Lesões precursoras do câncer cervicouterino: evolução histórica e subsídios para consulta de enfermagem ginecológica Lesiones precursoras del cáncer cervical-útero: evolución histórica consolidando la consulta de enfermería ginecológica Cervical-uterine cancer precursor lesions: historical evolution supporting the gynecological nursing consultation

Estudo emergido de recorte de dissertação de mestrado, ilustrando a evolução histórica das lesões precursoras do câncer cervicouterino (LPCCU). Trata-se da história das LPCCU, delineando a relevância do conhecimento para prática do enfermeiro na área da saúde da mulher. O conceito de LPCCU inicia-se a partir do século XIX, dando início aos estudos das células alteradas. Objetivo: descrever as diversas fases da evolução histórica das alterações cervicais. Estudo qualitativo, descritivo-analítico, recorte temporal no período de 1940 a 2008. Dados levantados mediante bibliografia de fonte primária e recurso BIREME. Pontuaram-se as classificações que já existiram, destacando a Nomenclatura Brasileira, importante para corresponder às necessidades e o perfil da saúde das mulheres do Brasil. Este estudo é o ponto de partida para respaldar as práticas de consulta de enfermagem ginecológica com abordagens educativas, contemplando a população feminina em ações preventivas e incentivo ao tratamento.<br>Estudio emergido de recorte de disertación de máster, ilustrando la evolución histórica de las lesiones precursoras del cáncer cervical-uterino (LPCCU). Se trata de la historia de las LPCCU, delineando la relevancia del conocimiento para la práctica del enfermero en cuidados en la salud de la mujer. El concepto de LPCCU se inicia a partir del siglo XIX, empezando los estudios de las células alteradas. Como objetivo: describir las diversas fases históricas de las alteraciones cervicales. Estudio cualitativo, descriptivo-analítico, recorte temporal en el período de 1940 hasta 2008. Datos acrecentados mediante bibliografía de fuente primaria y recurso BIREME. Se puntuó las diferentes clasificaciones que ya existieron, conde destaque para la nomenclatura brasileña, importante para corresponder a las necesidades y el perfil de la salud de las mujeres del Brasil. Esto estudio es el ponto de partida para respaldar las prácticas de consulta de enfermería ginecológica con abordajes educativas, contemplando la población femenina en acciones preventivas y incentivo al tratamiento.<br>Study emerged from an article of the master degree that illustrates the phases of the historical evolution of the precursor lesions of the cervical-uterine cancer. Thus, it is a question of the history about, delineating the relevance of this knowledge for the nurse's practice in care in the woman's health. The precursor lesions concept of the cervical-uterine cancer, initiates itself from the XIX century, beginning with studies of the cells altered. It had as objective: describe the diverse historical phases of the cervical-uterine cancer. A qualitative, descriptive-analytical study, using time cutting in the period of 1940 to 2008. The data were raised by means of bibliographical reference as primary spring and about the resource BIREME, By means of this study was possible to score the different classifications that already existed, highlighting the Brazilian Nomenclature was important to correspond the needs and the profile of the health of the women of Brazil. This study is the starting point to support the gynecological nursing consultation practices with educational approaches, contemplating the female population in preventive actions and incentive to the treatment

A retrospective clinical audit of cervical smears reported as 'glandular neoplasia'

The aims of this study were to review the diagnostic pathway of women with smears reported as 'glandular neoplasia' and to outline the management, colposcopy findings, treatment and final histological diagnosis in these women. The design was a retrospective review. A total of 114 women were identified over a 5-year period from the cytology database at the Royal Liverpool University Hospital Cytology Department, whose hospital case notes were available for review. Methods included a review of the case notes for the demographic details, indication for smear, colposcopic findings, investigation and/or treatment procedures, histology, final diagnosis and current disease status. Of 114 smears reported as 'glandular neoplasia', 67 were reported as consistent with cervical glandular intra-epithelial neoplasia (CGIN), six with endocervical adenocarcinoma, 36 with endometrial adenocarcinoma and five with other glandular neoplastic abnormalities. The average age was 46.5 years. 79 (69.3%) smears were routine call/recall and 36 (30.7%) women were symptomatic. The positive predictive value (PPV) for a significant histological abnormality in the CGIN smear group was 80.6% (23.9% invasive carcinomas, 43.3% CGIN and 13.4% CIN) and the PPV of an 'endometrial adenocarcinoma' smear was 86.1%. Smears indicating glandular neoplasia are associated with a high probability of clinically significant lesions, the PPV of a CGIN smear being over 80%. Immediate referral for colposcopy and assessment by an experienced colposcopist is recommended.</p