Secreção vaginal anormal: Sensibilidade, especificidade e concordância entre o diagnóstico clínico e citológico
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Data
2015
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Resumo
PURPOSE: To estimate the prevalence of bacterial vaginosis (BV), candidiasis and trichomoniasis and compare the findings of
physical examination of the vaginal secretion with the microbiological diagnosis obtained by cytology study of a vaginal smear
using the Papanicolaou method. METHODS: A cross-sectional study of 302 women aged 20 to 87 years, interviewed and
submitted to a gynecology test for the evaluation of vaginal secretion and collection of a cytology smear, from June 2012 to
May 2013. Sensitivity analyses were carried out and specificity, positive predictive value (PPV) and negative predictive value
(NPV) with their respective 95%CI were determined to assess the accuracy of the characteristics of vaginal secretion in relation
to the microbiological diagnosis of the cytology smear . The kappa index (k) was used to assess the degree of agreement
between the clinical features of vaginal secretion and the microbiological findings obtained by cytology. RESULTS: The
prevalence of BV, candidiasis and trichomoniasis was 25.5, 9.3 and 2.0%, respectively. The sensitivity, specificity, PPV and
NPV of the clinical characteristics of vaginal secretion for the cytological diagnosis of BV were 74, 78.6, 54.3 and 89.9%,
respectively. The sensitivity, specificity, PPV and the NPV of the clinical characteristics of vaginal secretion for the cytological
diagnosis of candidiasis were 46.4, 86.2, 25.5 and 94%, respectively. The correlation between the clinical evaluation of
vaginal secretion and the microbiological diagnosis of BV, candidiasis and trichomoniasis, assessed by the kappa index,
was 0.47, 0.23 and 0.28, respectively. CONCLUSION: The most common cause of abnormal vaginal secretion was BV.
The clinical evaluation of vaginal secretion presented amoderate to weak agreement with the microbiological diagnosis,
indicating the need for complementary investigation of the clinical findings of abnormal vaginal secretion.
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Biologia celular, Vaginose bacteriana/microbiologia, Esfregaço vaginal, Candidíase vaginite por trichomona, Cell biology, Vaginal smears, Vaginosis, bacterial/microbiology, Candidiasis, Trichomonas vaginitis
Citação
CAMARGO, Kélvia Cristina de et al. Secreção vaginal anormal: sensibilidade, especificidade e concordância entre o diagnóstico clínico e citológico. Revista Brasileira de Ginecologia e Obstetrícia, São Paulo, v. 37, n. 5, p. 222-228, 2015.