Resumen

NOBUYOSHI KANESHIMA, Edilson et al. The application and its importance in non-classic morphologic approaches to cytopathology diagnostic of Human Papillomavirus (HPV) previously detected for PCR. Acta bioquím. clín. latinoam. [online]. 2005, vol.39, n.1, pp.61-68. ISSN 0325-2957.

There is great concern at present over the improvement in cytopathology diagnosis for HPV, and for this reason we have been studying the introduction of non-classic morfologic approaches, bearing in mind the high frequency of this viral infection as well as its carcinogenic potential. The object of this work is to make a new reading of 41 positive cases for HPV by PCR, introducing non-classic approaches, where as the initial ones were mad simply based on the classic ones. The most frequently observed cytopathology approaches were the non-classic, being two or many nucleuses the most frequent, with n = 37 (90.24%), followed by hypercromatic nucleus with n = 35 (85.36%) and nucleus in blot, with n = 24 (58.54%). In relation to the classic approaches, diskeratosis was observed in n = 17 cases (41.46%) and koilocytosis n= 10 (24.35%), representing the fourth and ninth approaches in numeric order of observation. It was also made clear that the more advanced the lesion diagnosed by the citopatology, the lower the frequency of classic criteria and the higher the frequency of non-classic criteria. After inclusion of the non classic approaches, diagnosis of HPV rose from 24.39% of the cases to 75.61% of the cases, being 40.00% of ASCUS and 100.00% of NIC I, NIC II, NIC III and cervical cancers became positive for the virus. This fact is of the highest importance for the improvement of the cytopathology services used to trace cervical cancers. Even so, the only normal case for the cytology, the two inflammatory cases, the four cases of scamous metaplasia and the three cases out of five cases of ASCUS remained negative for HPV, representing false-negative tests. That is quite preoccupying since, once patient are carriers of virus, independent of the clinical state, they haver higher probabilities of developing precursor lesions and even cervical cancers.

Palabras clave : HPV; PCR; Non-classics approaches.

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