COEXAMEN CITOLOGIA-VPH : (I) : RESULTADOS DE UN ESTUDIO PROSPECTIVO DE 11 AÑOS (2008-2018)
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sep 27, 2023
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https://doi.org/10.36677/medicinainvestigacion.v11i2.20669
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Jorge López Olmos
http://orcid.org/0000-0001-8924-6100
http://orcid.org/0000-0001-8924-6100
Resumen
Objetivo: Presentamos los resultados de un estudio prospectivo de coexamen citología cervicovaginal – vph (virus del papiloma humano),en una serie de 1600 casos en los 11 años 2008-2018. Resultados: La media de edad fue 37,63 años (rango 16-69), la paridad media fue 1 (rango 0-7). Eran nuligestas 30,81 % y menopáusicas 5,31 %. Con antecedente de conización 8,43 %. En 26 casos eran vih(+), con virus de la inmunodeficiencia humana. Vacuna frente a vph tenian 2,43 %. En 54,56 % no utilizaban ningún método contraceptivo. La citología fue normal o negativa en 35,31 %. Hubo infecciones en 33 % (siendo la más frecuente por vaginosis bacteriana (vb) en 22,56 %). Hubo lesiones celulares cervicales en 31,68 %; ascus, 14,81 %; lsil, 13,18 %; hsil, 1,93 % y 4 casos de carcinoma epidermoide (0,25 %). El vphar(+) se dio en 42,06 %. (vph-16(+) en 17,02 %; vph-18(+) en 3,95 % y vph-otros(+) en 79,02 %). Citologia(+) y vph-ar(+), fue aumentando la frecuencia en relación a la gravedad de las lesiones : 60% en ascus, 75 % en lsil, 87 % en hsil y 100 % en carcinoma. En lesiones con vph negativo, ocurrió a la inversa. Con citología negativa estaban vacunadas de vph 4,25 %; con lesiones, ninguna estaba vacunada.
Conclusiones: Para la prevención del cáncer de cérvix, recomendamos primariamente la vacunación vph con 9 tipos antes del inicio de la vida sexual, y la detección de its (infecciones de trasmisión sexual), citología y vph-ar, para el cribado de las lesiones.
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LÓPEZ OLMOS, Jorge.
COEXAMEN CITOLOGIA-VPH : (I) : RESULTADOS DE UN ESTUDIO PROSPECTIVO DE 11 AÑOS (2008-2018).
Medicina e Investigación Universidad Autónoma del Estado de México, [S.l.], v. 11, n. 2, p. 17-25, sep. 2023.
ISSN 2594-0600.
Disponible en: <https://medicinainvestigacion.uaemex.mx/article/view/20669>. Fecha de acceso: 18 ago. 2026
doi: https://doi.org/10.36677/medicinainvestigacion.v11i2.20669.
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Esta obra está bajo licencia internacional Creative Commons Reconocimiento-NoComercial-SinObrasDerivadas 4.0.
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Krashias, G; Koptides, D Y Christodoulou, C.HPV prevalence and type distri-bution in Cypriot women with cervical cytological abnormalities. BMC Infect Dis. 2017; 17: 346-354.
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Bruhn, L.V; Andersen, S.J Y Hariri, J. HPV-testing versus HPV-cytology co-testing to predict the outcome after conization.Acta Obstet Gynecol Scand. 2018; 97: 758-765.
Ge, Y; Mody, R.R; Olsen; R.J; Zhou, H; Luna, ; Armylagos, D; Puntachart, N et al. HPV status in women with high-grade dys-plasia on cervical biopsy and preceding negative HPV tests.J Am Soc Cytopathol. 2019; 8: 149-156.
Tracht, J.M; Davis; A: O; Fascia-no, D.N y Eltoum, I-E. Discrep-ant HPV/cytology cotesting results: are there differences between cytology–negative versus HPV-negative cervi-cal intraepithelial neoplasia?Cancer Cytopathol. 2017. doi: 10.1002/ cncy.21905.
Rossi, P; Borghi, L; Ferro, R y Mencarelli, R. A population of 1136 HPV-DNA-HR positive women: expression of p16INK4a / Ki 67 dual stain cytology and cytological diagnosis. Histologi-cal correlations and cytological follow-up.Pathologica, 2015; 107: 185-191.
Crossley, B. Y Crossley, J.A review of the use of Human Papilloma Virus (HPV) in cervical screening.Br J Biomed Sci, 2017. doi.org/10.1080/09674845.2017.1332555.
Di Stefano, F; Rossi, P.G; Carozzi, F; Ronco, G; Cacciani, L; Vecchi, S; Naldoni, C; Segnan, Ne grouppo di lavoro MIDDIR. L ́implementazione del DNA-HPV come test primario nei programme italiani di screening del cervicocarcinoma. Risultati del Progetto MIDDIR. Epidemiol Prev. 2017; 41: 116-124.
Schiffman, M; Hyun, N; Raine-Bennett, T.R; Katki, H; Fetterman, B; Gace, J.C et als.A cohort study of cervical screening using partial HPV typing and cytology triage.Int J Cancer. 2016; 139: 2606-2615.
Koliopoulos, G; Nyaga, V.N; Santesso, N; Bryant, A; Martin-Hirsch, P.P.L; Mustafa, R.A; Schünemann, H; Paraskevaidis, E. y Arbyn, N.Cytology versus HPV testing for cervical cancer screening in the general population (review).Cochrane Database of Systematic Review. 2017. Doi: 10.1002 / 14651858.CD008587.pub2.
Lopez-Olmos, J. Infecciones vaginales y lesions celulares cervicales (I): Pro-grama de cribado de otras infecciones y ETS simultáneas. Clin Investí Gine-col Obstet. 2011; 38: 208-221.
Moresada, T; Teramoto, K; Takano, H; Sakamoto, I; Nishio, H; Iwata, T; Hashi, A; Katoh, R; Okamoto, A. et al. CITRUS, cervical cancer screening trial by randomization of HPV testing intervention for upcoming screening: design, methods and baseline data of 18471 women.Cancer Epidemiol. 2017; 50: 60-67.
Zhang, D; Li, T; Chen, L; Zhang, X; Zhao, G y Liu, Z.Epidemiological investigation of the relationship between common lower genital tract infections and high-risk human papillomavirus infections among women in Beijing, Chi-na.Plos One. 2017, doi.org /10.1371/journal.pone.0178033.
Lopez-Olmos, J. Detección de ITS (infecciones de trasmisión sexual) en mujeres afectas de ASCUS y LSIL en la citología cervicovaginal. Estudio prospectivo de 4 meses. Clin Invest Ginecol Obstet, 2019; 46: 115-121.
Li, K; Yin; R; Li, Q y Wang, D. Anal-ysis of HPV distribution in patients with cervical precancerous lesions in western China. Medicine. 2017; 96: 29(e7304).
Zhao, X-L; Hu, S-Y; Zhang, Q; Dong, L; Feng, R-M; Han, R Y Zhao, F-H. High-risk human papillomavirus genotype distribution and attribution to cervical cancer and precancerous lesions in a rural Chinese population.J Gynecol Oncol. 2017; 28: e-30, 1-11.
Sangrajrang, S; Laowahutanont, P; Wongsena, M; Muwonge, R; Karalak, A; Imsanran, W; Senkomago, V y Sankaranarayanan, R.Comparative accuracy of Pap smear and HPV screening in Ubon Ratchathani, in Thailand.Papillomavirus Res. 2017; 3: 30-35.
Phoolcharoen, N; Kantathavorn, N; Sricharunrat, T; Saeloo, S y Krongthong, W. A population-based study of cervical cytology findings and human papillomavirus infection in a suburban area of Thailand.Gynecol Oncol Reports. 2017; 21: 73-77.
Nah, E-H; Cho, S; Kim, S Y Cho, H-I.Human papillomavirus genotype distri-bution among 18.815 women in 13 Korean cities and relationship with cervi-cal cytology findings.Ann Lab Med. 2017; 37: 426-433.
Tay, S.K; Lin, L.E.O Y Goh, R.C.H.Detection rate of high-grade cervical neo-plasia and cost-effectiveness of high-risk human papillomavirus genotyping with reflex liquid-based cytology in cervical cancer screening.Ann Acad Med Singapore. 2017; 46: 1-7.
Krashias, G; Koptides, D Y Christodoulou, C.HPV prevalence and type distri-bution in Cypriot women with cervical cytological abnormalities. BMC Infect Dis. 2017; 17: 346-354.
Valim Duarte, D; Covre Vieira, R; Baia De Brito, E; Nascimento Pinheiro, Mª. C; Valente Monteiro, J.S; Rocha Valente, M.D. et al. Prevalence of human papillomavirus infection and cervical cancer screening among Riverside women of the Brazil-ian Amazon. Rev Bras Ginecol Obstet. 2017; 39: 350-357.
Dalgo Aguilar, P; Lojan Gonzalez, C; Cordova Rodriguez, A; Acurio Paez, K; Arevalo, A.P y Bobokova, J. Prevalence of high-risk genotypes of human papillomavirus: women diagnosed with premalignant and malignant Pap smear tests in Southern Ecuador.Infect Dis Obstet Gynecol. 2017. doi.org / 10.1155/ 2017/ 8572065.
Cuzick, J; Myer, O; Lee, J-H; Shi, Y; Gage, J.C; Hunt, W.C; Robertson, M; Wheeler, C-M for the New Mexico HPV Registry Strering Committee.Outcomes in women with cytology showing atypical squamous cells of undetermined significance with vs without human papillomavirus testing. JAMA Oncol. 2017; 3: 1327-1334.
Bruhn, L.V; Andersen, S.J Y Hariri, J. HPV-testing versus HPV-cytology co-testing to predict the outcome after conization.Acta Obstet Gynecol Scand. 2018; 97: 758-765.
Ge, Y; Mody, R.R; Olsen; R.J; Zhou, H; Luna, ; Armylagos, D; Puntachart, N et al. HPV status in women with high-grade dys-plasia on cervical biopsy and preceding negative HPV tests.J Am Soc Cytopathol. 2019; 8: 149-156.
Tracht, J.M; Davis; A: O; Fascia-no, D.N y Eltoum, I-E. Discrep-ant HPV/cytology cotesting results: are there differences between cytology–negative versus HPV-negative cervi-cal intraepithelial neoplasia?Cancer Cytopathol. 2017. doi: 10.1002/ cncy.21905.
Rossi, P; Borghi, L; Ferro, R y Mencarelli, R. A population of 1136 HPV-DNA-HR positive women: expression of p16INK4a / Ki 67 dual stain cytology and cytological diagnosis. Histologi-cal correlations and cytological follow-up.Pathologica, 2015; 107: 185-191.