Luis M. Puig-Tintore

• MD, PhD, Professor (Associate)
• Retired at University of Barcelona

Pap cytology is known to be more specific but less sensitive than testing for human papillomavirus (HPV) for the detection of high-grade cervical intraepithelial neoplasia (CIN2+). We assessed whether p16/Ki-67 dual-stained cytology, a biomarker combination indicative of transforming HPV infections, can provide high sensitivity for CIN2+ in screeni...

Objective. Oncogenic human papillomaviruses (HPVs) are essential causes of cervical cancer. Screening prevents cancer by detecting precancerous lesions (cervical intraepithelial neoplasia, CIN). Our aim was to assess the annual number of Pap smears and CIN diagnoses in Spain and to estimate associated management costs. Materials and Methods. A 1-ye...

A population-based survey (AFRODITA Study) was conducted in Spain in order to estimate the coverage and factors associated with cervical cancer cytological screening. The results of this survey indicate that the rate of screening for cervical cancer in Spain is 75.6% in women between 18 and 65 years. This high rate of opportunistic cervical cancer...

The aim was to determine the feasibility of surgical identification and pathological ultrastaging of sentinel nodes (SNs) in vulvar carcinoma and to evaluate whether SN negativity rules out the possibility of metastasis in other nodes and can therefore avoid conventional lymphadenectomy. In 26 patients with vulvar squamous cell carcinoma the SNs we...

To quantify the coverage and monitor the factors associated with opportunistic cervical cytological screening in Spain. Population-based survey of selected women through the Access Panel technique representative of the general population. A total of 6,852 women (60%) replied to the questionnaire; 981 (14.3%) were excluded from the analysis because...

This is the second Spanish edition of the "Atlas Digital de Enfermedades de la Vulva" published in the year 2005 on a CD. Considerably enhanced and updated, this edition is presented in a website (www.puig-tintore.com) and soon in a digital book. Here is a sample of the book and website Forty years ago a vulvar diseases clinic was established at th...

El objetivo de esta exposición es familiarizar al ginecólogo con las posibilidades que ofrecen las técnicas quirúrgicas actuales para realizar una cirugía con criterios conservadores que permitan mantener, en lo posible, los aspectos anatómicos y funcionales del órgano sin disminuir la eficacia curativa. En este contexto, la cirugía plástica y repa...

El objetivo de esta exposición es familiarizar al ginecólogo con las posibilidades que ofrecen las técnicas quirúrgicas actuales para realizar una cirugía de las neoplasias de vulva con criterios conservadores que permitan mantener, en lo posible, los aspectos anatómicos y funcionales del órgano sin disminuir la eficacia curativa. En este contexto,...

0 ARTÍCULOS ORIGINALES RESUMEN Objetivo: Determinar, en la neoplasia cervical intraepitelial (CIN), la correlación histológica de la información morfométrica obtenida mediante un sistema original de colposcopia digital, y establecer sus posibles aplicaciones clínicas. Métodos: En 101 pacientes con colposcopia valorable se midió el área de la zona...

Lesson on intraepithelial neoplasias of the vulva (VIN), vagina (VAIN) and anus (AIN). Course on Gynecologic Oncology for postgraduate of the Hospital Clinic, University of Barcelona,.

Postgraduate updated clinical review of the vulva, vagina and anus intraepithelial neoplasias.

Grupo de Consenso de la Sociedad Española de Ginecología y Obstetricia (SEGO), Sociedad Española de Citología (SEC) y Asociación Española de Patología Cervical y Colposcopia (AEPCC) sobre “La Infección por Papilomavirus 2002”. Coordinador: LM Puig-Tintoré. Tras la confirmación de la etiología vírica del cáncer de cuello, se han producido incesante...

2006 Consensus on Cervical Cancer Prevention Before Vaccination Against Human Papiloma Virus of the Spanish Societies: Sociedad Española de Ginecología y Obstetricia (SEGO), Asociación Española de Patología Cervical y Colposcopia (AEPCC), Sociedad Española de Citología (SEC), Sociedad Española de Anatomía Patológica (SEAP) (In Spanish). Contents: I...

Resumen del CD sobre Enfermedades de la Vulva editado en el año 2005. La obra consta de 14 capítulos. Los primeros tratan de la morfología normal y la exploración. En los capítulos siguientes se revisan 76 enfermedades, incluyendo: 1) Anomalías congénitas; 2) Seudotumores; 3) Trastornos de la pigmentación; 4) Traumatismos; 5) Vulvodinia; 6) Infecci...

Comments of the course director on the development of the training course. After the second round about 4,300 Spanish gynecologists took part in the activity. Half of them were presented to the assessment test and earned 11 credits.

INTRODUCCION (Edición 2005) Luis M. Puig-Tintoré Profesor Titular de Ginecología, Universidad de Barcelona Presidente de la AEPCC Las características anátomo-funcionales de la vulva condicionan una frecuente y variada patología. A pesar de que se solapen en ella patologías ginecológicas y dermatológicas, la atención prestada a este órgano tanto por...

El reconocimiento de que la infección persistente por ciertos tipos de VPH de alto riesgo oncogénico es el factor etiológico necesario para el desarrollo del cáncer cervical ha cambiado el paradigma de prevención de los cánceres del cuello uterino y tracto genital inferior. Por una parte disponemos de la vacunación frente al VPH y por otra conocemo...

BACKGROUND: Pap cytology is known to be more specific but less sensitive than testing for human papillomavirus (HPV) for the detection of high-grade cervical intraepithelial neoplasia (CIN2+). We assessed whether p16/Ki-67 dual-stained cytology, a biomarker combination indicative of transforming HPV infections, can provide high sensitivity for CIN2...

Background Pap cytology is known to be more specific but less sensitive than testing for human papillomavirus (HPV) for the detection of high-grade cervical intraepithelial neoplasia (CIN2+). We assessed whether p16/Ki-67 dual-stained cytology, a biomarker combination indicative of transforming HPV infections, can provide high sensitivity for CIN2+...

Vaccines against cervical cancer have been implemented in a wide number of countries around the world as part of systematic vaccination programmes. In addition, rescue vaccination has been recommended for teenagers and young women. From a Public Health perspective, routine vaccination in older women is not proposed for reasons of cost-effectiveness...

Conceptos generales sobre oncogénesis. Transformación celular por VPHs de alto riesgo oncogénico. Oncogenes virales. Mecanismo de evasión tumoral. Persistencia de la infección viral. Historia biológica de la infección por VPH y carcinogénesis

Objetivo. Los virus del papiloma humano (VPH) oncogenicos son causas principales del cancer de cervix. El cribado previene el cancer mediante la deteccion de lesiones precancerosas (neoplasia cervical intraepitelial, CIN). Nuestro objetivo consistio en evaluar el numero anual de citologias y diagnosticos de CIN en Espana y calcular los costes de tr...

Genital warts (GW) are common and increasing in young people. Ninety percent of GW are due to Human Papillomavirus (HPV) types 6 and 11. The objective of this study was to assess the epidemiology and management costs associated with GW in Spain. A 1-year (2005) retrospective observational study was performed among a sample of gynaecologists, dermat...

The recent development of two highly effective vaccines against persistent infection by the 2 most important types of human papillomavirus (HPV) (16 and 18) and against high grade premalignant lesions (CIN2+) has opened a new scenario for the primary prevention of cervical cancer. The optimum target population for vaccination should be individually...

Objetivo. Cuantificar la cobertura y monitorizar los factores asociados con el cribado citologico oportunista del cervix en Espana. Material y metodos. Estudio de base poblacional de mujeres seleccionadas mediante la tecnica de Access Panel representativas de la poblacion general. Contestaron el cuestionario un total de 6.852 mujeres (60%); 981 (14...

The AFRODITA study was designed to describe patterns relating to the number of lifetime sexual partners (SP) and age at first sexual intercourse (AFSI) by geographic region in a representative sample of Spanish women. A representative sample of the female Spanish population was obtained using the Access Panel Technique. Postal questionnaires were s...

This study was undertaken to evaluate the value of high-risk human papillomavirus (HPV) testing in the follow-up of cervical intraepithelial neoplasia grade 1/low-grade squamous intraepithelial lesion treated by loop electrosurgical excision procedure because of the risk criteria established by the American Society for Colposcopy and Cervical Patho...

Two types of vulvar squamous cell carcinomas (VSCCs) are recognized according to their relationship to human papillomavirus (HPV). Basaloid or warty carcinomas are considered HPV-associated tumors, whereas differentiated keratinizing neoplasms are considered non-HPV-associated. Recently, immunohistochemical detection of p16 and p53 has been propose...

To evaluate whether high-risk human papillomavirus (HR-HPV) detection and viral load prior to treatment and status of cone margins can predict residual/recurrent disease as well as the ability of current diagnostic tools to identify residual/recurrent disease during follow-up of high-grade cervical intraepithelial neoplasia (CIN) treated by conizat...

The aim of the study was to evaluate whether the results of the Hybrid Capture II (HCII) assay for detecting high-grade squamous intraepithelial lesions (H-SIL) or cervical carcinoma can be improved by increasing the relative light units (RLU) level. We included 2271 women (mean age 38.7 +/- 12.3, range 15-92) referred to a colposcopic clinic due t...

Two distinct types of vulvar squamous cell carcinomas and their precursors, vulvar intraepithelial neoplasias (VIN), which differ in terms of clinical presentation and behavior, have been delineated. Human papillomavirus (HPV)-associated carcinomas are of basaloid or warty type, whereas tumors unrelated to HPV are usually keratinizing and different...

5028 Background: Two distinct types of vulvar carcinomas have been delineated which differ in terms of clinical presentation and outcome. The first, usually of basaloid or warty type is frequently preceded by the undifferentiated form of vulvar intraepithelial neoplasia (VIN) and is human papillomavirus (HPV)-related. The second, generally keratini...

Lymphatic mapping and sentinel node biopsy represent one of the most revolutionary advances in oncological surgery in recent years. In this review, the current state of sentinel node detection in gynaecological cancers and its use in vulvar and cervical cancer are assessed. Since the recent clinical application of sentinel node biopsy for melanomas...

Background and objective High risk human papillomaviruses (HR-HPV) are consistently associated with premalignant and malignant lesions of the uterine cervix. Thus, the use of molecular techniques to detect HPV has been proposed to improve the results of conventional diagnostic strategies. In the present study, we evaluated the usefulness of the det...

High risk human papillomaviruses (HR-HPV) are consistently associated with premalignant and malignant lesions of the uterine cervix. Thus, the use of molecular techniques to detect HPV has been proposed to improve the results of conventional diagnostic strategies. In the present study, we evaluated the usefulness of the detection of HR-HPV in a cer...

Carcinoembryonic antigen (CEA) and squamous cell carcinoma(SCC) serum levels were prospectively determined in 159 untreated patients diagnosed with carcinoma of the uterine cervix from 1991 to 2001. The histological analysis showed epidermoid cancer in 117 patients, adenocarcinoma in 26 patients, adenosquamous carcinoma in 12 patients and other his...

En la vulva, la sospecha del médico y la práctica liberal de la pequeña biopsia permiten diagnosticar la VIN y el cáncer microinvasivo, y prevenir así el cáncer invasor

Background: Sarcomatous neoplasms of the uterine corpus are still a challenge in terms of obtaining prognostic factors and the most optimum complementary treatment to surgery. The most important prognostic factor is stage; relapses usually appear during the first 2 years, and most patients die within the first 3 years. We have performed a multivar...

Aim: To demonstrate that sentinel lymph node (SLN) in vulvar cancer patients is the first one that receives the metastatic cells from tumour and its negativity rule out metastatic involvement of the remaining nodes. Method: The day before surgery a lymphoscintigraphy was performed to 26 patients with squamous vulvar cancer by injecting a colloid la...

Objective To determine the histological correlation of morphometric information obtained through an original digital colposcopy system in cervical intraepithelial neoplasia (CIN) and to establish its possible clinical applications Methods The size of the transformation zone and of colposcopic lesions was measured in 101 patients with evaluable col...

Objective The aim of our study is to evaluate the usefulness of ultrasound, color and pulsed Doppler and serum CA125 in the prediction of malignancy in ovarian masses.Material And Methods Over a one year period, 126 women diagnosed of an adnexal mass underwent a complete ultrasound color and pulsed Doppler examination and a serum determination of C...

The 18th international papillomavirus conference took place in Barcelona, Spain in July 2000. The HPV clinical workshop was jointly organised with the annual meeting of the Spanish Association of Cervical Pathology and Colposcopy. The conference included 615 abstracts describing ongoing research in epidemiology, diagnosis/screening, treatment/progn...

Abstract Book XXIX ISOBM Meeting. p195.

En este trabajo se prescnta un sislema de base de dalos clinicos e imágenes colposcópicas, dcsarrollado en colaboración entre el Hospital Clinic de Barcelona y la lJniversitat Polilccnica de Catalunya, que pemtite el estudio objetivo de algunos factores relacionados con la progresión de las le­siones intraepitelialcs del cuello uterino a cancer inv...

Revista de Oncología, 1999; 1(supl.3):102.

Objectives: To know the efficacy of both lymphatic mapping with blue dye and preoperative and intraoperative lymphoscintigraphy in sentinel lymph node detection in patients with breast cancer. To assess the histological agreement between sentinel lymph node and complete axillary dissection. Patients and Methods: 45 breast cancer patients who underw...

Clinical usefulness of human papillomavirus (HPV) detection by molecular techniques is not well established. The aim of the study is to determine, by in situ hybridization, HPV DNA in patients with cervical intraepithelial neoplasia (CIN), assessing the prevalence rate, the association with epidemiologic factors and the correlation with classic dia...

Our aim was to compare cervical intraepithelial neoplasia (CIN) treatment results in the use of large-loop excision of the transformation zone (LLETZ), laser vaporization, and cold-knife cone biopsy. We included in the study patients with CIN lesions diagnosed at the Hospital Universitario Materno-Infantil Vall d'Hebron and Hospital Clinic i Provin...

Colposcopy should characterize with the highest accuracy possible the lesions findings, guide the biopsy so as to confirm the diagnosis contribute to the taking of therapeutic decisions and ease the follow-up of patients. Recent advances in the digital study of images using computers have allowed the development of digital colposcopy (DC). Compared...

This study analyzes the diagnostic agreement between cytology, colposcopy and colposcopically directed punch biopsy in patients with cervical squamous lesions. During 1994, 195 patients were evaluated and 138 included in the study. Conservative treatment was performed in 119 (86%) cases, mostly using diathermic loop procedure in 87 (63%) of them. D...

To assess the potential role of magnetic resonance imaging (MRI) in evaluating the response of cervical tumor to neoadjuvant chemotherapy. We studied 14 patients with locally advanced carcinoma of the cervix. MRI was performed before and after each cycle. All patients underwent laparotomy four weeks after the last cycle. MR images after chemotherap...

A group of two hundred and sixty women, most of them young, with histologic diagnosis of CIN located at the exocervix, has been treated by means of CO2 laser vaporization. The entire transformation zone and a minimum of 10 mm at the base of cervical canal was vaporized to a depth of 6-7 mm. Of the treated group, 239 patients (114 CIN I, 78 SIN II a...

The significance of the gland openings with a white ring, in the colposcopic transformation zone, is reviewed and its importance discussed. This picture was present in 9.8% of colposcopic examinations on 914 patients selected on cytological and/or clinical basis. In these 90 patients cytology suggested mild dysplasia in 22.4% and severe dysplasia,...

Introducción El concepto y la terminología de las alteraciones premalignas del epitelio cervical, han evolucionado paralelamente al avance del conocimiento de su biología e historia natural. Actualmente está bien aceptada la etiología del cáncer de cuello uterino a partir de la infección del epitelio por tipos específicos de papilomavirus humano (H...