Revista Colombiana de Obstetricia y Ginecología (Jan 2004)
Concordancia diagnóstica entre la citología cervicovaginal, la biopsia de cérvix y la histerectomía en pacientes con NIC en el Hospital Erasmo Meoz de Cúcuta, Colombia Diagnostic concordance between cervico-vaginal cytology, cervix biopsy and hysterectomy in patients with Cervical Intraepithelial Neoplasia at the Erasmo Meoz Hospital in Cucuta, Colombia
Abstract
Entre diciembre 15 de 2001 y agosto 30 de 2002 se practicaron 433 histerectomías en el Hospital Erasmo Meoz de Cúcuta, 130 de ellas con diagnóstico preoperatorio de neoplasia intraepitelial cervical de diverso grado. Se compara el diagnóstico citopatológico con el histopatológico y se calcula el porcentaje: neoplasia intraepitelial cervical 1: 38,3%, neoplasia intraepitelial cervical 2: 50% y neoplasia intraepitelial cervical 3: 77% y el coeficiente Kappa, 0,33: bajo. Para biopsia versus histerectomía el porcentaje de acuerdo es: neoplasia intraepitelial cervical 1: 47,6%; neoplasia intraepitelial cervical 2: 37,1% y neoplasia intraepitelial cervical 3: 70,6%. El coeficiente Kappa es 0,57: moderado. Se presentan las normas actuales del Ministerio de Salud para el manejo de la neoplasia intraepitelial cervical y se hacen recomendaciones para mejorar la calidad de la atención médica, destacando la necesidad de seguir normas y correlacionar métodos diagnósticos.During eight and a half months, 433 hysterectomies were performed at the Erasmo Meoz Hospital. The diagnoses revealed that 132 (30,5%) of them were squamous intraepithelial lesions of the cervix. The calculated rate of agreement between cytologic and histologic diagnoses is 36% for cervical intraepithelial neoplasia 1, 50% for cervical intraepithelial neoplasia 2 and 77% for cervical intraepithelial neoplasia 3. The Kappa value is 0,32 for cytology vs. biopsy. The rate of agreement between the biopsy and the hysterectomy is 47,6% for cervical intraepithelial neoplasia 1, 37,1% for cervical intraepithelial neoplasia 2 and 70,6% for cervical intraepithelial neoplasia 3; the Kappa value is 0,57. The current policies of the Ministry of Health regarding the management of these lesions are presented and a review of the nomenclature is made.
