RESUMO
Having analysed the results of a large series of patients, the Authors propose endocervical examination as a vital step to be performed at the same time as colposcopy or, in certain well identified cases, following cytohistological results. Endocervical examination either before or after colposcopy is then described in a protocol taking into account the various parameters. The most important are: the assessment of the squamocolumnar line, the type of colposcopic lesion, and cytohistological findings. Following a brief discussion of traditional diagnostic tests (endocervical curettage, endocervical observation using Kagan forceps), the Authors underline the importance of the endocervicoscope which allows a closer, noninvasive and precise evaluation to be made.
Assuntos
Colposcopia/métodos , Doenças Uterinas/diagnóstico , Neoplasias Uterinas/diagnóstico , Colo do Útero , Diagnóstico Diferencial , Feminino , Humanos , Doenças Uterinas/patologia , Neoplasias Uterinas/patologiaRESUMO
We performed an open study on 37 patients (average age 35 years), with CIN III or VAIN III and Viral Cytopatic Effects (VCE), who underwent a new standardized bifasic therapy by means of intralesional beta-interferon, topic beta-interferon and subcutaneous timopentine injection. Each therapeutic and checking step was made by colposcopic and microcolpohysteroscopic inspection, which showed spreading necrotic zones in the dysplastic places and peripheral typical epithelium replacement. Microcolpohysteroscopy allowed us to obtain correct diagnosis of the lesion and its location, to discriminate each pathologic aspects (CIN, VAIN, VCE), to perform an adeguated biopsy and intralesional therapy and to follow-up lesion course without repeated biopsies. After two months of therapy as maximum safety limit, we performed conization (in CIN case) in order to confirm the effects of therapy by hystology and especially to evaluate the deep lesional border. The istologic examination underlined the previous microcolpohysteroscopic report of dysplastic regression until its disapperance, with lasting VCE in all the cases.