RESUMEN
Cervical cancer (CC) is the most common in Mexican female population. The human papillomavirus (HPV) 16 and 18 frequencies in worldwide may be different due to geographical distribution. We analyzed the prevalence of HPV types and determinated their association in cervical lesion in a Mexican population. One hundred fifty-nine normal cervical smears, 95 low-grade squamous intraepithelial lesions (LGSIL), 59 high-grade squamous intraepithelial lesions (HGSIL), and 108 CC samples of the patients were collected. HPV types were determined by sequencing. We detected 11 high-risk types, four low-risk types, three not determinated, and two probably high risk. HPV were present in 12%, 57%, 88%, and 92% from normal, LGSIL, HGSIL, and CC samples, respectively. HPV 16 was the most common in all cervical lesions (71.6% in CC). HPV 58 was present in 18.6% of HGSIL, and the HPV 18 in 4.6% of CC. The 76% of all detected viruses belong to A9 species branch. Control women showed high percentage of HPV high-risk infection, suggesting that this is a high-risk group. High frequency of HPV 16 compared with a low incidence of HPV 18 was observed. HPV 58 is frequently detected in HGSIL but low frequency is found in CC. These findings might be considered for HPV screening.
Asunto(s)
Carcinoma de Células Escamosas/virología , Papillomaviridae/genética , Enfermedades del Cuello del Útero/virología , Displasia del Cuello del Útero/virología , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma de Células Escamosas/epidemiología , Estudios de Casos y Controles , ADN Viral/análisis , Femenino , Frecuencia de los Genes , Humanos , Tamizaje Masivo/métodos , México/epidemiología , Persona de Mediana Edad , Papillomaviridae/aislamiento & purificación , Filogenia , Prevalencia , Factores de Riesgo , Neoplasias del Cuello Uterino/epidemiología , Neoplasias del Cuello Uterino/virología , Displasia del Cuello del Útero/epidemiologíaRESUMEN
Human papillomavirus (HPV) is the etiologic agent for cervical cancer. In Mexico, a women dies every 2 h, and since 1990 the statistics have shown that the numbers of deaths are increasing. We conducted a phase II clinical trial to evaluate the potential use of the MVA E2 recombinant vaccinia virus in treating high-grade lesions (CIN 2 and CIN 3) associated with oncogenic papillomavirus. Fifty-four female patients with high degree lesions were treated either with an MVA E2 therapeutic vaccine or with conization. Thirty-four women received the therapeutic vaccine, at a total of 10(7) virus particles per dose injected directly into the uterus once every week over a 6-week period. Twenty control patients were treated with conization. By colposcopy, 19 patients out of 34 showed no lesion, in three patients the lesions were reduced by 85-90%, in eight other lesions had reduced by 60%, and in four more patients, they were reduced by 25%. Histological analysis showed total elimination of high-grade lesions in 20 out of 34 patients after treatment with MVA E2. Eleven patients had a 50% reduction in lesion size. In two other patients, the lesion was reduced to CIN 2 and in one more patient the lesion was reduced to low grade (CIN 1). All patients developed antibodies against the MVA E2 vaccine, and generated a specific cytotoxic response against papilloma-transformed cells. DNA viral load was significantly reduced in MVA E2-treated patients. Conization eliminated the lesions in 80% of the patients, but patients did not develop cytotoxic activity specific against cancer cells and did not eliminate the papillomavirus. In addition, three patients treated with conization had recurrence of lesions 1 year later. These results show that therapeutic vaccination with MVA E2 proved to be very effective in stimulating the immune system against papillomavirus, and in generating regression of high-grade lesion.
Asunto(s)
Displasia del Cuello del Útero/terapia , Neoplasias del Cuello Uterino/prevención & control , Vacunas de ADN/uso terapéutico , Virus Vaccinia/inmunología , Adulto , Vacunas contra el Cáncer/uso terapéutico , Colposcopía , Demografía , Femenino , Humanos , Persona de Mediana Edad , Papillomaviridae/inmunología , Infecciones por Papillomavirus/sangre , Infecciones por Papillomavirus/inmunología , Vacunas contra Papillomavirus , Selección de Paciente , Resultado del Tratamiento , Carga Viral , Displasia del Cuello del Útero/patología , Displasia del Cuello del Útero/virologíaRESUMEN
OBJECTIVE: To evaluate the effectiveness and safety of interferon beta in women with recurrent cervical human papillomavirus (HPV) lesions. METHODS: Women with recurrent HPV of the cervix were assigned randomly to received either 3 million IU of interferon beta daily for 5 days, followed by 2 days of rest for 3 weeks, or placebo on the same schedule (N = 61 in each group). They were evaluated at 6 and 12 months after cytology, colposcopy, and directed punch biopsy. Comparison between groups was carried out by chi(2), Fisher exact test, and Student t test, depending on the variable. Multivariable logistic regression was used to evaluate influence of variables to treatment and categorical and continuous variables were compared by Mantel-Haenszel and Wilcoxon tests. RESULTS: When treatment success rates for all patients at 6 and 12 months were compared, a highly significant statistical difference was found in the treated group compared with the placebo group [48 of 61 (79%) versus 33 of 61 (54%), P =.001, and 43 of 61 (70%) versus 26 of 61 (43%), P =.002, respectively]. Multivariable analysis showed treatment success rates with interferon beta were higher between the group with initial histopathology of cervical intraepithelial neoplasia (CIN) (odds ratio 4.86; 95% confidence interval 1.75, 13.49), and the group receiving placebo (P =.002). Side effects treatments were minimal in 70% of women; the most severe events were headaches and flulike symptoms that did not interfere with the treatment. No clinically significant changes were found in laboratory measurements of glucose or transaminases during treatment or follow-up. CONCLUSIONS: Intramuscular injections of interferon beta were effective for treating recurrent HPV lesions, particularly when associated with CIN. The only side effects were mild and controllable.
Asunto(s)
Antineoplásicos/uso terapéutico , Interferón beta/uso terapéutico , Papillomaviridae , Infecciones por Papillomavirus/prevención & control , Infecciones Tumorales por Virus/prevención & control , Displasia del Cuello del Útero/prevención & control , Neoplasias del Cuello Uterino/prevención & control , Adulto , Antineoplásicos/administración & dosificación , Femenino , Humanos , Inyecciones Intramusculares , Interferón beta/administración & dosificación , Modelos Logísticos , Prevención Secundaria , Resultado del TratamientoRESUMEN
UNLABELLED: The objective of this study was to know the prognostic value of estrogen receptors and progesterone receptors positives (ER+, PR+) in the management of low grade squamous intraepithelial lesions [(LGSIL), human papillomavirus (HPV) and cervical intraepithelial neoplasia grade 1 (CIN 1) and menopausal status]. MATERIAL AND METHODS: From January 1995 to January of 1999, was studied in 144 women with abnormal citology to HPV and CIN grades 1, 2 or 3. Colposcopy was carried out and two biopsies were taken from the suspicious lesion, they were sent for histopathological study, and for ER/PR by the dextran-coated charcoal technique. In addition to the receptor status information, histological type of squamous intraepithelial lesions (SIL), and menopausal status were recorded and analyzed and were correlated later. RESULTS: In normal cervix, 89% and 60% of specimens were ER+, PR+ (+6 fmol/mg protein) There was significant difference in ER status between the normal cervix con HPV and CIN, (P < 0.003), but no with PR (P > 0.53). ER levels in premenopausal and postmenopausal patients there was no significant difference (P > 0.27) but PR levels there was significant difference (P < 0.04). ER/PR levels in HPV o CIN grade no correlated to the histologic grade and menopausal status (P > 0.35, > 0.97, respectively). CONCLUSION: The women with levels ER+ were significant higher in the normal cervix than SIL, ER+, PR+ levels no correlated to the prognostic value in the management of LGSIL and menopausal status.
Asunto(s)
Receptores de Estrógenos/análisis , Receptores de Progesterona/análisis , Displasia del Cuello del Útero/química , Neoplasias del Cuello Uterino/química , Adolescente , Adulto , Anciano , Femenino , Humanos , Menopausia , Persona de Mediana Edad , Estadificación de Neoplasias , Papillomaviridae , Infecciones por Papillomavirus/complicaciones , Pronóstico , Infecciones Tumorales por Virus/complicaciones , Neoplasias del Cuello Uterino/patología , Neoplasias del Cuello Uterino/virología , Displasia del Cuello del Útero/patología , Displasia del Cuello del Útero/virologíaAsunto(s)
Bromocriptina/administración & dosificación , Agonistas de Dopamina/administración & dosificación , Hiperprolactinemia/tratamiento farmacológico , Administración Intravaginal , Femenino , Hormona Folículo Estimulante/sangre , Humanos , Hormona Luteinizante/sangre , Prolactina/sangre , Resultado del TratamientoRESUMEN
The objective of this study was to know if there is a correlation in contents progesterone receptors (RPg) in biopsies from patients pre and postmenopausal, with normal cervix, Low-Grade squamous intraepithelial lesions (LGESIL) and High-Grade (HGSIL), and invasive cancer. Sixty three patients with abnormal cytology; colposcopy was carried out and two biopsies were taken from the suspicious lesion, they were sent for histopathological study, and for RPg; both studies were correlated later. Both pre and postmenopausal with LGSIL, the RPg the mean values were 16.81 fmol/mg, protein, and values negative, respectively. With regard to HGSIL, the RPg content, the mean values was 20.31 fmol/mg, protein in pre-menopausal patients, whereas it was 3.8 fmol/mg, protein in postmenopausal patients. It was seen that RPg concentration is higher in invasive cancer than to LGSIL and HGSIL patients in pre and postmenopausal. It is concluded that this study on quantification to RPg receptor level measurement may well be to select poor prognostic groups of patients for inclusion in the management of squamous intraepithelial lesions and invasive cancer.
Asunto(s)
Carcinoma de Células Escamosas/diagnóstico , Receptores de Progesterona/análisis , Displasia del Cuello del Útero/patología , Neoplasias del Cuello Uterino/patología , Adulto , Anciano , Biopsia , Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas/cirugía , Cuello del Útero/química , Diagnóstico Diferencial , Femenino , Humanos , Persona de Mediana Edad , Posmenopausia , Premenopausia , Pronóstico , Resultado del Tratamiento , Neoplasias del Cuello Uterino/cirugía , Displasia del Cuello del Útero/cirugíaRESUMEN
Bethesda system is useful in the citologic diagnosis of premalign diseases of cervix. It was determined the correlation between citologic report using Bethesda system and combined colposcopic index (CCI) or Reid, to diagnose premalign diseases of cervix by histologic diagnostic of punch biopsy by colposcopy. A total of 118 patients come to the colposcopy clinic having smear anormal citology to cervical intraepithelial neoplasia (CIN), only o associated to HPV. It was taken to all of them a new cervical smear, colposcopy and punch biopsy. We analized the findings for citology with Bethesda system and colpospic with CCI of Reid, using histologic diagnosis of punch biopsy by colposcopy. Diagnosis correlation between Bethesda system and the punch biopsy by colposcopy was 98.5% for 82 patients with low grade squamous intraepithelial lesions with a concordance of 100% for HPV and 97% for CNI I (p < 0.05). In the other hand 92% from 36 patients classified as high grade squamous intraepithelial lesions with a concordance of 84% to CIN II and 100% to CIN III (p < .05) Sensibility of 93%, especifidad and positive predictive value of 96% and negative predictive value of 98%. We conclude correlation between citologic report with Bethesda system and the Combined Colposcopic Index of Reid which are effective to diagnose premalign disease of cervix.
Asunto(s)
Biopsia/métodos , Enfermedades del Cuello del Útero/diagnóstico , Neoplasias del Cuello Uterino/diagnóstico , Biopsia/instrumentación , Cuello del Útero/patología , Colposcopía , Diagnóstico Diferencial , Femenino , Humanos , Enfermedades del Cuello del Útero/patología , Neoplasias del Cuello Uterino/patologíaRESUMEN
OBJECTIVE: Our purpose was to determine the effectiveness of 5-fluorouracil (5-FU) in the treatment of vaginal intraepithelial neoplasia (VaIN) in a Mexican population. MATERIALS AND METHODS: The study was performed in 30 patients with a mean age of 54 years and previous diagnoses from reviewed records and histopathology slides selected from a group of 65 patients with VaIN from 1980 to 1997. Patients received intravaginal treatment with 5-FU, 1.5 g once weekly for 10 weeks, and all patients were followed up for a 1-year minimum. Papanicolaou smear and colposcopy were performed, as was biopsy when indicated. RESULTS: Twenty-eight (93%) patients with VaIN had prior or concurrent anogenital squamous neoplasia, including 5 with invasive cervical carcinoma and 23 with cervical intraepithelial neoplasia. In 23 of 30 treated patients (77%), VaIN went into remission after a single treatment; in 3, (10%), it went into remission after two treatments; 3 (10%) had recurrent VaIN 3; and in 1 (3%), it progressed to invasive vaginal cancer. The treatment was well tolerated. CONCLUSIONS: We conclude that 5-FU is an option choice for VaIN treatment. It is effective, with minimal side effects. Its use should be confined to treating extensive or multifocal high-grade VaIN.
RESUMEN
The objective of this study was to know if there is a correlation in contents o (R + E) in biopsies from patients pre and post-menopausal, in normal cervix with cervical intraepithelial neoplasia (NIC) and invasive cancer. Thirty four patients with abnormal cytology; colposcopy was carried out, and two biopsies were taken from the suspicious lesion, they were sent for histopathological study, and for estrogenic receptors; both studies were correlated later. It was seen that (R +/- E) concentration is higher in intraepithelial lesions of low and high degree than in control patients; and it was not so in premenopausal with invasive cancer where (R +/- E) are much lower, as to postmenopausal (R + E) concentration is higher specially in invasive cancer. It is concluded that the study on quantification to (R + E) in cervical pathology means a good alternative in hormonal treatment, as it has been seen in mammary pathology, and so, more research has to be done.
Asunto(s)
Carcinoma in Situ/química , Cuello del Útero/química , Receptores de Estrógenos/análisis , Neoplasias del Cuello Uterino/química , Adulto , Anciano , Femenino , Humanos , Persona de Mediana Edad , Posmenopausia , PremenopausiaRESUMEN
Human papilloma virus (HPV) has a predisposing association as cofactor in etiopathology of cervicouterine cancer; it is known also that viral infection is not enough, and there are other agents, as Chlamydia trachomatis. The objective of this study was to investigate the association of these cofactors as predisposal for intraepithelial cervical neoplasia (NIC). Prospectively, at Clinica de Colposcopia, Hospital de Ginecología y Obstetricia "Luis Castelazo Ayala", IMSS, 37 patients with cytologic, colposcopic and histological diagnosis of CIN pure or associated to HPV, underwent endocervical cytologies, and by immunofluorescence method, using monoclonal antibodies of conjugated fluoresceine, it was tried to demonstrate Chlamydia trachomatis, presence. From all patients, 12(32,4) were positive for Chlamydia trachomatis, significant percentually, and with Xi square of 0.32, non significant for this group of population. It is concluded that there is an important association of Chlamydia trachomatis and HPV, which should be taken into consideration in diagnosis and treatment of intraepithelial cervical neoplasia.
Asunto(s)
Infecciones por Chlamydia/microbiología , Chlamydia trachomatis , Papillomaviridae , Infecciones Tumorales por Virus/virología , Displasia del Cuello del Útero/microbiología , Adolescente , Adulto , Anciano , Infecciones por Chlamydia/complicaciones , Infecciones por Chlamydia/patología , Femenino , Humanos , Persona de Mediana Edad , Infecciones Tumorales por Virus/complicaciones , Infecciones Tumorales por Virus/patología , Frotis Vaginal , Displasia del Cuello del Útero/patología , Displasia del Cuello del Útero/virologíaRESUMEN
The purpose of this study was to compare the results of conservative management with cryosurgery and with hysterectomy in different stages of NIC. The records of 235 treated patients from 1984 to 1991, were reviewed; 140 patients were treated with cryosurgery and 95 with total hysterectomy. Cure rate was for stage I in 34 patients (94.5); for stage II in 54 patients (98.2%), and for stage III in 46 patients (93.9%). For hysterectomy in NIC I in 5 patients (100%); for NIC II in 15 (100%), and for NIC III in 74 (98.66%). Statistical study with square Chi showed a not significant P which means that there is no difference in the results of Cure and No Cure in both procedures. It is concluded that intraepithelial cervical neoplasia may be managed with both procedures, provided that the established criteria for cryosurgery and hysterectomy, are followed.
Asunto(s)
Displasia del Cuello del Útero/cirugía , Neoplasias del Cuello Uterino/cirugía , Adulto , Criocirugía , Femenino , Humanos , Histerectomía , Persona de Mediana Edad , Estadificación de Neoplasias , Neoplasias del Cuello Uterino/patología , Displasia del Cuello del Útero/patologíaRESUMEN
At the Colposcopy Clinic, Hospital "Luis Castelazo Ayala", from January 1990 to May, 1991, 24 cases of vaginal intraepithelial neoplasia, were diagnosed. The average age of the patients was 54.2 years. Twenty had antecedents of previous hysterectomy; seven (29%) with benign pathology, and twelve (50%) with malignant pathology. Only four patients (17%) presented with symptomatology. In all the cases it was suspected by abnormal cytology. Colposcopy was done, as well as directed biopsy, finding that the pointillism and white epithelium, were the most frequent findings, with localization mainly in the vaginal cupule and vaginal upper third. Histopathological correlation showed NIVa I in three cases (13%) NIVa II in six cases (25%), and NIVa III in 15 (62%). Treatment was done with cryotherapy in 10 patients; with 5-fluorouracil in eight; cryotherapy plus 5-fluorouracil in three; radiotherapy in two, and it was not done in one. It was found persistent lesion in two cases treated with cryotherapy, and in one case with radiotherapy; there was a complication in one case after cryotherapy (retrovaginal fistula). Vaginal cytology should be done in every patient after hysterectomy, by benign or malignant pathology. In NIVa the colposcopic study is mandatory for the adequate diagnosis. 5-Fluorouracil showed to be an adequate treatment.
Asunto(s)
Carcinoma in Situ/diagnóstico , Neoplasias Vaginales/diagnóstico , Adulto , Carcinoma in Situ/tratamiento farmacológico , Carcinoma in Situ/radioterapia , Carcinoma in Situ/cirugía , Colposcopía , Terapia Combinada , Criocirugía , Femenino , Fluorouracilo , Humanos , Persona de Mediana Edad , Neoplasias Vaginales/tratamiento farmacológico , Neoplasias Vaginales/radioterapia , Neoplasias Vaginales/cirugía , Frotis VaginalRESUMEN
This is a prospective, comparative study of 142 patients of combined colposcopic index according to Reid's criterium and the index used at the Clinics of Colposcopy, Gyn-Ob Hospital "Luis Castelazo Ayala", IMSS. Seventy two patients were studied with the Hospital Index, and 70 with the CCI. This constituted by neatness of peripheral edges, the color, characteristics of vessels and iodine tinction; a score of 0, 1, 2 was given, the sum of which gave a final qualification, and it was traspolated to a colposcopic diagnosis. The CCI correlated with the histological diagnosis in 64 patients (91.42%); while for the Hospital Index it was in 61 cases (84.7%). The indexes showed a good sensitivity (0.95), a high positive predictive value (0.95 vs 0.88), and adequate accuracy (0.91 vs 0.84), as well as a good prevalence (0.90 vs 0.85). It is concluded that the CCI is reliable for the colposcopic diagnosis of human papillomavirus and for CIN.
Asunto(s)
Colposcopía , Infecciones Tumorales por Virus/diagnóstico , Neoplasias del Cuello Uterino/diagnóstico , Femenino , Humanos , México/epidemiología , Valor Predictivo de las Pruebas , Prevalencia , Estudios Prospectivos , Infecciones Tumorales por Virus/epidemiología , Infecciones Tumorales por Virus/patología , Neoplasias del Cuello Uterino/epidemiología , Neoplasias del Cuello Uterino/patologíaRESUMEN
Ever since the alterations caused by the HPV on the cervix were discovered, countless treatments have been employed but the ideal method still remains unknown. The objective of the experiment was to assess the efficiency of handling the cervical infection caused by the HPV, by means of trichloroacetic acid, 85% rate. During the period comprised between April 1989 and March 1990, 60 patients were subject to close analysis. The general diagnosis drawn cytology, colposcopy, and histopathology was cervical condyloma, lacking any collateral evidence of intraepithelial cervical neoplasia. The treatment consisted of 3 weekly applications of trichloroacetic acid at 85% rate directly upon the cervix. They were all assessed through cytology and colposcopy every 3 months, during a year's period. After the first 3 months, a 73.4% healing rate was observed, which decreased to 68% after 6 months and to a 65% after 9 months; this last healing rate remained unchanged after 12 months. Pregnant patients showed higher healing rates. We have drawn the conclusions that the trichloroacetic acid is an efficient agent to treat the referred injuries, and it offers as well the advantages of low costs, no secondary effects and an easy application and handling.
Asunto(s)
Papillomaviridae , Infecciones por Papillomavirus/tratamiento farmacológico , Ácido Tricloroacético/uso terapéutico , Infecciones Tumorales por Virus/tratamiento farmacológico , Enfermedades del Cuello del Útero/tratamiento farmacológico , Adulto , Colposcopía , Femenino , Estudios de Seguimiento , Humanos , México/epidemiología , Persona de Mediana Edad , Infecciones por Papillomavirus/diagnóstico , Infecciones por Papillomavirus/epidemiología , Estudios Prospectivos , Infecciones Tumorales por Virus/diagnóstico , Infecciones Tumorales por Virus/epidemiología , Enfermedades del Cuello del Útero/diagnóstico , Enfermedades del Cuello del Útero/epidemiologíaRESUMEN
Genital papillomavirus is an infection sexually transmitted, besides it is frequently associated with cancer of the uterine cervix. It is controversial if it is useful to treat the sexual partner. The present study analyzes in a comparative way patients with CIN with treated partner and untreated partner. From 1986 to 1991 251 women treated for CIN, were prospectively studied; they had completed a one year follow up and during this time they presented, or not, treatment failure. Fifty six were examined and their sexual partners were treated for genital papillomavirus, and the control were 195 women, similar to the study group as to age, race, socio-economical level, CIN histological degree, distribution of lesions and therapeutical methods, in whom the male was not examined nor treated. Statistical methods were Umann-Whitney, homogeneity test, and the fractions difference test to compare the groups. It were obtained the persistence and recidive of the treated couple and untreated couple (41% vs 32.8% with P greater than 0.05) not significant, which shows that papillomavirus treatment of the male partner has no effect on CIN treatment failure in the woman. These statistical results should be considered with caution as it is known that the male is a virus reservoir that together with other cofactors may explain the greater risk for the woman to develop CIN.
Asunto(s)
Condiloma Acuminado/cirugía , Neoplasias Glandulares y Epiteliales , Enfermedades Virales de Transmisión Sexual/terapia , Infecciones Tumorales por Virus/transmisión , Neoplasias del Cuello Uterino , Femenino , Humanos , Masculino , Pronóstico , Factores de Riesgo , Resultado del Tratamiento , Infecciones Tumorales por Virus/terapiaRESUMEN
From 1988 to 1990, prospectively, were studied 113 masculine couples (males), and 113 women, treated for intraepithelial cervical neoplasia, alone, or associated to viral infection by human papilloma virus-80 males were asymptomatic (70.7%). Colposcopy and local application of acetic acid, were needed for the diagnosis of 69.9% of lesions, which presented with a gray color to a brilliant white color. Papulous lesion, (56.70%) was most frequent; and the classical lesions as condyloma acuminatum, were 15.52%; urethral cytology was positive for condyloma (one condyloma in 30%), and biopsies in 91.66%. There were persistence and recidiva, nonsignificant, when the man had received treatment suggesting that the treatment does not alter the appearance of condyloma, nor cervical intraepithelial, neoplasia.
Asunto(s)
Carcinoma in Situ/epidemiología , Condiloma Acuminado/epidemiología , Parejas Sexuales , Neoplasias del Cuello Uterino/epidemiología , Factores de Edad , Carcinoma in Situ/diagnóstico , Carcinoma in Situ/etiología , Condiloma Acuminado/diagnóstico , Condiloma Acuminado/etiología , Femenino , Humanos , Incidencia , Masculino , México/epidemiología , Papillomaviridae , Neoplasias del Pene/diagnóstico , Neoplasias del Pene/epidemiología , Neoplasias del Pene/etiología , Estudios Prospectivos , Recurrencia , Infecciones Tumorales por Virus/diagnóstico , Infecciones Tumorales por Virus/epidemiología , Infecciones Tumorales por Virus/transmisión , Neoplasias del Cuello Uterino/diagnóstico , Neoplasias del Cuello Uterino/etiologíaRESUMEN
The causal lesions by VPH in the cervix, are associated to cancer. Currently 56 different subtypes have been isolated, from which, the 16, 18, 31, 33, 35 and 39 are more frequently related with the cervical intraepithelial neoplasia; from here derives the importance of opportune treatment. The objective of this paper is to evaluate VPH of the cervix opportune treatment with cryosurgery. Seventy five patients were analyzed, from April 1988 to May 1990 with diagnosis of cervical VPH, by cytology, colposcopy and histopathology; in whom cryosurgery with double freezing technique, was practiced; and were evaluated ever six months, during two years with cytology and colposcopy. Whenever there was persistence or recurrence, cryosurgery was used again; doing this even three times, previously discarding intraepithelial cancer. Seventy seven per cent of the patients received only one session; 16% two, and 7% three. At the six months review, it was found that 92% of the cases were negative, and 8% with persistence; at 12 months, 89% negative and 11% with recurrences; at 18 months, 93% negative, 3% with persistence and 4% with recurrence; at 24 months, 96% negative and 4% with recurrence. It is concluded that cryosurgery is efficacious in the treatment of these lesions, easy to use, well tolerated, with minimal side effects, it does not require anesthesia and is of a low cost.