Comparação entre o exame de detecção de Papiloma Vírus Humano no colo uterino e o desfecho das pacientes atendidas em ambulatório de colposcopia em um hospital público no Distrito Federal
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Apr 25, 2025
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Resumo
Objetivo: Realizar a correlação entre os resultados da autocoleta de DNA-HPV e as alterações citológicas e histológicas em pacientes de um ambulatório especializado. Métodos: Trata-se de um estudo retrospectivo, quantitativo, transversal, descritivo e observacional. Realizado com pacientes de 25 e 64 anos em um ambulatório de colposcopia de um hospital público do Distrito Federal, que apresentaram alterações em colpocitologias oncóticas e foram submetidas ao autoteste de DNA-HPV no período de maio de 2023 a maio de 2024. Resultados: Das 191 pacientes incluídas no presente estudo, 57,1% tinham entre 30 a 49 anos. O teste DNA-HPV foi detectado em 65,4% dos casos. Das pacientes DNA-HPV positivo, o resultado histopatológico mais prevalente foi NIC2/3. Essa relação foi estatisticamente significativa em pacientes de 30 a 49 (p-valor 0,049.) e acima de 50 anos (p- valor0,006 ), porém não em pacientes abaixo de 29 anos ( p- valor 0,164). Conclusão: O teste de HPV pode ser utilizado para direcionar o tratamento de pacientes com citologias alteradas, selecionando assim, aquelas com indicação de medidas mais ou menos invasivas.
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RauppD. R. L., SouzaS. M. de P., PinheiroB. L. M., LustosaC. R., GadelhaJ. T. de S., GonzattiP. H. F., RamosS. E. de P., SilvaH. T. C. S. O., & RauppJ. L. (2025). Comparação entre o exame de detecção de Papiloma Vírus Humano no colo uterino e o desfecho das pacientes atendidas em ambulatório de colposcopia em um hospital público no Distrito Federal. Revista Eletrônica Acervo Saúde, 25, e19902. https://doi.org/10.25248/reas.e19902.2025
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Referências
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7. DIMITROVA M, et al. Economic consequences of the implementation of primary DNA-HPV genotype testing in Bulgaria. Biotechnol Biotechnol Equip., 2024; 38(1): 2358134.
8. EFFAH K, et al. Cervical precancer screening using self-sampling, HPV DNA testing, and mobile colposcopy in a hard-to-reach community in Ghana: a pilot study. BMC Cancer, 2024; 24: 1367.
9. EKAWATI FM, et al. Cervical cancer screening program in Indonesia: is it time for HPV-DNA tests? Results of a qualitative study exploring the stakeholders’ perspectives. BMC Women's Health, 2024; 24: 125.
10. FONSECA FV, et al. Cervical Intraepithelial Neoplasia: Analyzing the Disease Present Exclusively in the Endocervical Canal. Revista Brasileira de Ginecologia e Obstetrícia, 2022; 44(4): 385–390.
11. GRCE M, DAVIES P. Human papillomavirus testing for primary cervical cancer screening. Expert Review of Molecular Diagnostics 2008; 8(5): 599-605.
12. GUPTA C, et al. Evaluating different samples & techniques for hr-HPV DNA genotyping to improve the efficiency of risk profiling for oral & cervical cancers in Sikkim, India. Indian J Med Res., 2024; 160(2): 226-235.
13. JANSEN EEL, et al. Effect of organisef cervical cancer mortality in Europe: a systematic review. Eur J Cancer, 2020; 127: 207-223.
14. JUNG Y, et al. Clinical factors that affect diagnostic discrepancy between colposcopically directed biopsies and loop electrosurgical excision procedure conization of the uterine cervix. Obstet Gynecol Sci., 2018; 61(4): 477–483.
15. KITTISIAM T, et al. Clinical Performance of Self-collected Specimen HPV-DNA vs Clinician-collected Specimen HPV-mRNA to Detect High-risk HPV and High-grade Cervical Lesions and Cancer. Asian Pac J Cancer Prev., 2024; 25(1): 211-217.
16. LIM LM, et al. Self-sampling HPV DNA test for cervical cancer screening in Singapore: A prospective study. Ann Acad Med Singap., 2022; 51(11): 733–735.
17. ARAUJO ACM, et al. Nota Técnica No 41/2024-CGICI/DPNI/SVSA/MS. 2024.
18. MIGLIORELLI A, et al. Circulating HPV Tumor DNA and Molecular Residual Disease in HPV-Positive Oropharyngeal Cancers: A Scoping Review. Diagnostics, 2024; 14(23): 2662.
19. OKADA PA, et al. External quality assessment program for human papillomaviruses DNA testing in Thailand. Pract Lab Med., 2024; 38: e00352.
20. PERERA KCM, et al. Prevalence of vaginal and cervical HPV infection among 35-year age cohort ever-married women in Kalutara district of Sri Lanka and the validity of vaginal HPV/DNA specimen as a cervical cancer screening tool: a cross-sectional study. BMC Infect Dis., 2024; 24: 1249.
21. PEREIRA NCF, et al. Sobretratamento excisional ambulatorial do colo uterino: histologia negativa para atipias. Revista Eletrônica Acervo Saúde, 2024; 24(2): e15936.
22. PRZYBYLSKI M, et al. Evaluation of Automatic Signal Detection of In Situ Hybridization for Detecting HPV DNA in Cervical Tissue Derived from Patients with Cervical Intraepithelial Neoplasia. Cancers (Basel), 2024; 16(20): 3485.
23. SANTI M, et al. Prevalence of hr-HPV genotypes among vaccinated and unvaccinated women in central Italy: a retrospective study. Acta Biomed., 2024.
24. SCHIFFMAN M, et al. Carcinogenic human papillomavirus infection. Nat Rev Dis Primers, 2016; 2: 16086.
25. SCHEIBERHUBER L, et al. Cervical cancer screening using DNA methylation triage in a real-world population. Nat Med., 2024; 30(8): 2251-2257.
26. TEIXEIRA JC, et al. Cervical cancer screening program based on primary DNA-HPV testing in a Brazilian city: a cost-effectiveness study protocol. BMC Public Health, 2020; 20: 576.
27. TEIXEIRA JC, et al. Cervical Cancer Screening with DNA-HPV Testing and Precancerous Lesions Detection: A Brazilian Population-based Demonstration Study. Rev Bras Ginecol Obstet., 2023; 45(1): 21–30.
28. TEIXEIRA JC, et al. Transition from opportunistic cytological to organized screening program with DNA-HPV testing detected prevalent cervical cancers 10 years in advance. Sci Rep., 2024; 14: 20761.
29. TERÁN-FIGUEROA Y, et al. Coleta de amostra para identificação de DNA do papilomavírus: conhecimento e habilidades. Acta Paul Enferm., 2019; 32(5): 514-20.
30. WRIGHT TC, et al. "The ATHENA Human Papillomavirus Study: The Impact of HPV Testing on Clinical Management of Cervical Cytology Abnormalities." Obstetrics & Gynecology, 2015; 126(3): 453-459.
31. WORLD HEALTH ORGANIZATION. Comprehensive Cervical Cancer Control: A guide to essential practice. WHO Library; 2021.
32. ZHOU Y, et al. Correlations between C-myc expression, BMI-1 expression, and vaginal microecology with HPV-DNA load in patients with different cervical lesions. Am J Transl Res., 2024; 16(6): 2544-2553.
2. ARBYN M, et al. Accuracy of human papillomavirus testing on self-collected versus clinician-collected samples: a meta-analysis. Lancet Oncol., 2014; 15(2): 172–183.
3. AUSTRALIAN INSTITUTE OF HEALTHCARE AND WELFARE. Cervical screening in Australia. 2019.
4. BRASIL. Diretrizes Brasileiras para o Rastreamento do Câncer do Colo de útero. Rio de Janeiro: INCA, 2016; 2.
5. CARVALHO CF, et al. Cervical Cancer Screening with HPV testing: Updates on the recommendation. Rev Bras Ginecol Obstet., 2022; 44(3): 264–271.
6. CHAN KKL, et al. PAX1/SOX1 DNA methylation versus cytology and HPV16/18 genotyping for the triage of high-risk HPV-positive women in cervical cancer screening: Retrospective analysis of archival samples. BJOG, 2025; 132: 197-204.
7. DIMITROVA M, et al. Economic consequences of the implementation of primary DNA-HPV genotype testing in Bulgaria. Biotechnol Biotechnol Equip., 2024; 38(1): 2358134.
8. EFFAH K, et al. Cervical precancer screening using self-sampling, HPV DNA testing, and mobile colposcopy in a hard-to-reach community in Ghana: a pilot study. BMC Cancer, 2024; 24: 1367.
9. EKAWATI FM, et al. Cervical cancer screening program in Indonesia: is it time for HPV-DNA tests? Results of a qualitative study exploring the stakeholders’ perspectives. BMC Women's Health, 2024; 24: 125.
10. FONSECA FV, et al. Cervical Intraepithelial Neoplasia: Analyzing the Disease Present Exclusively in the Endocervical Canal. Revista Brasileira de Ginecologia e Obstetrícia, 2022; 44(4): 385–390.
11. GRCE M, DAVIES P. Human papillomavirus testing for primary cervical cancer screening. Expert Review of Molecular Diagnostics 2008; 8(5): 599-605.
12. GUPTA C, et al. Evaluating different samples & techniques for hr-HPV DNA genotyping to improve the efficiency of risk profiling for oral & cervical cancers in Sikkim, India. Indian J Med Res., 2024; 160(2): 226-235.
13. JANSEN EEL, et al. Effect of organisef cervical cancer mortality in Europe: a systematic review. Eur J Cancer, 2020; 127: 207-223.
14. JUNG Y, et al. Clinical factors that affect diagnostic discrepancy between colposcopically directed biopsies and loop electrosurgical excision procedure conization of the uterine cervix. Obstet Gynecol Sci., 2018; 61(4): 477–483.
15. KITTISIAM T, et al. Clinical Performance of Self-collected Specimen HPV-DNA vs Clinician-collected Specimen HPV-mRNA to Detect High-risk HPV and High-grade Cervical Lesions and Cancer. Asian Pac J Cancer Prev., 2024; 25(1): 211-217.
16. LIM LM, et al. Self-sampling HPV DNA test for cervical cancer screening in Singapore: A prospective study. Ann Acad Med Singap., 2022; 51(11): 733–735.
17. ARAUJO ACM, et al. Nota Técnica No 41/2024-CGICI/DPNI/SVSA/MS. 2024.
18. MIGLIORELLI A, et al. Circulating HPV Tumor DNA and Molecular Residual Disease in HPV-Positive Oropharyngeal Cancers: A Scoping Review. Diagnostics, 2024; 14(23): 2662.
19. OKADA PA, et al. External quality assessment program for human papillomaviruses DNA testing in Thailand. Pract Lab Med., 2024; 38: e00352.
20. PERERA KCM, et al. Prevalence of vaginal and cervical HPV infection among 35-year age cohort ever-married women in Kalutara district of Sri Lanka and the validity of vaginal HPV/DNA specimen as a cervical cancer screening tool: a cross-sectional study. BMC Infect Dis., 2024; 24: 1249.
21. PEREIRA NCF, et al. Sobretratamento excisional ambulatorial do colo uterino: histologia negativa para atipias. Revista Eletrônica Acervo Saúde, 2024; 24(2): e15936.
22. PRZYBYLSKI M, et al. Evaluation of Automatic Signal Detection of In Situ Hybridization for Detecting HPV DNA in Cervical Tissue Derived from Patients with Cervical Intraepithelial Neoplasia. Cancers (Basel), 2024; 16(20): 3485.
23. SANTI M, et al. Prevalence of hr-HPV genotypes among vaccinated and unvaccinated women in central Italy: a retrospective study. Acta Biomed., 2024.
24. SCHIFFMAN M, et al. Carcinogenic human papillomavirus infection. Nat Rev Dis Primers, 2016; 2: 16086.
25. SCHEIBERHUBER L, et al. Cervical cancer screening using DNA methylation triage in a real-world population. Nat Med., 2024; 30(8): 2251-2257.
26. TEIXEIRA JC, et al. Cervical cancer screening program based on primary DNA-HPV testing in a Brazilian city: a cost-effectiveness study protocol. BMC Public Health, 2020; 20: 576.
27. TEIXEIRA JC, et al. Cervical Cancer Screening with DNA-HPV Testing and Precancerous Lesions Detection: A Brazilian Population-based Demonstration Study. Rev Bras Ginecol Obstet., 2023; 45(1): 21–30.
28. TEIXEIRA JC, et al. Transition from opportunistic cytological to organized screening program with DNA-HPV testing detected prevalent cervical cancers 10 years in advance. Sci Rep., 2024; 14: 20761.
29. TERÁN-FIGUEROA Y, et al. Coleta de amostra para identificação de DNA do papilomavírus: conhecimento e habilidades. Acta Paul Enferm., 2019; 32(5): 514-20.
30. WRIGHT TC, et al. "The ATHENA Human Papillomavirus Study: The Impact of HPV Testing on Clinical Management of Cervical Cytology Abnormalities." Obstetrics & Gynecology, 2015; 126(3): 453-459.
31. WORLD HEALTH ORGANIZATION. Comprehensive Cervical Cancer Control: A guide to essential practice. WHO Library; 2021.
32. ZHOU Y, et al. Correlations between C-myc expression, BMI-1 expression, and vaginal microecology with HPV-DNA load in patients with different cervical lesions. Am J Transl Res., 2024; 16(6): 2544-2553.