[Colposcopy and cervical biopsy in patients with routine Papanicolaou smear].
Clínica de Colposcopía Privada, Durango, Dgo.Ginecología y obstetricia de México 06/1997; 65:235-8.
The objective of this report was to assess the sensitivity and specificity of Pap smear and to evaluate if routine colposcopy can improve cervical screening. One hundred and fifty patients undergoing routine cervical cytologic screening in our outpatient clinic were randomly selected. All patients were evaluated by colposcopy and cervical punch biopsy. Pap smears and biopsies specimens were interpreted independently. Colposcopy was performed and interpreted without knowledge of cytologic or histologic findings. The statistical analysis was carried out with a chi square (chi 2) test. A P value of less than 0.05 was considered significant. Twenty three patients (15.3%) who had biopsy proved to have cervical pathology. Pap smear identified only 4/23 (17%) of these patients. Colposcopy noted atypical transformation zones in 20/23 (97%), P < 0.001). Fifteen of 27 patients (55.5%) with negative Pap smears had colposcopic anormalities and histologically proved cervical intraepithelial neoplasia (CIN). We concluded that it is necessary to improve sensitivity and that colposcopy may enhance cervical screening particularly in women with otherwise negative Papapnicolaou smears.
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ABSTRACT: Colposcopy has been adapted from cervical cytology screening as a tool to assess the tolerance of vaginal products in development for anti-infective and contraceptive indications. As the vagina is poorly enervated, symptoms do not correlate well with visual findings, which increases the importance of secondary assessment. Dysplasia screening has used biopsy liberally to verify the colposcopic diagnostic impression. The few studies that include correlative biopsy with colposcopy performed for product development are reviewed. A recent study of the reproducibility of two observations at a single visit by a single or two different physicians is discussed. The review points to magnification and experience of the observer as factors in improving the agreement between observations. Observers are more likely to agree on areas greater than 1 cm in diameter. Variation is reduced when fewer observers are used and they report findings as dichotomous or categorical data.
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ABSTRACT: Objective: To describe the characteristics of the anal and perianal human papillomavirus infection associated with genital infection by the same virus. Methods: We selected 65 patients, with genital infection by human papillomavirus, who was made them cytology, polymerase chain reaction and colposcopy in genital region, anus and periano. Setting: Servicio de Ginecologia de la Maternidad "Concepción Palacios" Results: The frequency of detection of papillomavirus in anus and periano was 31.3 %. There was consistency between the genital papillomavirus infection and the anus and region parianal in 19.67 % (P > 0,397) and between viral genotypes in 33.74 % (P = 0,0053), this correlation was increased to virus 6. They were 38 evaluable Papanicolaou test anal and perianal (59.4 %) and none diagnosed abnormalities. Among these, 15 were polymerase chain reaction positive for papillomavirus, 21 negative and 2 unsatisfactory. The most common lesions were subclinical. The distribution of the anoscopia result refects normal is most often (67.2 %). Conclusions: The risk of HPV infection in anus and periano is increased in patients with genital infection. We believe it is important to extend the gynecologic evaluation to the anal and perianal region despite the limitations of the use of Papanicolaou test and the colposcopy.
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