracy rate was 80.5% (95% CI, 75.7-85.3). The accuracy rates for biopsy were 79.6% (95% CI, 75-84.2) and 84.6% (95% CI, 80-89.1) for the highest-grade lesions. High-grade lesions were accurately confirmed in 76.9% and 85% of patients with 1 and 2 or more affected quadrants, respectively. For women younger than 40 years, the accuracy rates were 77.6% and 80.8% for colposcopy and biopsy, respectively. For women 40 years or older, the accuracy rates were 72.5% and 76.3% for colposcopy and biopsy, respectively.

    Conclusion

    There is no difference between the accuracy of colposcopy and that of biopsy in diagnosing cervical intraepithelial lesions in relation with the result of conization. The patients who received the greatest benefit when biopsy was not performed were those with high-grade lesions at colposcopy, a lesion involving 2 or more quadrants, and those younger than 40 years.

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  • Original Article

    Colposcopic Findings and Diagnosis in Low-Income Brazilian Women with ASC-H pap Smear Results

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(2):178-186

    Summary

    Original Article

    Colposcopic Findings and Diagnosis in Low-Income Brazilian Women with ASC-H pap Smear Results

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(2):178-186

    DOI 10.1055/s-0042-1742289

    Views10

    Abstract

    Objective

    To determine the accuracy of colposcopy findings in diagnosing cervical intraepithelial neoplasia (CIN) in women with an atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion (ASC-H) pap smear result and analyze whether the prevalence of HSIL and cancer correlates with sociodemographic risk factors and specific colposcopic findings.

    Methods

    Colposcopic findings and sociodemographic risk factors were analyzed as possible predictors of a CIN 2 or worse diagnosis in women with an ASC-H pap smear result.

    Results

    Accuracy of the colposcopic impression was 92%, sensitivity was 91.6%, and specificity was 93.1%, with a positive predictive value of 96.4% and negative predictive value of 84.3%. Diagnosis of CIN 2 or worse was more frequent in patients with a previous history of cervical dysplasia and pre-menopausal patients. Identification of major colposcopic findings, dense acetowhite epithelium, coarse mosaicism, and punctuation correlated significantly with CIN 2 or worse.

    Conclusion

    Colposcopy performed by an experienced examiner can accurately differentiate patients with CIN 1 or less from patients with CIN 2 or worse. Diagnosis of CIN 2 or worse was more frequent in patients with a previous history of cervical dysplasia and pre-menopausal patients. The degree of acetowhite changes was the best colposcopic feature to predict CIN2 or worse.

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    Colposcopic Findings and Diagnosis in Low-Income Brazilian Women with ASC-H pap Smear Results
  • Artigos Originais

    Effects of tibolone on the breast parenchyma: experimental study

    Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(5):233-240

    Summary

    Artigos Originais

    Effects of tibolone on the breast parenchyma: experimental study

    Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(5):233-240

    DOI 10.1590/SO100-720320150005333

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    OBJECTIVE:

    To assess the effect of tibolone on mammary tissue of castrated rats over 3
    different periods of time.

    METHODS:

    Sixty virgin female Wistar rats were submitted to oophorectomy. Twenty-one days
    after surgery, with hypoestrogenism confirmed, the experimental rats were randomly
    assigned to six groups: Tibolone 1 (n=10) received tibolone 1 mg/day for 23 days,
    tibolone 2 (n=10) for 59 days and tibolone 3 (n=10) for 118 days. The groups
    control 1 (n=8), control 2 (n=7) and control 2 (n=10) received distilled water for
    23, 59 and 118 days, respectively. After treatment, all six pairs of mammary
    glands were removed and stained with hematoxylin and eosin (HE) for histological
    analysis after euthanasia. The histological parameters evaluated were: epithelial
    cell proliferation and secretory activity. The variables were analyzed
    statistically, with the level of significance set at 0.05.

    RESULTS:

    Histological changes were observed in 20/55 rats, mild epithelial hyperplasia in
    7/55, moderate epithelial hyperplasia in 5/55, alveolar-nodular hyperplasia in
    7/55, atypia without epithelial proliferation in 1/55, and no cases of severe
    epithelial hyperplasia were found. Secretory activity was observed in 31/55 rats.
    The secretory activity was significantly higher in the tibolone groups compared to
    control at all the time points assessed (p=0,001). The histological changes were
    did not show significance when the control and tibolone groups were compared. The
    time of exposure to tibolone did not show significance when the three different
    periods of evaluation were compared.

    CONCLUSION:

    No relation between histological modification and tibolone treatment was verified
    after short-, medium- and long-term treatment.

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    Effects of tibolone on the breast parenchyma: experimental study
  • Artigos Originais

    Effect of trimegestone on mammary gland of castrated rats

    Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(7):137-142

    Summary

    Artigos Originais

    Effect of trimegestone on mammary gland of castrated rats

    Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(7):137-142

    DOI 10.1590/S0100-72032011000700004

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    PURPOSE: To evaluate the efect of trimegestone on the histological changes of the mammary tissue of castrated rats. METHODS: Forty-five virgin female Wistar rats were used after oophorectomy. Sixty days after surgery, with hypoestrogenisms confirmed, the experimental rats were randomly assigned to three groups of 15 animals each, when then the specific treatment for each group was started. The control group (C) and experimental groups 1 and 2 respectively received 0.9% saline solution, 17-beta-estradiol and 17-beta-estradiol in combination with trimegestone for 60 consecutive days. After the end of treatment , the inguinal mammary glands were removed, stained with hematoxylin and eosin (HE) for morphometry and examined by immunohistochemistry for the quantification of anti-PCNA antibody in the mammary tissue, followed by euthanasia. The morphometric parameters evaluated were: epithelium cell-proliferation, secretor activity and mammary stroma changes. There were nine deaths during the experiment. The variables were submitted to statistical analysis adopting the 0.05 level of significance. RESULTS:Histological changes were observed in 16/36 rats, mild epithelial hyperplasia in 13/36, moderate epithelial hyperplasia in 3/36, with no cases of severe epithelial hyperplasia. Stromal fibrosis was found in 10/36 and secretory activity in 5/36 rats. All morphometric variables were significant in the estrogen group compared to control (p=0.0361), although there were no difference between the group receiving combined treatment and the controls (p=0.405). The immunohistochemical analysis showed no difference between groups. CONCLUSIONS:The hormones administered to castrated rats, i.e., 17 beta-estradiol alone or in combination with trimegestone, increased the proliferation of breast cells, but this effect appeared to be lower in the combined treatment, the same occurring regarding fibrosis of the mammary stroma.

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    Effect of trimegestone on mammary gland of castrated rats
  • Editorial

    The ObGyn, the pathologist and the pap smear test

    Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(8):383-386

    Summary

    Editorial

    The ObGyn, the pathologist and the pap smear test

    Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(8):383-386

    DOI 10.1590/S0100-72032007000800001

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