BackgroundHuman Papillomavirus (HPV) high-risk (HR) types are the causal factor for cervical cancer and premalignant dysplasia. Data on frequency of HPV types provide a basis to design and evaluate HPV prevention programs. Taking into account the heterogeneity of HPV types across and within populations this study aims to access the HPV frequency in Brazilian women.ResultsWe identified 24 different types of HPV, including a Betapapillomavirus and a likely new type, previously reported, from 132 women positive for the virus analysed by Hybrid Capture II assay. These women were infected by a single or multiple HPV types and 142 HPV strains were identified. HR types were found in 75% of women and HPV types 16, 18, 45, 58, and 66 had the highest frequency. Significant differences in frequency of HR HPV types were found for presence of cervical lesions, and for different HPV species and women age.ConclusionsCompared with previous studies in Brazil, our data indicated differences in frequency and HPV type diversity, a significant association of other HR-types but HPV16 and 18 and cervical lesions, and a trend for distinct distribution of HPV types by age.

Prevalence of cervical intraepithelial neoplasia grades II/III and cervical cancer in patients with cytological diagnosis of atypical squamous cells when high-grade intraepithelial lesions (ASC-H) cannot be ruled out Prevalência de neoplasia intra-epitelial cervical graus II/III e câncer cervical nas pacientes com diagnóstico citológico de células escamosas atípicas, quando não se pode excluir lesão intra-epitelial de alto grau (ASC-H)Andréa RESULTS:The prevalence of CIN II/III in cases with ASC-H cytology was 19.29% (95% confidence interval, CI, 9.05-29.55%) and the risk of these lesions was greater among patients with ASC-H than with ASC-US cytology (prevalence ratio, PR, 10.42; 95% CI, 2.39-45.47; P = 0.0000764). Pre-invasive lesions were more frequently found in patients under 50 years of age with ASC-H cytology (PR, 2.67; 95% CI, 0.38-18.83); P = 0.2786998). There were no uterine cervical cancer cases. CONCLUSION:The prevalence of CIN II/III in patients with ASC-H cytology was significantly higher than with ASC-US, and division into ASC diagnostic subcategories had good capacity for discriminating the presence of pre-invasive lesions. RESUMO CONTEXTO E OBJETIVO:A última atualização do Sistema Bethesda dividiu a categoria de células escamosas atípicas de significado indeterminado (ASCUS) em ASC-US (de significado indeterminado) e ASC-H (quando não se pode excluir lesão intra-epitelial de alto grau). Os objetivos deste estudo foram medir a prevalência da lesão pré-invasiva (Neoplasia Intra-epitelial Cervical, NIC II/III) e câncer cervical, de pacientes que foram encaminhadas ao Instituto Fernandes Figueira (IFF), com citologia ASC-H e compará-la com os casos ASC-US. RESULTADOS: A prevalência de NIC II/III na citologia ASC-H foi de 19,29% (intervalo de confiança, IC 95% 9,05-29,55%) e o risco destas lesões foi maior entre as pacientes com citologia ASC-H comparado às pacientes com citologia ASC-US (razão de prevalência, RP = 10,42; IC 95% 2,39-45,47; P = 0,0000764). A lesão pré-invasiva na citologia ASC-H foi mais frequente abaixo dos 50 anos (RP = 2,67; IC 95% 0,38-18,83), P = 0,2786998. Não houve casos de câncer do colo do útero. TIPO DE ESTUDO E LOCAL:CONCLUSÕES: A prevalência de NIC II/III em pacientes com citologia ASC-H foi significativamente mais alta que a de ASC-US, e a divisão em subcategorias do diagnóstico ASC se mostrou com boa capacidade para discriminar a presença de lesões pré invasivas.

To compare the performance of human papillomavirus DNA tests (samples collected by a healthcare professional and self-collected) and liquid-based cytology with conventional cytology in the detection of cervix uteri cancer and its precursor lesions. A cross-sectional study was carried out in 1777 women living in poor communities in Rio de Janeiro State, Brazil. Eligibility criteria included ages 25-59 years and not having had a Papanicolau test within at least 3 years prior to the study. Cytology (conventional or liquid-based) and human papillomavirus DNA (collected by a healthcare professional or self-collected) tests were performed using samples collected in a single visit. Women with abnormalities in at least one test and a systematic sample of 70 women with negative test results were referred to a colposcopic examination. Test readings were double-masked, and the outcome of interest was high-grade squamous intraepithelial lesion or worse. The pathology report was used as the gold standard. The prevalence of high-grade squamous intraepithelial lesion or worse was 2.0%. Human papillomavirus DNA test collected by a health professional alone or combined with conventional cytology had the highest sensitivity (91.4 and 97.1%, respectively). The highest specificity was found for conventional cytology (91.6%) and for a human papillomavirus DNA test collected by a healthcare professional (90.2%). On the basis of only test performance, the use of human papillomavirus DNA tests, alone or combined with cytology, would seem to be recommended. Its population-wide implementation, however, is conditional on a cost-effectiveness analysis.

www.datasus.gov.br) para o mesmo ano foram analisadas. RESULTADOS: Dos 1.028 laboratórios que informaram os resultados dos exames citopatológicos cervicovaginais ao DATASUS, em 2002, 739 responderam à enquete (71,9%). Desses, 18,9% processaram 15 mil exames ou mais no ano; 70,2% eram privados; 50,2% encontravam-se vinculados à gestão municipal; e 48,7% realizavam exames histopatológicos. Em 74,8% dos casos o responsável técnico pelo laboratório era médico. Dos 10.505.773 exames incluídos no SISCOLO em 2002, uma parcela das amostras (1,66%) foi considerada insatisfatória. As alterações detectadas foram: células escamosas atípicas de significado indeterminado (ASCUS), 1,26%; papilomavírus humano (HPV), 0,93%; neoplasia intra-epitelial cervical I (NIC I), 0,84%; NIC II, 0,20%; NIC III, 0,17%; carcinoma escamoso invasivo, 0,05%; células glandulares atípicas de significado indeterminado (AGUS), 0,14%; adenocarcinoma in situ, 0,01; e adenocarcinoma invasivo, 0,01%. CONCLUSÃO: Este estudo permitiu avaliar o perfil dos laboratórios de citopatologia que prestaram serviço ao SUS em 2002, e o SISCOLO se mostrou um excelente instrumento para o monitoramento da qualidade dos exames citopatológicos realizados no país.]]>

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