RESUMO
This study was conducted retrospectively at the Queen Elizabeth Hospital and a private laboratory in Barbados to determine the types of epithelial abnormalities in cervico-vaginal Papanicolaou (Pap)-stained smears, and their clinical implications in Barbadian girls, 18 years and under, during the five-year period January 1995 to December 1999. Two hundred and sixty-five Pap smears from 236 patients were examined and the gynaecological history, initial and repeat Pap smear diagnoses, and histology reports of these patients were analyzed. Of the 236 first-visit smears, 94 (39.8%) were abnormal with 36 (15.3%) displaying cytologic features of squamous intra-epithelial lesions (SIL), (33 low grade and 3 high grade). A diagnosis of atypical squamous cells of undetermined significance (ASCUS) was reported in the remaining 58 (24.5%) abnormal smears, of which 35 (60.3%) were suspected to be related to human papillomavirus (HPV) infection. Twenty-two (23.4%) of these 94 patients, who had abnormal smears of either ASCUS or low grade squamous intra-epithelial lesions (LSIL) were re-evaluated within six to twelve months of the initial abnormal Pap smear diagnosis. Eight of these 22 patients (36.4%) had histological diagnosis of LSIL inclusive of cervical intra-epithelial neoplasia grade 1 (CIN 1) and condylomata. High-risk HPV DNA types were detected in two of these eight patients (25%). The study confirms that sexually active teenage girls are at risk of developing SIL and high-risk HPV infection. Screening of sexually active teenaged girls by Pap smears followed by other appropriate investigative procedures is recommended.
Assuntos
Infecções por Papillomavirus/epidemiologia , Infecções Tumorais por Vírus/epidemiologia , Neoplasias do Colo do Útero/patologia , Adolescente , Barbados/epidemiologia , Biomarcadores , Colposcopia , Feminino , Humanos , Teste de Papanicolaou , Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/diagnóstico , Estudos Retrospectivos , Doenças Virais Sexualmente Transmissíveis/diagnóstico , Doenças Virais Sexualmente Transmissíveis/epidemiologia , Infecções Tumorais por Vírus/diagnóstico , Displasia do Colo do Útero/patologia , Esfregaço VaginalRESUMO
The study was conducted retrospectively at the Queen Elizabeth Hospital and a private laboratory in Barbados to determine the types of epithelial abnormalities in cervico-vaginal Papanicolaou (Pap)-stained smears, and their clinical implications in Barbadian girls, 18 years and under, during the five-year period January 1995 to December 1999. Two hundred and sixty-five Pap smears from 236 patients were examined and the gynaecological history, initial and repeat Pap smear diagnoses, and histology reports of these patients were analyzed. Of the 236 first-visit smears, 94 (39.8 percent) were abnormal with 36 (15.3 percent) displaying cytological features of squamous intra-epithelial lesions (SIL), (33 low grade and 3 high grade). A diagnosis of atypical squamous cells of undetermined significance (ASCUS) was reported in the remaining 58 (24.5 percent) abnormal smears, of which 35 (60.3 percent) were suspected to be related to human papillomavirus (HPV) infection. Twenty-two (23.4 percent) of these 94 patients, who had abnormal smears of either ASCUS or low grade squamous intra-epithelial lesions (LSIL) were re-evaluated within six to twelve months of the initial abnormal Pap smear diagnosis. Eight of these 22 patients (36.4 percent) had histological diagnosis of LSIL inclusive of cervical intra-epithelial neoplasia grade 1 (CIN 1) and condylomata. High-risk HPV DNA types were detected in two of these eight patients (25 percent). The study confirms that sexually active teenage girls are at risk of developing SIL and high-risk HPV infection. Screening of sexually active teenage girls by Pap smears followed by other appropriate investigative procedures is recommended. (AU)
Assuntos
Feminino , Humanos , Adolescente , Esfregaço Vaginal , Papillomavirus Humano/patogenicidade , Barbados , Estudos Retrospectivos , /diagnóstico , Papiloma/patologiaRESUMO
This study was conducted retrospectively at the Queen Elizabeth Hospital and a private laboratory in Barbados to determine the types of epithelial abnormalities in cervico-vaginal Papanicolaou (Pap)-stained smears, and their clinical implications in Barbadian girls, 18 years and under, during the five-year period January 1995 to December 1999. Two hundred and sixty-five Pap smears from 236 patients were examined and the gynaecological history, initial and repeat Pap smear diagnoses, and histology reports of these patients were analyzed. Of the 236 first-visit smears, 94 (39.8) were abnormal with 36 (15.3) displaying cytologic features of squamous intra-epithelial lesions (SIL), (33 low grade and 3 high grade). A diagnosis of atypical squamous cells of undetermined significance (ASCUS) was reported in the remaining 58 (24.5) abnormal smears, of which 35 (60.3) were suspected to be related to human papillomavirus (HPV) infection. Twenty-two (23.4) of these 94 patients, who had abnormal smears of either ASCUS or low grade squamous intra-epithelial lesions (LSIL) were re-evaluated within six to twelve months of the initial abnormal Pap smear diagnosis. Eight of these 22 patients (36.4) had histological diagnosis of LSIL inclusive of cervical intra-epithelial neoplasia grade 1 (CIN 1) and condylomata. High-risk HPV DNA types were detected in two of these eight patients (25). The study confirms that sexually active teenage girls are at risk of developing SIL and high-risk HPV infection. Screening of sexually active teenaged girls by Pap smears followed by other appropriate investigative procedures is recommended.
Assuntos
Humanos , Feminino , Adolescente , Neoplasias do Colo do Útero , Infecções por Papillomavirus/epidemiologia , Infecções Tumorais por Vírus/epidemiologia , Papillomaviridae , Barbados , Displasia do Colo do Útero , Estudos Retrospectivos , Colposcopia , Doenças Virais Sexualmente Transmissíveis/diagnóstico , Doenças Virais Sexualmente Transmissíveis/epidemiologia , Esfregaço Vaginal , Infecções por Papillomavirus/diagnóstico , Infecções Tumorais por Vírus/diagnóstico , BiomarcadoresRESUMO
During the two year period, January 1995 to December 1996 124 cervico-vaginal smears from 109 girls 18 years old and younger were examined. The gynaecological history, cytology reports, histological and cytological follow-up reports were analyzed to determine the demographics, common infections, epithelial abnormalities and follow-up management in this age group. The mean age was 17.4 with a range of 15-18 years. Twenty-five percent were gravid and 4.5 percent multigravida. The teen delivery/termination ratio was 0.73:1. The most common specific infection was yeast and, suspected infection, HPV .39 percent had normal smears, 14.7 percent inflammatory epithelial changes, 36 percent atypical squamous cells of undetermined significance (ASCUS), 8.3 percent low grade squamous intra-epithelial lesions (LGSIL) and 1.0 percent high grade intra-epithelial lesions (HGSIL). The ASCUS/SIL ratio was 3.9. Only 40 percent of patients with cytologic diagnosis of SIL and 28 percent with ASCUS had follow-up by repeat smear and/or colposcopy, endocervical curettage and guided cervicals biopsy. Five (45 percent) of the followed up patients had LGSIL inclusive of CIN 1 and condyloma. These results indicate that sexually active girls are risk of developing SIL and those with a diagnosis of ASCUS should be adequately followed up.(AU)