title: Preinvasive and invasive disease in women with cytological diagnosis of high-grade lesion and high-grade lesion cannot exclude microinvasion.
abstract: BACKGROUND
  Cervical cancer is the third most common cancer in Brazil and has a high potential for prevention and cure. The prevalence of invasive and preinvasive disease in women with cytological diagnosis of high-grade lesion - cannot exclude microinvasion (HSIL-micro) is not known.
  
  
  METHODS
  This cross-sectional study used a cytology lab database to identify women with HSIL-micro and HSIL referred to two colposcopic units from June 2006 to December 2012. For each woman with HSIL-micro, four women with cytologic diagnosis of HSIL who met the inclusion criteria were identified. Data were obtained from review of medical records.
  
  
  RESULTS
  Forty-seven patients with report of HSIL-micro and 188 patients with report of HSIL were included. The final diagnoses revealed a frequency of preinvasive lesions of 31.9 % (15/47) and 59.6 % (112/188) in patients with HSIL-micro and HSIL, respectively, while the frequency of invasive disease was 63.8 % (30/47) and 11.7 % (22/188), respectively. The HSIL-micro group showed prevalence of preinvasive or invasive disease 6.5 times greater (95 % CI = 1.6-5.7) and, for invasive disease, 2.4 times greater (95 % CI = 1.7-3.6) than the HSIL group.
  
  
  CONCLUSIONS
  Higher risk of preinvasive and invasive lesions in women with cytologic diagnosis of HSIL-micro reinforces recommendations for immediate investigation.
authors.affiliation: Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz (IFF/Fiocruz), Av. Rui Barbosa, 716 - Flamengo, CEP 22250-020, Rio de Janeiro, Brazil. nskuperman@yahoo.com.br.
authors.forename: Nina de Siqueira
authors.initials: Nde S
authors.lastname: Kuperman
authors.affiliation: Department of Gynecology, Colposcopy Clinic, Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz (IFF/Fiocruz), Rio de Janeiro, Brazil. fabiorussomano@gmail.com.
authors.forename: Fábio Bastos
authors.initials: FB
authors.lastname: Russomano
authors.affiliation: Department of Gynecology, Universidade Federal do Estado do Rio de Janeiro (HUGFF/UNIRIO), Rio de Janeiro, Brazil. yarafurtadorj@terra.com.br.
authors.forename: Yara Lucia Mendes Furtado
authors.initials: YL
authors.lastname: de Melo
authors.affiliation: Department of Clinical Research, Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz (IFF/Fiocruz), Rio de Janeiro, Brazil. scgomes@iff.fiocruz.br.
authors.forename: Saint Clair dos Santos
authors.initials: SC
authors.lastname: Gomes
mesh_terms: D000328:Adult; D001938:Brazil / Q000453:epidemiology; D003585:Cell Biology; D003127:Colposcopy / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy; D015995:Prevalence; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D014626:Vaginal Smears / Q000706:statistics & numerical data