Colposcopia digital en la neoplasia cervical intraepitelial. Correlación histológica y utilidad clínica

Puig-Tintoré, L.M.; Torné, A.

doi:10.1016/S0304-5013(01)75704-4

Información del artículo

Resumen

Bibliografía

Descargar PDF

Estadísticas

Resumen

Objetivo

Determinar, en la neoplasia cervical intraepitelial (CIN), la correlación histológica de la información morfométrica obtenida mediante un sistema original de colposcopia digital, y establecer sus posibles aplicaciones clínicas

Métodos

En 101 pacientes con colposcopia valorable se midió el área de la zona de transformación y de las lesiones colposcópicas. En 62 casos, en los que se practicó exéresis de la lesión con asa, estos datos se correlacionaron con la extensión de las lesiones histológicas

Resultados

A mayor grado histológico las lesiones cervicales incrementan significativamente su tamaño colposcópico (CIN-I, CIN-II, CIN-III: 90mm2, 134mm2, 265mm2, respectivamente) y ocupan una disposición más central en el cérvix. Existe una muy buena correlación, cercana al 85%, con el tamaño medido mediante morfometría histológica

Conclusiones

El tamaño de la lesión colposcópica de la CIN es un buen indicador del verdadero tamaño lesional. Estos resultados abren una nueva perspectiva en la conducta a seguir en las lesiones de bajo grado, al ofrecer un método objetivo y fiable para controlar su evolución

Palabras clave:

Colposcopia

Análisis de imagen

CIN

Morfometría

Historia natural

Summary

Objective

To determine the histological correlation of morphometric information obtained through an original digital colposcopy system in cervical intraepithelial neoplasia (CIN) and to establish its possible clinical applications

Methods

The size of the transformation zone and of colposcopic lesions was measured in 101 patients with evaluable colposcopy. In the 62 patients who underwent loop excision of the lesion these data were correlated with histologic lesion size

Results

The size of colposcopic lesions significantly increased with histologic grade (CIN-I, CIN-II, CIN-III: 90mm2, 134mm2 and 265mm2, respectively) and their location in the cervix was more central. A good correlation, nearly 85%, was found with size measured by histologic morphometry

Conclusions

The size of colposcopic CIN lesions is a good indicator of true lesion size. These results provide a new perspective on the management of low-grade lesions by offering an objective and reliable method for controlling their evolution

keywords:

Colposcopy

Image processing

Cervical intraepithelial neoplasia

Morphometry

Natural history

El Texto completo está disponible en PDF

Bibliografía

[1.]

J.L. Benedet, H. Bender, I.I.I. Jones H, H.Y.S. Ngan, S. Pecorelli.

FIGO staging classifications in the management of gynecologic cancers.

Int J Gynecol Obstet, 70 (2000), pp. 209-262

[2.]

L.M. Puig Tintoré, A. Torné.

Colposcopia digital. Técnica, aplicaciones y perspectivas futuras.

Prog Obstet Ginecol, 40 (1997), pp. 89-99

[3.]

L.M. Puig-Tintoré, J. Galcerán, A. Torné, A. Grau, L.M. Puig Soler.

Sistema integrado de base de datos clínicos e imágenes colposcópicas, en la prevención del cáncer del tracto genital inferior de la mujer.

Libro de Actas, XVIII Congreso de la Sociedad Española de Ingeniería Biomédica. Cartagena, 27–29 septiembre, pp. 291-294

[4.]

International Federation of Cervical Pathology and Colposcopy IFCPC.

International colposcopic terminology, mayo, (1990),

[5.]

E. Burghardt.

Extent of Atypical Cervical Epithelium. En Burghardt E.

Early histological diagnosis of cervical cancer, pp. 44-45

[6.]

F.W. Abdul-Karim, Y.S. Fu, J.W. Reagan, W.B. Wentz.

Morphometric study of intraepithelial neoplasia of the uterine cervix.

Obstet Gynecol, 60 (1982), pp. 210-214

Medline

[7.]

M.R. Jarmulowicz, D. Jenkins, S.E. Barton, A.L. Goodall, A. Holingworth, A. Singer.

Cytological status and lesion size: a further dimension in cervical neoplasia.

Br J Obstet Gynaecol, 96 (1989), pp. 1061-1066

Medline

[8.]

M.I. Shafi, C.B. Finn, D.M. Luesley.

Lesion size and histology of atypical cervical transformation zone.

Br J Obstet Gynaecol, 98 (1991), pp. 490-492

Medline

[9.]

P. Tidbury, A. Singer, D. Jenkins.

CIN 3: the role of lesion size in invasion.

Br J Obstet Gynaecol, 99 (1992), pp. 583-586

Medline

[10.]

G.F. Brunton, T.E. Wheldon.

The Gompertz equation and the construction of tumour growth curves.

Cell Tissue Kinet, 13 (1980), pp. 455-460

Medline

[11.]

O. Kierkegaard, C. Byrjalen, K.C. Hansen, K.H. Frandsen, M. Frydenberg.

Association between colposcopic findings and histology in cervical lesions: the significance of the size of the lesion.

Gynecol Oncol, 57 (1995), pp. 66-71

Medline

[12.]

S.E. Furber, E. Weisberg, J.M. Simpson.

Progression and regression of low-grade epithelial abnormalities of the cervix.

Aust N Z J Obstet Gynaecol, 37 (1997), pp. 107-112

Medline

[13.]

A. Torné.

Colposcopia digital en las lesiones premalignas de cuello uterino.

Morfometría y análisis de imagen [Tesis doctoral]. Universidad de Barcelona, (febrero 2000),

[14.]

S.E. Barton, D. Jenkins, A. Hollingworth, J. Cuzick, A. Singer.

An explanation to the problem of false-negative cervical smears.

Br J Obstet Gynecol, 96 (1989), pp. 482-485

[15.]

E.J. Buxton, D.M. Luesley, M.I. Shafi, M. Rollason.

Colposcopically directed punch biopsy: a potentially misleading investigation.

Brit J Obstet Gynaec, 98 (1991), pp. 1273-1276

Medline

[16.]

E. Guijon, M. Paraskevas, P. McNicol.

Human papillomavirus infection and the grade of cervical intraepithelial neoplastic lesions associated with failure of therapy.

Int J Gynecol Obstet, 42 (1993), pp. 137-142

[17.]

A. Torné, L.M. Puig Tintoré, P. Jou, E. Sánchez, J.A. Lejarcegui, J. Ordi, X. Iglesias.

Risk factors associated with failure of laser therapy in cervical intraepithelial neoplasia. The role of human papillomavirus infection and lesion size.

Abstracts 2nd International Congress of Papillomavirus in Human Pathology, París, (1994),

[18.]

M.S. Mikhail, I.R. Merkatz, S.L. Romney.

Clinical usefulness of computerized colposcopy: image analysis and conservative management of mild displasia.

Obstet Gynecol, 80 (1992), pp. 5-8

Medline

[19.]

M.S. Mikhail, A. Anyaegbunam, S.L. Romney.

Computerized colposcopy and conservative management of cervical intraepithelial neoplasia in pregnancy.

Acta Obstet Gynecol Scand, 74 (1995), pp. 376-378

Medline

[20.]

G.Y.F. Ho, R. Bierman, L. Beardsley, C.J. Chang, R.D. Burk.

Natural history of cervicovaginal papillomavirus infection in young women.

N Engl J Med, 338 (1998), pp. 423-428

http://dx.doi.org/10.1056/NEJM199802123380703 | Medline

[21.]

A.G. Östor.

Natural history of cervical intraepithelial neoplasia -a critical review.

Ing J Gynecol Pathol, 12 (1993), pp. 186-192

[22.]

K.J. Syrjänen.

Spontaneous evolution of intraepithelial lesions according to the grade and type of the implicated human papillomavirus (HPV).

Eur J Obstet Gynecol Reprod Biol, 65 (1996), pp. 45-53

Medline

[23.]

M.A.E. Nobbenhuis, J.M.M. Walboomers, T.J.M. Helmerhorst, L. Rozendaal, A.J. Remmink, E.K. Risse, et al.

Relation of human papillomavirus status to cervical lesions and consequences for cervical-cancer screening: a prospective study.

Lancet, 354 (1999), pp. 20-25

http://dx.doi.org/10.1016/S0140-6736(98)12490-X | Medline

[24.]

S.S.N. Lee, R.J. Collins, T.C. Pun, D.K.L. Cheng, H.Y.S. Ngan.

Conservative treatment of low grade squamous intraepithelial lesion (SIL) of the cervix.

Int J Gynecol Obstet, 60 (1998), pp. 35-40

Indexada en:

Síguenos:

Indexada en:

Síguenos:

Suscríbase a la newsletter