Titre du document / Document title

Hormonal effects of depo-provera in cervical smears: A comparison with triphasil and postmenopausal effects

Auteur(s) / Author(s)

KAPTAIN Stamatina ⁽¹⁾ ; BLOOM Leonard I. ⁽²⁾ ; WEIR Michele M. ⁽³⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Department of Pathology, St. Joseph's Wayne Hospital, Wayne, New Jersey, ETATS-UNIS
⁽²⁾ Department of Clinical Laboratory Sciences, University of Tennessee Health Science Center, Memphis, Tennessee, ETATS-UNIS
⁽³⁾ Department of Pathology, London Health Sciences Centre, Victoria Campus, London, Ontario, CANADA
Department of Pathology, St. Joseph's Regional Medical Center, Patterson, New Jersey, ETATS-UNIS

Résumé / Abstract

BACKGROUND. Long-acting injectable contraceptive agents may cause changes in cervical smears that could impair the detection of epithelial abnormalities. The objectives of the current study were to 1) compare the hormonal effects of depot-medroxyprogesterone acetate (Depo-Provera®) (DP) in cervical smears with those of levonorgestrel and ethinyl estradiol (Triphasil®) (TP) and postmenopausal (PM) changes; and 2) determine whether the duration of DP use affects squamous maturation. METHODS. Satisfactory cervical smears from 50 DP users, 55 TP users, and 51 PM patients were evaluated blindly for: 1) squamous cell curling, crowding, cytolysis, and navicular cell formation; 2) pseudoparakeratosis, blue blobs, and histiocytes; 3) endometrial cells and blood; 4) single or enlarged endocervical nuclei and mucin-depleted endocervical cells; 5) lactobacilli and coccobacilli amounts; and 6) squamous maturation (ratio of parabasal:intermediate:superficial cells). RESULTS. No statistically significant differences were observed for blue blobs, histiocytes, blood, endometrial cells, or single or enlarged endocervical nuclei among smears from the three groups. More smears from DP and TP users demonstrated squamous cell curling, crowding, and cytolysis as well as navicular cells and abundant lactobacilli compared with smears from PM patients. There were more PM smears with pseudoparakeratosis and mucin-depleted endocervical cells compared with the other groups. The majority of PM smears (98%) demonstrated predominantly parabasal cells with some intermediate cells. The majority of DP (86%) and TP (93%) smears demonstrated mostly intermediate and some superficial cells, regardless of the duration of DP use. CONCLUSIONS. Certain progestational-dependent effects (i.e., curling, crowding, navicular cells, and abundant lactobacilli) were identified more often in TP users compared with DP users and less often in PM patients. The mostly parabasal pattern observed in smears from PM patients contrasted with the predominantly intermediate pattern found in smears from DP and TP users. The duration of DP use did not appear to have any effect on squamous maturation.

Revue / Journal Title

Cancer   ISSN 0008-543X   CODEN CANCAR 

Source / Source

2002, vol. 96, n^o2, pp. 74-82 (17 ref.)

Langue / Language

Anglais

Editeur / Publisher

Wiley-Liss, New York, NY, ETATS-UNIS  (1948) (Revue)

Mots-clés anglais / English Keywords

Human ; Comparative study ; Cytology ; Cervical smear ; Postmenopause ; Implant ; Levonorgestrel ; Injectable form ; Contraceptive ; Progestagen ; Medroxyprogesterone ;

Mots-clés français / French Keywords

Homme ; Etude comparative ; Cytologie ; Frottis cervical ; Postménopause ; Implant ; Lévonorgestrel ; Forme injectable ; Contraceptif ; Progestatif ; Médroxyprogestérone ;

Mots-clés espagnols / Spanish Keywords

Hombre ; Estudio comparativo ; Citología ; Frotis cervical ; Postmenopausia ; Implante ; Levonorgestrel ; Forma inyectable ; Anticonceptivo ; Progestágeno ; Medroxiprogesterona ;

Localisation / Location

INIST-CNRS, Cote INIST : 2701, 35400010057835.0030