Cistos No Interior De Nódulo Mamários Benignos: Risco De Malignidade

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)The objective of this study is to assess whether the largest cyst diameter is useful for BI-RADS ultrasonography classification of predominantly solid breast masses with an oval shape, circumscribed margins, and largest axis parallel to the skin, which, except for the cystic component, would be likely classified as benign. Methods This study received approval fromthe local institutional review board. From March 2009 to August 2014, we prospectively biopsied 170 breast masses from 164 women. We grouped the largest cyst and mass diameters according to histopathological diagnoses. We used Student’s t-test, linear regression, and the area under the receiver operating characteristic curve (AUC) for statistical assessment. Results Histopathological examination revealed 143 (84%) benign and 27 (16%)malignant masses. The mean largest mass diameter was larger among malignant (mean ± standard deviation, 34.1 ± 16.6 mm) than benign masses (24.7 ± 16.7 mm) (P < 0.008). The mean largest cyst diameter was also larger among malignant (9.9 ± 7.1 mm) than benign masses (4.6 ± 3.6 mm) (P < 0.001). Agreement between measurements of the largest mass and cyst diameters was low (R2 = 0.26). AUC for the largest cyst diameter (0.78) was similar to the AUC for the largest mass diameter (0.69) (p = 0.2). A largest cyst diameter < 3, ≥ 3 to < 11, and ≥ 11 mm had a positive predictive value of 0, 15, and 52%, respectively. Conclusion A largest cystic component < 3 mm identified within breast masses that show favorable characteristics may be considered clinically inconsequential in ultrasonography characterization. Conversely, masses with a largest cystic component ≥ 3 mm should be classified as BI-RADS-US category 4. © 2016 by Thieme Publicações Ltda, Rio de Janeiro, Brazil.3841701762012/15059-8, FAPESP, Fundação de Amparo à Pesquisa do Estado de São PauloFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Bayesian Estimation Of Performance Measures Of Cervical Cancer Screening Tests In The Presence Of Covariates And Absence Of A Gold Standard

In this paper we develop a Bayesian analysis to estimate the disease prevalence, the sensitivity and specificity of three cervical cancer screening tests (cervical cytology, visual inspection with acetic acid and Hybrid Capture II) in the presence of a covariate and in the absence of a gold standard. We use Metropolis-Hastings algorithm to obtain the posterior summaries of interest. The estimated prevalence of cervical lesions was 6.4% (a 95% credible interval [95% CI] was 3.9, 9.3). The sensitivity of cervical cytology (with a result of ≥ ASC-US) was 53.6% (95% CI: 42.1, 65.0) compared with 52.9% (95% CI: 43.5, 62.5) for visual inspection with acetic acid and 90.3% (95% CI: 76.2, 98.7) for Hybrid Capture II (with result of >1 relative light units). The specificity of cervical cytology was 97.0% (95% CI: 95.5, 98.4) and the specifi cities for visual inspection with acetic acid and Hybrid Capture II were 93.0% (95% CI: 91.0, 94.7) and 88.7% (95% CI: 85.9, 91.4), respectively. The Bayesian model with covariates suggests that the sensitivity and the specificity of the visual inspection with acetic acid tend to increase as the age of the women increases. The Bayesian method proposed here is an useful alternative to estimate measures of performance of diagnostic tests in the presence of covariates and when a gold standard is not available. An advantage of the method is the fact that the number of parameters to be estimated is not limited by the number of observations, as it happens with several frequentist approaches. However, it is important to point out that the Bayesian analysis requires informative priors in order for the parameters to be identifiable. The method can be easily extended for the analysis of other medical data sets.63346Begg, C.B., Greenes, R.A., Assessment of diagnostic tests when disease verification is subject to selection bias (1983) Biometrics, 39, pp. 207-215Zhou, X., Maximum likelihood estimators of sensitivity and specificity corrected for verification bias (1983) Commun Statis Theory Meth, 22, pp. 3177-3198Hui, S.L., Walter, S.D., Estimating the error rates of diagnostic tests (1980) Biometrics, 36, pp. 167-171Joseph, L., Gyorkos, T.W., Coupal, L., Bayesian estimation of disease prevalence and the parameters of diagnostic tests in the absence of a gold standard (1985) Am J Epidemiol, 141, pp. 263-272Hitt, E., Cancer in the Americas (2003) Lancet Oncol, 4, p. 9Brasil. Ministério da Saúde. Secretaria Nacional de Assistência à Saúde. Instituto Nacional do Câncer. Estimativas da incidência e mortalidade por câncer no Brasil. Rio de Janeiro: INCA2002. Available on website: 〈http://www.inca.org.br/cancer/ epide miologia/estimativa2002/estimativas.html〉Mitchell, M.F., Schottenfeld, D., Tortolero-Luna, G., Cantor, S.B., Richards-Kortum R. Colposcopy for the diagnosis of squamous intraepithelial lesions: A meta-analysis (1998) Obstet Gynecol, 91, pp. 626-631Hopman, E.H., Kenemans, P., Helmerhorst, T.J., Positive predictive rate of colposcopic examination of the cervix uteri: An overview of literature (1998) Obstet Gynecol Surv, 53, pp. 97-106Begg, C.B., Biases in the assessment of diagnostic tests (1987) Stat Med, 6, pp. 411-423Hui, S.L., Zhou, X.H., Evaluation of diagnostic tests without gold standards (1998) Stat Methods Med Res, 7, pp. 354-370Zhou, X.H., Correcting for verification bias in studies of a diagnostic test's accuracy (1998) Stat Methods Med Res, 7, pp. 337-353McCrory, D.C., Matchar, D.B., Bastian, L. et al. 1999. Evaluation of cervical cytology. Evidence report/technology assessment n.5. (Prepared by Duke University under Contract n. 290-97-0014). AHCPR publication n. 99-E010. Rockville: Agency for Health Care Policy and ResearchDendukuri, N., Joseph, L., Bayesian approaches to modelling the conditional dependence between multiple diagnostic tests (2001) Biometrics, 57, pp. 208-217Faraone, S.V., Tsuang, M.T., Measuring diagnostic accuracy in the absence of a "gold standard (1994) Am J Psychiatry, 151, pp. 650-657Qu, Y., Tan, M., Kutner, M.H., Random effects models in latent class analysis for evaluating accuracy of diagnostic tests (1996) Biometrics, 52, pp. 797-810Hadgu, A., Qu, Y., A biomedical application of latent models with random effects (1998) Appl Statist, 47, pp. 603-616Tanner, M., Wong, W., The calculation of posterior distributions by data augmentation (1987) J Am Statist Ass, 82, pp. 528-550Gelfand, A.E., Smith, A.F.M., Sampling Based Approaches to Calculating Marginal Densities (1990) J Am Stat Assoc, 85, pp. 398-409Gelfand, A.E., Gibbs sampling (2000) J Am Stat Assoc, 95, pp. 1300-1304Syrjanen, K., Naud, P., Derchain, S., Comparing PAP smear cytology, aided visual inspection, screening colposcopy, cervicography and HPV testing as optional screening tools in Latin America. Study design and baseline data of the LAMS study (2005) Anticancer Res, 25, pp. 3469-3480Sarian, L.O., Derchain, S.F., Naud, P., Evaluation of visual inspection with acetic acid (VIA), Lugol's iodine (VILI), cervical cytology and HPV testing as cervical screening tools in Latin America. This report refers to partial results from the LAMS (Latin AMerican Screening) study (2005) J Med Screen, 12, pp. 142-149Solomon, D., Davey, D., Kurman, R., The 2001 Bethesda System: Terminology for reporting results of cervical cytology (2002) JAMA, 287, pp. 2114-2119Blumenthal, P., Sanghvi, H., (1997) Atlas for unaided visual inspection of the cervix, , Baltimore and Harare: JHPIEGO Corporation and University of Zimbabwe Medical SchoolNanda, K., McCrory, D.C., Myers, E.R., Accuracy of the Papanicolaou test in screening for and follow-up of cervical cytologic abnormalities: A systematic review (2000) Ann Intern Med, 132, pp. 810-819Belinson, J.L., Pretorius, R.G., Zhang, W.H., Wu, L.Y., Qiao, Y.L., Elson, P., Cervical cancer screening by simple visual inspection after acetic acid (2001) Obstet Gynecol, 98, pp. 441-444Visual inspection with acetic acid for cervical-cancer screening: Test qualities in a primary care setting (1999) Lancet, 353, pp. 869-873. , University of Zimbabwe/JHPIEGO Cervical Cancer ProjectSchiffman, M., Herrero, R., Hildensheim, A., HPV DNA testing in cervical cancer screening: Results from women in a high-risk province of Costa Rica (2000) JAMA, 283, pp. 87-93Wright Jr, T.C., Lynette, D., Kuhn, L., Pollack, A., Lorincz, A., HPV DNA testing of self-collected vaginal samples compared with cytologic screening to detect cervical cancer (2000) JAMA, 283, pp. 81-86Box, G.E.P., Tiao, G.C., (1992) Bayesian Inference in Statistical Analysis, , Reprint edition. New York: Wiley-InterscienceAltman, D.G., Bland, J.M., Diagnostic tests 2: Predictive values (1994) BMJ, 309, p. 102Franco, E.L., Primary screening of cervical cancer with human papillomavirus tests (2003) J Natl Cancer Inst Monogr, 31, pp. 89-96Geweke J. 1992. Evaluating the accuracy of sampling-based approaches to calculating posterior moments. Bayesian Statistics 4Bernardo, J.M.Berger, J.O.Dawid, A.P and.Smith, A.F.M., Eds.Clarendom Press: Oxford, 169-94Carlin, B.P., Louis, T.A., (2000) Bayes and empirical Bayes methods for data analysis, , 2nd ed. London: Chapman and Hall/CRCKoss, L.G., Human papillomavirus testing as a screening tool for cervical cancer (2000) JAMA, 283, p. 2525Shlay, J.C., Dunn, T., Byers, T., Barón, A.E., Douglas, J.M., Prediction of cervical intraepithelial neoplasia grade 2-3 using risk assessment and human papillomavirus testing in women with atypia on Papanicolaou Smears (2000) Obstet Gynecol, 96, pp. 410-416Spiegelhalter, D.J., Best, N.G., Carlin, B.P., van der Linde A Bayesian measures of model complexity and fit (with discussion) (2002) J Roy Statist Soc B, 64, pp. 583-640Franco, E.L., Ferenczy, A., Assessing gains in diagnostic utility when human papillomavirus testing is used as an adjunct to papanicolaou smear in the triage of women with cervical cytologic abnormalities (1999) Am J Obstet Gynecol, 181, pp. 382-386Macaskill, P., Walter, S.D., Irwig, L., Franco, E.L., Assessing the gain in diagnostic performance when combining two diagnostic tests (2002) Statis Med, 21, pp. 2527-2546Brenner, H., How independent are multiple "independent" diagnostic classifications? Stat MedEspeland, M.A., Handelman, S.L., Using latent class models to characterize and assess relative error in discrete measurements (1989) Biometrics, 45, pp. 587-599Yang, I., Becker, M.P., Latent variable modeling of diagnostic accuracy (1997) Biometrics, 53, pp. 948-958Ratman, S., Franco, E.L., Ferenczy, A., Human papillomavirus testing for primary screening of cervical cancer precursors (2000) Cancer Epidemiol Biomarkers Prev, 9, pp. 945-951Coste, J., Cochand-Priollet, B., de Cremoux, P., Cross sectional study of conventional cervical smear, monolayer cytology and human papillomavirus DNA testing for cervical cancer screening (2003) BMJ, 326, p. 733Schiffman, M., Hildesheim, A., Herrero, R., Bratti, M., In reply: Human papillomavirus testing as a screening tool for cervical cancer (2000) JAMA, 283, pp. 2525-2526Londhe, M., George, S.S., Seshadri, L., Detection of CIN by naked eye visualization after application of acetic acid (1997) Indian J Cancer, 34, pp. 88-91Sankaranarayanan, R., Wesley, R., Somanathan, T., Visual inspection of the uterine cervix after the application of acetic acid in the detection of cervical carcinoma and its precursors (1998) Cancer, 83, pp. 2150-2156Sankaranarayanan, R., Shyamalayumary, B., Wesley, R., Sreedevi Amma, N., Parkin, D.M., Nair, M.K., Visual inspection with acetic acid in the early detection of cervical cancer and precursors (1999) Int J Cancer, 80, pp. 161-163Denny, L., Kuhn, L., Pollack, A., Wainwright, H., Wright Jr., T.C., Evaluation of alternative methods of cervical cancer screening in resource-poor settings (2000) Cancer, 89, pp. 826-833Denny, L., Kuhn, L., Pollack, A., Wright Jr., T.C., Direct visual inspection for cervical cancer screening: An analysis of factors influencing test performance (2002) Cancer, 94, pp. 1699-1707Parmigiani, G., Measuring uncertainty in complex decision analysis models (2002) Stat Methods Med Res, 11, pp. 513-537Koss, L.G., Human papillomavirus testing as a screening tool for cervical cancer (2000) JAMA, 283, pp. 2525-2526Smith, A.F.M., Roberts, G.O., Bayesian Computation via the Gibbs Sampler and Related MCMC Methods (1993) J R Stat SocB, 55, pp. 3-2

Prophylactic Hpv Vaccines [vacinas Profiláticas Para O Hpv]

[No abstract available]296281284Munoz N, Castellsague X, de Gonzalez AB, Gissmann L. Chapter 1: HPV in the etiology of human cancer. Vaccine. 2006;24 Suppl 3:S1-S10Lazcano-Ponce, E., Alonso, P., Ruiz-Moreno, J.A., Hernandez-Avila, M., Recommendations for cervical cancer screening programs in developing countries. The need for equity and technological development (2003) Salud Publica Mex, 45 (SUPPL. 3), pp. S449-S462Lowy, D.R., Schiller, J.T., Prophylactic human papillomavirus vaccines (2006) J Clin Invest, 116 (5), pp. 1167-1173Tewari, K.S., DiSaia, P.J., Primary prevention of uterine cervix cancer: Focus on vaccine history and current strategy (2002) Obstet Gynecol Clin North Am, 29 (4), pp. 843-868Villa LL, Costa RL, Petta CA, Andrade RP, Ault KA, Giuliano AR, et al. Prophylactic quadrivalent human papillomavirus (types 6, 11, 16, and 18) L1 virus-like particle vaccine in young women: a randomised double-blind placebo-controlled multicentre phase II efficacy trial. Lancet Oncol. 2005;6(5):271-8Villa LL, Ault KA, Giuliano AR, Costa RL, Petta CA, Andrade RP, et al. Immunologic responses following administration of a vaccine targeting human papillomavirus Types 6, 11, 16, and 18. Vaccine. 2006;24(27-28):5571-83Harro, C.D., Pang, Y.Y., Roden, R.B., Hildesheim, A., Wang, Z., Reynolds, M.J., Safety and immunogenicity trial in adult volunteers of a human papillomavirus 16 L1 virus-like particle vaccine (2001) J Natl Cancer Inst, 93 (4), pp. 284-292Koutsky, L.A., Ault, K.A., Wheeler, C.M., Brown, D.R., Barr, E., Alvarez, F.B., A controlled trial of a human papillomavirus type 16 vaccine (2002) N Engl J Med, 347 (21), pp. 1645-1651Harper, D.M., Franco, E.L., Wheeler, C., Ferris, D.G., Jenkins, D., Schuind, A., Efficacy of a bivalent L1 virus-like particle vaccine in prevention of infection with human papillomavirus types 16 and 18 in young women: A randomised controlled trial (2004) Lancet, 364 (9447), pp. 1757-1765Harper, D.M., Franco, E.L., Wheeler, C.M., Moscicki, A.B., Romanowski, B., Roteli-Martins, C.M., Sustained efficacy up to 4.5 years of a bivalent L1 virus-like particle vaccine against human papillomavirus types 16 and 18: Follow-up from a randomised control trial (2006) Lancet, 367 (9518), pp. 1247-1255Joura EA, Leodolter S, Hernandez-Avila M, Wheeler CM, Perez G, Koutsky LA, et al. Efficacy of a quadrivalent prophylactic human papillomavirus (types 6, 11, 16, and 18) L1 virus-like-particle vaccine against high-grade vulval and vaginal lesions: a combined analysis of three randomised clinical trials. Lancet. 2007;369(9574):1693-702Ault, K.A., Future II Study Group. Effect of prophylactic human papillomavirus L1 virus-like-particle vaccine on risk of cervical intraepithelial neoplasia grade 2, grade 3, and adenocarcinoma in situ: A combined analysis of four randomised clinical trials (2007) Lancet, 369 (9576), pp. 1861-1868Schiller JT, Nardelli-Haefliger D. Chapter 17: second generation HPV vaccines to prevent cervical cancer. Vaccine. 2006;24 Suppl 3:S147-53Franco EL, Cuzick J, Hildesheim A, de Sanjose S. Chapter 20: issues in planning cervical cancer screening in the era of HPV vaccination. Vaccine. 2006;24 Suppl 3:S171-7Zimmerman, R.K., Ethical analysis of HPV vaccine policy options (2006) Vaccine, 24 (22), pp. 4812-4820Goldie SJ, Kim JJ, Myers E. Chapter 19: cost-effectiveness of cervical cancer screening. Vaccine. 2006;24 Suppl 3:S164-70Goldie, S.J., Grima, D., Kohli, M., Wright, T.C., Weinstein, M., Franco, E., A comprehensive natural history model of HPV infection and cervical cancer to estimate the clinical impact of a prophylactic HPV-16/18 vaccine (2003) Int J Cancer, 106 (6), pp. 896-90

Diagnostic Methods For Cervical Cancer Screening [métodos Diagnósticos Para O Rastreamento Do Câncer De Colo]

[No abstract available]328363367Sankaranarayanan, R., Overview of cervical cancer in the developing world (2006) Int J Gynaecol Obstet, 95 (1), pp. S205-S210. , FIGO 6th Annual Report on the Results of Treatment in Gynecological CancerBray, F., Loos, A.H., McCarron, P., Weiderpass, E., Arbyn, M., Møller, H., Trends in cervical squamous cell carcinoma incidence in 13 European countries: Changing risk and the effects of screening (2005) Cancer Epidemiol Biomarkers Prev, 14 (3), pp. 677-686Cervical Cancer Statistics, , http://www.cdc.gov/cancer/cervical/statistics, Centers for Disease Control and Prevention, [Internet]. Atlanta: CDC2010 [cited 2010 Jul 29]Katz, L.M., Souza, A.S., Fittipaldi, S.O., Santos, G.M., Amorin, M.M., Concordância entre a citologia, a colposcopia e a histopatologia cervical (2010) RBGO, 32 (8), pp. 368-373Safaeian, M., Solomon, D., Castle, P.E., Cervical cancer prevention-cervical screening: Science in evolution (2007) Obstet Gynecol Clin North Am, 34 (4), pp. 739-760Cronjé, H.S., Parham, G.P., Cooreman, B.F., de Beer, A., Divall, P., Bam, R.H., A comparison of four screening methods for cervical neoplasia in a developing country (2003) Am J Obstet Gynecol, 188 (2), pp. 395-400Hakama, M., Chamberlain, J., Day, N.E., Miller, A.B., Prorok, P.C., Evaluation of screening programmes for gynaecological cancer (1985) Br J Cancer, 52 (4), pp. 669-673Mayrand, M.H., Duarte-Franco, E., Rodrigues, I., Walter, S.D., Hanley, J., Ferenczy, A., Human papillomavirus DNA versus Papanicolaou screening tests for cervical cancer (2007) N Engl J Med, 357 (16), pp. 1579-1588Arbyn, M., Bergeron, C., Klinkhamer, P., Martin-Hirsch, P., Siebers, A.G., Bulten, J., Liquid compared with conventional cervical cytology: A systematic review and meta-analysis (2008) Obstet Gynecol, 111 (1), pp. 167-177Arbyn, M., Dillner, J., Schenck, U., Nieminen, P., Weiderpass, E., da Silva, D., Methods for screening and diagnosis (2008) European Guidelines For Quality Assurance In Cervical Cancer Screening, pp. 69-152. , In: Arbyn M, Anttila A, Jordan J, Ronco G, Schenck U, Segnan N, et al., editors, Luxembourg: Offce for Offcial Publications of the European CommunitiesNanda, K., McCrory, D.C., Myers, E.R., Bastian, L.A., Hasselblad, V., Hickey, J.D., Accuracy of the Papanicolaou test in screening for and follow-up of cervical cytologic abnormalities: A systematic review (2000) Ann Intern Med, 132 (10), pp. 810-819van Oortmarssen, G.J., Habbema, J.D., Epidemiological evidence for age-dependent regression of pre-invasive cervical cancer (1991) Br J Cancer, 64 (3), pp. 559-565Zhu, X., Lv, J., Yu, L., Zhu, X., Wu, J., Zou, S., Proteomic identifcation of differentially-expressed proteins in squamous cervical cancer (2009) Gynecol Oncol, 112 (1), pp. 248-256Wentzensen, N., Sherman, M.E., Schiffman, M., Wang, S.S., Utility of methylation markers in cervical cancer early detection: Appraisal of the state-of-the-science (2009) Gynecol Oncol, 112 (2), pp. 293-299Dürst, M., Gissmann, L., Ikenberg, H., Hausen, H.Z., A papillomavirus DNA from a cervical carcinoma and its prevalence in cancer biopsy samples from different geographic regions (1983) Proc Natl Acad Sci USA, 80 (12), pp. 3812-3815Cox, J.T., History of the use of HPV testing in cervical screening and in the management of abnormal cervical screening results (2009) J Clin Virol, 45 (1), pp. S3-12Castle, P.E., Fetterman, B., Poitras, N., Lorey, T., Shaber, R., Kinney, W., Five-year experience of human papillomavirus DNA and Papanicolaou test cotesting (2009) Obstet Gynecol, 113 (3), pp. 595-600Wright, T.C., Massad, L.S., Dunton, C.J., Spitzer, M., Wilkinson, E.J., Solomon, D., 2006 consensus guidelines for the management of women with abnormal cervical cancer screening tests (2007) Am J Obstet Gynecol, 197 (4), pp. 346-355Rodriguez, A.C., Schiffman, M., Herrero, R., Wacholder, S., Hildesheim, A., Castle, P.E., Rapid clearance of human papillomavirus and implications for clinical focus on persistent infections (2008) J Natl Cancer Inst, 100 (7), pp. 513-517Sherman, M.E., Lorincz, A.T., Scott, D.R., Wacholder, S., Castle, P.E., Glass, A.G., Baseline cytology, human papillomavirus testing, and risk for cervical neoplasia: A 10-year cohort analysis (2003) J Natl Cancer Inst, 95 (1), pp. 46-52Cuzick, J., Szarewski, A., Terry, G., Ho, L., Hanby, A., Maddox, P., Human papillomavirus testing in primary cervical screening (1995) Lancet, 345 (8964)Cuzick, J., Szarewski, A., Mesher, D., Cadman, L., Austin, J., Perryman, K., Long-term follow-up of cervical abnormalities among women screened by HPV testing and cytology-Results from the Hammersmith study (2008) Int J Cancer, 122 (10), pp. 2294-2300Cuzick, J., Beverley, E., Ho, L., Terry, G., Sapper, H., Mielzynska, I., HPV testing in primary screening of older women (1999) Br J Cancer, 81 (3), pp. 554-558Dillner, J., Rebolj, M., Birembaut, P., Petry, K., Szarewski, A., Munk, C., Long-term predictive values of cytology and human papillomavirus testing in cervical cancer screening: Joint European cohort study (2008) BMJ, 337, pp. a1754Sankaranarayanan, R., Wesley, R., (2003) A Practical Manual On Visual Screening For Cervical Neoplasia, , [IARC Technical Publication, 41]. Lyon: IARC PressBlumenthal, P.D., Lauterbach, M., Sellors, J.W., Sankaranarayanan, R., Training for cervical cancer prevention programs in low-resource settings: Focus on visual inspection with acetic acid and cryotherapy (2005) Int J Gynaecol Obstet, 89 (2), pp. S30-S37Sarian, L.O., Derchain, S.F., Naud, P., Roteli-Martins, C., Longatto-Filho, A., Tatti, S., Evaluation of visual inspection with acetic acid (VIA), Lugol's iodine (VILI), cervical cytology and HPV testing as cervical screening tools in Latin America. This report refers to partial results from the LAMS (Latin AMerican Screening) study (2005) J Med Screen, 12 (3), pp. 142-149Arbyn, M., Ronco, G., Cuzick, J., Wentzensen, N., Castle, P.E., How to evaluate emerging technologies in cervical cancer screening- (2009) Int J Cancer, 125 (11), pp. 2489-249

Omentum For Mammary Disorders: A 30-year Systematic Review

Purpose: Although the safety of applying omentum to the female breast for total breast reconstruction is controversial, it has recently been used to treat certain mammary disorders as well. A systematic review was therefore conducted to analyze and establish the suitability and safety of applying omentum to the breast.Methods: Covereing the interval from January 1984 to December 2013, we performed searches in MEDLINE, Embase, SciELO, and Google-Scholar for original articles describing the applicability of greater omentum to the breast and its clinical complications.Results: Sixty observational articles with 985 women were chosen. The main clinical indications were total breast reconstruction after mastectomy due to breast cancer (45 studies), radiation damage (23 studies), and congenital Poland syndrome (4 studies). Altogether, 273 complications were identified among the 985 women treated. The most frequent was flap necrosis (26.74 %). The most serious was injury to the digestive system (1.10 %). There was a 35.48 % incidence of local breast cancer recurrence in eight observational studies on oncological risk. Seven of the eight included only women with advanced cancer. One of these studies reported the incidence and relapse time predominantly according to the primary tumor size.Conclusions: Although the oncological risk remains unclear, there was a high volume of complications that affected the digestive system. These findings suggest that omentum has well established applicability, but only for total breast reconstruction of huge defects, where muscular/myocutaneous or perforator flaps may be unsuitable

Clinically Undetectable Lymph Node Invasion In Vulvar Cancer [invasão Linfática Clinicamente Não Detectável Do Câncer Vulvar]

OBJECTIVE. To assess the neoplastic invasion of superficial and deep inguinal lymph nodes of women with invasive vulvar squamous carcinoma smaller than 5 centimeters with a clinically normal inguinal region. Methods: the medical records of 59 women cared at the State University of Campinas with invasive vulvar squamous carcinoma T1 and T2 and who presented clinically normal inguinal regions (N0) were reviewed. Clinical characteristics of both tumor and patients were evaluated as well as the follow-up data. Odds ratios and Fisher's Exact Test were used to assess the correlations between the invasion of inguinal lymph nodes and tumor size, grade, relapses and clinical complications. Confidence limits of 95% were used. RESULTS. Age of the patients ranged from 34 to 91 years (mean 67 years), and follow-up time ranged from 3 days (peri-operatory death) to 252 months (mean 27 months). Clinically, 22 (37%) women had lesions T1 lesions and 37 (63%) T2. Histological analysis showed unilateral lymphatic invasion in six (10%) women and bilateral in three (5%). There was no significant association between tumor size and lymph node invasion. Also, pathologic tumor size and grade were not associated with lymph node neoplastic involvement. Relapses and late complications were not correlated with lymph node neoplastic invasion. CONCLUSIONS. Superficial and deep inguinal dissection disclosed clinically undetectable lymph node neoplastic invasion, although tumor size and histological grade, relapses and late complications were not associated with node involvement.514228232Coleman, R.L., Santoso, J.T., Vulvar carcinoma (2000) Curr Treat Opion Oncol, 1, pp. 177-190Verdiani, L.A., Juliato, C.R., Derchain, S.F.M., Carcinoma da vulva: Epidemiologia e aspectos clínicos (1997) Rev Centro de Referência, 2, pp. 86-90Canavan, T.P., Cohen, D., Vulvar cancer (2002) Am Fam Physician, 66, pp. 1269-1274Disaia, P.J., Creasman, W.T., Invasive cancer of the vulva (1989) Clinical Gynecologic Oncology. 3 rd Ed., pp. 241-272. , Disaia PJ, Creasman WT. St Louis: MosbyDe Hullu, J.A., Hollema, H., Lolkema, S., Boezen, M., Boonstra, H., Burger, M.O., Vulvarcarcinoma: The price of less radical surgery (2002) Cancer, 95, pp. 2331-2338Micheletti, L., Levi, A.C., Bogliatto, F., Preti, M., Massobrio, M., Rationale and definition of the lateral extension of the inguinal lymphadenectomy for vulvar cancer derived from an embriological and anatomical study (2002) J Surg Oncol, 81, pp. 19-24Kim, R.Y., Alvarez, R.D., Omura, G.A., Advances in the treatment of gynecologic malignancies. Part 1: Cancers of the cervix and vulva (2002) Oncology, 16, pp. 1510-1517Rouzier, R., Haddad, B., Plantier, F., Dubois, P., Pelisse, M., Paniel, B.J., Local relapse in patients treated for squamous cell vulvar carcinoma: Incidence and prognostic value (2002) Obstet Gynecol, 100, pp. 1159-1167Edwards, S., Handfield-Jones, S., Gull, S., National guidelines on the management of vulval conditions (2002) Int J STD AIDS, 13, pp. 411-415Ulitin, H.C., Pak, Y., Dede, M., Can radiotherapy be a treatment option for elderly women with invasive vulvar carcinoma without radical surgery? (2002) Eur J Gynaecol Oncol, 23, pp. 426-428Puig-Tintore, L.M., Ordi, J., Vidal-Sicart, S., Lejarcegui, J.Á., Torn, A., Pahisa, J., Further data on the usefulness of sentinel lymph node identification and ultrastaging in vulvar squamous cell carcinoma (2003) Gynecol Oncol, 88, pp. 29-34Scheiströen, M., Nesland, J.M., Trope, C., Have patients with early squamous carcinoma of the vulva been overtreated in the past? The norvegian experience 1977-1991 (2002) Eur J Gynaecol Oncol, 23, pp. 93-103Hullu, J.A., Van Der Zee, A.G., Sentinel node techniques in cancer of the vulva (2003) Curr Womens Health Rep, 3, pp. 19-26Shepherd, J.H., Cervical and vulvar cancer: Changes in FIGO definitions of staging (1996) Br J Obstet Gynecol, 103, pp. 405-406Scully, R.E., Bonfligio, T.A., Kurman, R.J., Silverberg, S.G., Wilkins, E.J., Histological typing of female genital tract tumors (1994) Histological Classification of Tumors. 2th Ed., , World Health Organization. International. Berlin: Springer-VerlagBosquet, J.G., Kinney, W.K., Russel, A.H., Gaffey, T.A., Magrina, J.F., Podratz, K.C., Risk of occult inguinofemoral lymph node metastasis from squamous carcinoma of the vulva (2003) Int J Radiat Oncol Biol Phys, 2, pp. 419-424Gomes-Rueda, N., Vighi, S., Garcia, A., Cardinal, L., Belardi, M.G., Di Paola, G., Histologic predictive factors: Therapeutic impact in vulvar cancer (1994) J Reprod Med, 39, pp. 71-76Crum, C.P., Carcinoma of the vulva: Epidemiology and pathogenesis (1992) Obstet Gynecol, 79, pp. 448-454Kurman, R.J., Trimble, C.L., Shah, K.V., Human papilloma virus and the pathogenesis of vulvar carcinoma (1992) Curr Opin Obstet Gynecol, 4, pp. 582-585Trimble, C.L., Hildenshein, A., Brinton, L.A., Shah, K.V., Kurman, R.J., Heterogenous etiology of squamous carcinoma of the vulva (1996) Obstet Gynecol, 87, pp. 59-64AlGhamdi, A., Freedman, D., Miller, D., Poh, C., Rosin, M., Zhang, L., Vulvar squamous cell carcinoma in young women: A clinicopathologic study of 21 cases (2002) Gynecol Oncol, 84, pp. 94-101Morris, J.M., A formula for selective lymphadenectomy: Its application to cancer of the vulva (1977) Obstet Gynecol, 50, pp. 152-158Hacker, N.F., Management of regional lymph nodes and their prognostic influence in vulvar cancer (1983) Obstet Gynecol, 61, pp. 408-412DiSaia, P.J., Creasman, W.T., Rich, W.M., An alternate approach to early cancer of the vulva (1979) Am J Obstet Gynecol, 133, pp. 825-832Gordinier, M.E., Malpica, A., Burke, T.W., Bodurka, D.C., Wolf, J.K., Jhingran, A., Groin recurrence in patients with vulvar cancer with negative nodes on superficial inguinal lymphadenectomy (2003) Gynecol Oncol, 90, pp. 625-628Tilmans, A.S., Sutton, G.P., Look, K.Y., Sethman, F.B., Ehrilich, C.E., Hornback, N.B., Recurrent squamous carcinoma of the vulva (1992) Am J Obstet Gynecol, 167, pp. 1383-1389Levenback, C., Burke, T.W., Gershenson, D.M., Morris, M., Malpica, A., Ross, M.I., Intraoperative lymphatic mapping for vulvar cancer (1994) Obstet Gynecol, 84, pp. 163-167Terada, K.Y., Shimizu, D.M., Wong, J.H., Sentinel node dissection and ultrastaginc in squamous cell cancer of the vulva (2000) Gynecol Oncol, 76, pp. 40-4

Erbb-2 Expression And Hormone Receptor Status In Areas Of Transition From In Situ To Invasive Ductal Breast Carcinoma [expressão Da Proteína Erbb-2 E Dos Receptores De Hormônios Na Transição Das Regiões In Situ Para Invasora De Tumores Da Mama]

PURPOSE: to evaluate the expression of erbB-2 and of the estrogen and progesterone (ER/P) hormonal receptors in the transition regions between the in situ and the invasive fractions of ductal breast neoplasia (ISDC and IDC, respectively). METHODS: Eighty-five cases of breast neoplasia, containing contiguous ISDC and IDC areas, were selected. Histological specimens from the ISDC and the IDC areas were obtained through the tissue microarray (TMA) technique. The erbB-2 and the ER/PR expressions were evaluated through conventional immunohistochemistry. The McNemar's test was used for the comparative analysis of the expressions of erbB-2 protein and the ER/PR in the in situ and invasive regions of the tumors. The confidence intervals were set to 5% (p=0.05). Intraclass correlation coefficients (ICC) were calculated to assess the cross-tabulation agreement of the erbB-2 and the ER/PR expression in the ISDC and the IDC areas. RESULTS: the erbB-2 expression has not differed between the ISDC and the IDC areas (p=0.38). Comparing the two areas in each case, there was agreement in the expression of erbB-2 (ICC=0.64), PR (ICC=0.71) and ER (ICC=0.64). Restricting the analysis to tumors with the in situ component harboring necrosis (comedo), the ICC for erbB-2 was 0.4, compared to 0.6 for the whole sample. In this select group, the ICC for PR/ER did not differ substantially from those obtained with the complete dataset: as for the ER, ICC=0.7 (versus 0.7 for the entire sample) and for PR, ICC=0.7 (versus 0.6 for the entire sample). CONCLUSIONS: our findings suggest that the erbB-2 and the ER/PR expressions do not differ in the contiguous in situ and invasive components of breast ductal tumors.319461467Schnitt, S.J., The transition from ductal carcinoma in situ to invasive breast cancer: The other side of the coin (2009) Breast Cancer Res., 11 (1), p. 101Wiechmann, L., Kuerer, H.M., The molecular journey from ductal carcinoma in situ to invasive breast cancer (2008) Cancer, 112 (10), pp. 2130-42Skinner, K.A., Silverstein, M.J., The management of ductal carcinoma in situ of the breast (2001) Endocr Relat Cancer, 8 (1), pp. 33-45(2008) Drogas de alvo molecular na oncologia e hematologia [Internet], , http://www.nibsemabs.com.br/bases.asp?id=1, Nibs & Mabs, citado 2008 Set 6, Disponível emLatta, E.K., Tjan, S., Parkes, R.K., O'Malley, F.P., The role of HER2/neu overexpression/amplification in the progression of ductal carcinoma in situ to invasive carcinoma of the breast (2002) Mod Pathol., 15 (12), pp. 1318-25Hussein, M.R., Abd-Elwahed, S.R., Abdulwahed, A.R., Alterations of estrogen receptors, progesterone receptors and c-erbB2 oncogene protein expression in ductal carcinomas of the breast (2008) Cell Biol Int., 32 (6), pp. 698-707Heldring, N., Pike, A., Andersson, S., Matthews, J., Cheng, G., Hartman, J., Estrogen receptors: How do they signal and what are their targets (2007) Physiol Rev., 87 (3), pp. 905-31Provenzano, E., Hopper, J.L., Giles, G.G., Marr, G., Venter, D.J., Armes, J.E., Biological markers that predict clinical recurrence in ductal carcinoma in situ of the breast (2003) Eur J Cancer, 39 (5), pp. 622-30Wärnberg, F., Nordgren, H., Bergkvist, L., Holmberg, L., Tumour markers in breast carcinoma correlate with grade rather than with invasiveness (2001) Br J Cancer, 85 (6), pp. 869-74Gusterson, B.A., Machin, L.G., Gullick, W.J., Gibbs, N.M., Powles, T.J., Price, P., Immunohistochemical distribution of c-erbB-2 in infiltrating and in situ breast cancer (1988) Int J Cancer, 42 (6), pp. 842-5Park, K., Han, S., Kim, H.J., Kim, J., Shin, E., HER2 status in pure ductal carcinoma in situ and in the intraductal and invasive components of invasive ductal carcinoma determined by fluorescence in situ hybridization and immunohistochemistry (2006) Histopathology, 48 (6), pp. 702-7Sauter, G., Lee, J., Bartlett, J.M., Slamon, D.J., Press, M.F., Guidelines for human epidermal growth factor receptor 2 testing: Biologic and methodologic considerations (2009) J Clin Oncol., 27 (8), pp. 1323-33http://cran.r-project.org/doc/manuals/refman.pdf, The R Development Core Team. R: a language and environment for statistical computing: reference index [Internet]. Vienna: R Foundation for Statistical Computing2009 [cited 2009 Apr 20]. Available fromMoasser, M.M., The oncogene HER2: Its signaling and transforming functions and its role in human cancer pathogenesis (2007) Oncogene, 26 (45), pp. 6469-87Castro, N.P., Osorio, C.A., Torres, C., Bastos, E.P., Mourão-Neto, M., Soares, F.A., Evidence that molecular changes in cells occur before morphological alterations during the progression of breast ductal carcinoma (2008) Breast Cancer Res., 10 (5), pp. R87Soomro, S., Shousha, S., Taylor, P., Shepard, H.M., Feldmann, M., C-erbB-2 expression in different histological types of invasive breast carcinoma (1991) J Clin Pathol, 44 (3), pp. 211-4Sommerville, J.E., Clarke, L.A., Biggart, J.D., c-erbB-2 overexpression and histological type of in situ and invasive breast carcinoma (1992) J Clin Pathol., 45 (1), pp. 16-20Iglehart, J.D., Kerns, B.J., Huper, G., Marks, J.R., Maintenance of DNA content and erbB-2 alterations in intraductal and invasive phases of mammary cancer (1995) Breast Cancer Res Treat, 34 (3), pp. 253-63Man, Y.G., Zhang, Y., Shen, T., Zeng, X., Tauler, J., Mulshine, J.L., cDNA expression profiling reveals elevated gene expression in cell clusters overlying focally disrupted myoepithelial cell layers: Implications for breast tumor invasion (2005) Breast Cancer Res Treat, 89 (2), pp. 199-208Man, Y.G., Shen, T., Weisz, J., Berg, P.E., Schwartz, A.M., Mulshine, J.L., A subset of in situ breast tumor cell clusters lacks expression of proliferation and progression related markers but shows signs of stromal and vascular invasion (2005) Cancer Detect Prev, 29 (4), pp. 323-31Bose, S., Lesser, M.L., Norton, L., Rosen, P.P., Immunophenotype of intraductal carcinoma (1996) Arch Pathol Lab Med., 120 (1), pp. 81-5Moreno, A., Lloveras, B., Figueras, A., Escobedo, A., Ramon, J.M., Sierra, A., Ductal carcinoma in situ of the breast: Correlation between histologic classifications and biologic markers (1997) Mod Pathol., 10 (11), pp. 1088-92Mack, L., Kerkvliet, N., Doig, G., O'Malley, F.P., Relationship of a new histological categorization of ductal carcinoma in situ of the breast with size and the immunohistochemical expression of p53, c-erb B2, bcl-2, and ki-67 (1997) Hum Pathol, 28 (8), pp. 974-9Meijnen, P., Peterse, J.L., Antonini, N., Rutgers, E.J., van de Vijver, M.J., Immunohistochemical categorisation of ductal carcinoma in situ of the breast (2008) Br J Cancer, 98 (1), pp. 137-42Kononen, J., Bubendorf, L., Kallioniemi, A., Bärlund, M., Schraml, P., Leighton, S., Tissue microarrays for high-throughput molecular profiling of tumor specimens (1998) Nat Med, 4 (7), pp. 844-

The New Classification Of Breast Cancers: Finding The Luminal A [nova Classificação Dos Carcinomas Da Mama: Procurando O Luminal A]

PURPOSE: To compare the distributions of patients with clinical-pathological subtypes of luminal B-like breast cancer according to the 2011 and 2013 St. Gallen International Breast Cancer Conference Expert Panel. METHODS: We studied 142 women with breast cancer who were positive to estrogen receptor and had been treated in São Paulo state, southeast Brazil. The expression of the following receptors was assessed by immunohistochemistry: estrogen, progesterone (PR) and Ki-67. The expression of HER-2 was measured by fluorescent in situ hybridization analysis in tissue microarray. RESULTS: There were 29 cases of luminal A breast cancers according to the 2011 St. Gallen International Breast Cancer Conference Expert Panel that were classified as luminal B-like in the 2013 version. Among the 65 luminal B-like breast cancer cases, 29 (45%) were previous luminal A tumors, 15 cases (20%) had a Ki-67 >14% and were at least 20% PR positive and 21 cases (35%) had Ki-67 >14% and more than 20% were PR positive. CONCLUSIONS: The 2013 St. Gallen consensus updated the definition of intrinsic molecular subtypes and increased the number of patients classified as having luminal B-like breast cancer in our series, for whom the use of cytotoxic drugs will probably be proposed with additional treatment cost.3612575580(2013) GLOBOCAN 2012: Estimated cancer incidence, mortality and prevalence worldwide in 2012 [Internet], , http://globocan.iarc.fr, International Agency for Research on Cancer (IARC), Lyon: International Agency for Research on Cancer, [cited 2014 Jan 24]. Available from(2013) Ministério da Saúde. Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA). INCA e Ministério da Saúde apresentam estimativas de câncer para 2014 [Internet], , http://www2.inca.gov.br/wps/wcm/connect/agencianoticias/site/home/noticias/2013/inca_ministerio_saude_apresentam_estimativas_cancer_2014, Brasil, Rio de Janeiro: INCA, [citado 2014 Jan 24]. Disponível emColozza, M., Azambuja, E., Cardoso, F., Sotiriou, C., Larsimont, D., Piccard, M.J., Proliferative markers as prognostic and predictive tools in early breast cancer: Where are we now? (2005) Ann Oncol, 16 (11), pp. 1723-1739Parker, J.S., Mullins, M., Cheang, M.C., Leung, S., Voduc, D., Vickery, T., Supervised risk predictor of breast cancer based on intrinsic subtypes (2009) J Clin Oncol, 27 (8), pp. 1160-1167Albain, K.S., Barlow, W.E., Shak, S., Hortobagyi, G.N., Livingston, R.B., Yeh, I.T., Prognostic and predictive value of the 21-gene recurrence score assay in postmenopausal women with node-positive, oestrogenreceptor-positive breast cancer on chemotherapy: A retrospective analysis of a randomised trial (2010) Lancet Oncol, 11 (1), pp. 55-65Nielsen, T.O., Parker, J.S., Leung, S., Voduc, D., Ebbert, M., Vickery, T., A comparison of PAM50 intrinsic subtyping with immunohistochemistry and clinical prognostic factors in tamoxifen-treated estrogen receptor-positive breast cancer (2010) Clin Cancer Res, 16 (21), pp. 5222-5232Cheang, M.C., Chia, S.K., Voduc, D., Gao, D., Leung, S., Snider, J., KI67 index, HER2 status, and prognosis of patients with luminal B breast cancer (2009) J Natl Cancer Inst, 101 (10), pp. 736-750Parker, J.S., Mullins, M., Cheang, M.C., Leung, S., Voduc, D., Vickery, T., Supervised risk predictor of breast cancer based on intrinsic subtypes (2009) J Clin Oncol, 27 (8), pp. 1160-1167Bastien, R.R., Rodríguez-Lescure, A., Ebbert, M.T., Prat, A., Munárriz, B., Rowe, L., PAM50 breast cancer subtyping by RT-qPCR and concordance with standard clinical molecular markers (2012) BMC Med Genomics, 5, p. 44Goldhirsch, A., Winer, E.P., Coates, A.S., Gelber, R.D., Piccart-Gebhart, M., Thürlimann, B., Personalizing the treatment of women with early breast cancer: Highlights of the St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer (2013) Ann Oncol, 24 (9), pp. 2206-2223Goldhirsch, A., Wood, W.C., Coates, A.S., Gelber, R.D., Thürlimann, B., Senn, H.J., Strategies for subtypes - dealing with the diversity of breast cancer: Highlights of the St. Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2011 (2011) Ann Oncol, 22 (8), pp. 1736-1747Prat, A., Cheang, M.C., Martín, M., Parker, J.S., Carrasco, E., Caballero, R., Prognostic significance of progesterone receptor-positive tumor cells within immunohistochemically defined luminal A breast cancer (2013) J Clin Oncol, 31 (2), pp. 203-209Tavassoeli, F.A., Devilee, P., (2003) Pathology and genetics of tumours of the breast and female genital organs, , 3rd ed. Lyon: IARCHammond, M.E., Hayes, D.F., Dowsett, M., Allred, D.C., Hagerty, K.L., Badve, S., American Society of Clinical Oncology/College of American Pathologists guideline recommendations for immunohistochemical testing of estrogen and progesterone receptors in breast cancer (unabridged version) (2010) Arch Pathol Lab Med, 134 (7), pp. e48-e72Dowsett, M., Nielsen, T.O., A’hern, R., Bartlett, J., Coombes, R.C., Cuzick, J., Assessment of Ki67 in breast cancer: Recommendations from the international Ki67 in Breast Cancer working group (2011) J Natl Cancer Inst, 103 (22), pp. 1656-1664Middleton, L.P., Price, K.M., Puig, P., Hevdon, L.J., Tarco, E., Sneige, N., Implementation of American Society of Clinical Oncology/College of American Pathologists HER2 Guideline Recommendations in a tertiary care facility increases HER2 immunohistochemistry and fluorescence in situ hybridization concordance and decreases the number of inconclusive cases (2009) Arch Pathol Lab Med, 133 (5), pp. 775-780Paik, S., Shak, S., Tang, G., Kim, C., Baker, J., Cronin, M., A multigene assay to predict recurrence of tamoxifen-treated, node-negative breast cancer (2004) N Engl J Med, 351 (27), pp. 2817-2826Habel, L.A., Shak, S., Jacobs, M.K., Capra, A., Alexander, C., Pho, M., A population-based study of tumor gene expression and risk of breast cancer death among lymph node-negative patients (2006) Breast Cancer Res, 8 (3), p. R25Buyse, M., Loi, S., Van’T, L.V., Viale, G., Delorenzi, M., Glas, A.M., Validation and clinical utility of a 70-gene prognostic signature for women with node-negative breast cancer (2006) J Natl Cancer Inst, 98 (17), pp. 1183-1192Goncalves, R., Bose, R., Using multigene tests to select treatment for early-stage breast cancer (2013) J Natl Compr Canc Netw, 11 (2), pp. 174-182Ellis, M.J., Perou, C.M., The genomic landscape of breast cancer as a therapeutic roadmap (2013) Cancer Discov, 3 (1), pp. 27-3

Image Compression Impact On Quantitative Angiogenesis Analysis Of Ovarian Epithelial Neoplasms

Objective: This study aims to investigate the impact of digital image compression on manual and semiautomatic quantification of angiogenesis in ovarian epithelial neoplasms (including benign, borderline, and malignant specimens). Design: We examined 405 digital images (obtained from a previously validated computer-assisted analysis system), which were equally divided into 5 groups: images captured in Tagged Image File Format (TIFF), low and high compression Joint Photographic Experts Group (JPEG) formats, and low and high compression JPEG images converted from the TIFF files. Measurements: Microvessel density counts and CD34 endothelial areas manually and semiautomatically determined from TIFF images were compared with those from the other 4 groups. Results: Mostly, the correlations between TIFF and JPEG images were very high (intraclass correlation coefficients >0.8), especially for low compression JPEG images obtained by capture, regardless of the variable considered. The only exception consisted in the use of high compression JPEG files for semiautomatic microvessel density counts, which resulted in intraclass correlation coefficients of 3.0. CO;2-RHasan, J., Byers, R., Jayson, G.C., Intra-tumoural microvessel density in human solid tumours (2002) British Journal of Cancer, 86 (10), pp. 1566-1577. , DOI 10.1038/sj.bjc.6600315López, C.L., Effects of image compression on automatic count of immunohistochemically stained nuclei in digital images (2008) J Am Med Inform Assoc, 15, pp. 794-798Tengowski, M.W., Image Compression in Morphometry Studies Requiring 21 CFR Part 11 Compliance: Procedure Is Key with TIFFs and Various JPEG Compression Strengths (2004) Toxicologic Pathology, 32 (2), pp. 258-263. , DOI 10.1080/01926230490274399Landis, J.R., Koch, G.G., The measurement of observer agreement for categorical data (1977) Biometrics, 33 (1), pp. 159-174Montgomery, D.C., Peck, E.A., (1982) Introduction to Linear Regression Analysis, , New York: John Wiley and Sons In

Prevalence Of Genital Hpv Infection Among Women Screened For Cervical Cancer [prevalência Do Hpv Em Mulheres Rastreadas Para O Câncer Cervical]

Objective: To assess the prevalence of high-risk genital human papillomavirus (HPV) infection by age group and risk factors associated. Methods: Cross-sectional study in a sample of 2,300 women (15-65 years old) who self-referred to cervical cancer screening in Sao Paulo and Campinas, Southeastern Brazil, between February 2002 and March 2003. An epidemiological questionnaire was applied and cervical specimens were obtained for cytology and hybrid capture II test (HCII) for HPV detection. Statistical analysis included Pearson Chi-square and unconditional multiple logistic regression model (forward likelihood ratio). Results: High-risk genital HPV infection prevalence in this sample was 17.8% and age distribution was as follows: 27.1% (<25 years), 21.3% (25-34 years), 12.1% (35-44 years), 12.0% (45-54 years) and 13.9% (55-65 years). Subjects with the highest number of lifetime sexual partners had the highest rates of genital HPV infection. To be living with a partner, aged 35 to 44 years, and former smokers were protective factors. High-risk genital HPV infection was 14.3% in normal cytology, 77.8% in high grade squamous intraepithelial lesions and in the two cases (100%) of cervical cancer. Conclusions: High-risk HPV prevalence was high in the sample studied. The highest prevalence of HPV infection was seen in women under 25 years old and then a new increase was seen over the age of 55 and the highest rates were found among those with many sexual partners during their lifetime.421123130Baseman, J.G., Koutsky, L.A., The epidemiology of human papillomavirus infections (2005) J Clin Virol, 32 (SUPPL. 1), pp. S16-S24Bauer, H.M., Hildesheim, A., Schiffman, M.H., Glass, A.G., Rush, B.B., Scott, D.R., Determinants of genital human papillomavirus infection in low-risk women in Portland, Oregon (1993) Sex Transm Dis, 20 (5), pp. 274-278Bosch, F.X., Lorincz, A., Muñoz, N., Meijer, C.J., Shah, K.V., The causal relation between human papillomavirus and cervical cancer (2002) J Clin Pathol, 55 (4), pp. 244-265Burk, R.D., Kelly, P., Feldman, J., Bromberg, J., Vermund, S.H., DeHovitz, J.A., Declining prevalence of cervicovaginal human papillomavirus infection with age is independent of other risk factors (1996) Sex Transm Dis, 23 (4), pp. 333-341Castle, P.E., Schiffman, M., Herrero, R., Hildesheim, A., Rodriguez, A.C., Bratti, M.C., A prospective study of age trends in cervical human papillomavirus acquisition and persistence in Guanacaste, Costa Rica (2005) J Infect Dis, 191 (11), pp. 1808-1816Clifford, G.M., Gallus, S., Herrero, R., Munñoz, N., Snijders, P.J.F., Vaccarella, S., Worldwide distribution of Human papillomavirus types in cytologically normal women in the International Agency for Research on Cancer HPV prevalence surveys: A pooled analysis (2005) Lancet, 366 (9490), pp. 991-998Eluf-Neto, J., Nascimento, C.M., Cervical cancer in Latin America (2001) Semin Oncol, 28 (2), pp. 188-197Ferreccio, C., Prado, R.B., Luzoro, A.V., Ampuero, S.L., Snijders, P.J., Meijer, C.J., Population-based prevalence and age distribution of human papillomavirus among women in Santiago, Chile (2004) Cancer Epidemiol Biomarkers Prev, 13 (12), pp. 2271-2276Franco, E.L., Villa, L.L., Sobrinho, J.P., Prado, J.M., Rousseau, M.C., Désy, M., Epidemiology of acquisition and clearance of cervical human papillomavirus infection in women from a high-risk area for cervical cancer (1999) J Infect Dis, 180 (5), pp. 1415-1423Giuliano, A.R., Papenfuss, M., Abrahamsen, M., Denman, C., Zapien, J.G., Henze, J.L., Human papillomavirus infection at the United States-Mexico border (2001) Cancer Epidemiol Biomarkers Prev, 10 (11), pp. 1129-1136Giuliano, A.R., Papenfuss, M.R., Denman, C.A., Guemsey de Zapien, J., Abrahamsen, M., Hunter, J.B., Human papillomavirus prevalence at the USA - Mexico Border among women 40 years of age and older (2005) Int J STD AIDS, 16 (3), pp. 247-251Herrero, R., Hildesheim, A., Bratti, C., Sherman, M.E., Hutchinson, M., Morales, J., Population based study of hpv infection and cervical neoplasia in rural Costa Rica (2000) J Natl Cancer Inst, 92 (6), pp. 464-474Herrero, R., Castle, P.E., Schiffman, M., Bratti, M.C., Hildesheim, A., Morales, J., Epidemiologic profile of type-specific human papillomavirus infection and cervical neoplasia in Guanacaste, Costa Rica (2005) J Infect Dis, 191 (11), pp. 1796-1807Hosmer, D.W., Lemeshow, S., (1989) Applied logistic regression, , New York: Wiley;Kjaer, S.K., Svare, E.I., Worm, A.M., Walboomers, J.M., Meijer, C.J., Van den Brule, A.J., Human papillomavirus infection in Danish female sex workers: Decreasing prevalence with age despite continuously high sexual activity (2000) Sex Transm Dis, 27 (8), pp. 438-445Lazcano-Ponce, E., Herrero, R., Muñoz, N., Cruz, A., Shah, K.V., Alonso, P., Epidemiology of HPV infection among Mexican women with normal cervical cytology (2001) Int J Cancer, 91 (3), pp. 412-420Lorincz, A.T., Screening for cervical cancer: New alternatives and research (2003) Salud Publica Mex, 45 (SUPPL. 3), pp. S376-S387Matos, E., Loria, D., Amestoy, G.M., Herrera, L., Prince, M.A., Moreno, J., Prevalence of human papillomavirus infection among women in Concórdia, Argentina: A population-based study (2003) Sex Transm Dis, 30 (8), pp. 593-599Rama, C.H., Roteli-Martins, C.M., Derchain, S.F.M., Oliveira, E.Z., Mariani-Neto, C., Aldrighi, J.M., Detecção sorológica de anti HPV 16 e 18 e sua associação com achados do Papanicolaou em adolescentes e mulheres jovens. (2006) Rev Assoc Med Bras, 52 (1), pp. 43-47Sanjose, S., Almirall, R., Lloveras, B., Font, R., Diaz, M., Muñoz, N., Cervical human papillomavirus infection in the female population in Barcelona, Spain (2003) Sex Transm Dis, 30 (10), pp. 788-793Solomon, D., Davey, D., Kurman, R., Moriarty, A., O'Connor, D., Prey, M., The 2001 Bethesda System: Terminology for reporting results of cervical cytology (2002) JAMA, 287, pp. 2114-2119Syrjänen, K., Naud, P., Derchain, S., Roteli-Martins, C., Longatto-Filho, A., Tatti, S., Comparing Pap smear cytology, aided visual inspection, screening colposcopy, cervicography and HPV testing as optional screening tools in Latin America. Study design and baseline data of the LAMS study (2005) Anticancer Res, 25 (5), pp. 3469-3480Thomas, J.O., Herrero, R., Omigbodun, A.A., Ojemakinde, K., Ajayi, I.O., Fawole, A., Prevalence of papillomavirus infection in women in Ibadan, Nigeria: A population-based study (2004) Br J Cancer, 90 (3), pp. 638-645Trottier, H., Franco, E.L., The. epidemiology of genital human papillomavirus infection (2006) Vaccine, 24 (SUPPL. 1), pp. S1-15Walboomers, J.M.M., Jacobs, M.V., Manos, M.M., Bosch, F.X., Kummer, J.A., Shah, K.V., Human papillomavirus is a necessary cause of invasive cervical cancer worldwide (1999) J Pathol, 189 (1), pp. 12-1