HPV 16 veya HPV 18 pozitif hastalarda servikal sitoloji ile final patoloji sonuçları arasındaki ilişkinin analizi: Tersiyer merkez deneyimi

Yıl 2018, Cilt: 49 Sayı: 4, 0 - 0, 15.12.2018

Doğukan Yıldırım , Baki Erdem , Osman Aşıcıoğlu , Özgür Akbayır Volkan Ülker

https://doi.org/10.16948/zktipb.412982

Öz

Amaç:
Ulusal tarama programı kapsamında kliniğimize başvuran HPV 16 veya HPV 18
pozitif hastaların sitoloji ve patoloji sonuçlarını analiz etmek.

Gereç
ve Yöntem: Ocak 2014 ile Mayıs 2017 tarihleri arasında
Jinekolokik Onkoloji Kliniği’mize başvuran HPV 16 veya HPV 18 pozitif olan
hastaların verileri retrospektif olarak incelendi. Tüm hastalara kolposkopi
yapıldı. Biopsi, endoservikal küretaj veya eksizyonel işlem sonuçlarından elde
edilen en yüksek dereceli lezyon final patoloji olarak kabul edildi.

Bulgular:
Çalışmaya dahil edilen 720 hastanın yaş ortalaması 41.96±8.67, parite
ortalaması 2.39±1.58 idi. Hastaların 132 tanesi (%18.3) menopozdayken, 588 (%
81.7) tanesi premenopozaldi. Yüz otuz sekiz hastanın (%19.2) smear sonuçlarına
ulaşılamadı. Ulaşılan smear sonuçları; 398 hastanın (%55.3) normal veya
inflamasyon, 36 hastanın (%5) yetersiz, 91 hastanın (%12.6) ASCUS, 36 hastanın
(%5) LGSIL, 11 hastanın (%1.5) ASC-H, 4 hastanın HGSIL (%0.6), 6 hastanın AGC
(%0.8) idi. Final patolojide CIN 2+ lezyona neden olan anormal smear
sonuçlarının dağılımı; ASCUS: 23 (%25.3), LGSIL: 13 (%36.1), ASC-H: 6 (%54.5),
HGSIL: 4 (%100), AGC: 2 (%33.3) idi. HPV 16 veya 18 pozitif olan hastalardan
anormal sitolojisi olanlarda, sitolojisi normal olanlara göre daha fazla CIN 2+
lezyon saptandı ve bu fark istatistiksel olarak anlamlı bulundu (48 (%32.4) vs
60 (%15.1) , OR:2.7 (1.74-4.2), p<0.001). Smear testi CIN 2+ lezyonların
60’ında (%55.6), invaziv kanserlerin ise 3 ‘ünde (%75) negatif olarak
raporlanmıştı .

Sonuç:
Sonuçlarımız HPV 16 veya 18 pozitif hastalarda sitoloji normal olsa bile
kolposkopik değerlendirme yapılması görüşünü desteklemektedir.

Anahtar Kelimeler

HPV, HPV DNA taraması, serviks kanseri

Analysis of the Relationship Between Cervical Cytology and Final Pathology Results in HPV 16 or HPV 18 Positive Patients: A Tertiary Center Experience

Öz

Objective:
To analyse the cytology and pathology results of HPV 16 or
HPV 18 positive patients referred to our clinic as part of the national
screening program.

Material
and Methods: Data of patients with HPV 16 or HPV 18 positive
who were referred to our Gynecologic Oncology Clinic between January 2014 and
May 2017 were retrospectively reviewed. All patients underwent colposcopy. The
highest grade lesion obtained from biopsy, endocervical curettage or excisional
procedure results was accepted as the final pathology.

Results:
The mean age of the 720 patients included in the study was 41.96 ± 8.67, and
the parity average was 2.39 ± 1.58. One hundred and thirty-two of them (18.3%)
were menopausal, and 588 (81.7%) were premenopausal. The smear results of 138
patients could not be reached. Reached smear results were; normal or
inflammation in 39 patients (55.3%), insufficient in 36 patients (5%), ASCUS in
91 patients (12.6%), LGSIL in 36 patients (5%), 
ASC-H in 11 patients (1.5%), HGSIL in 4 patients (0.6%), and AGC in 6
patients (0.8%). Distribution of abnormal smear results that cause CIN 2+
lesion in the final pathology were; ASCUS: 23 (25.3%), LGSIL: 13 (36.1%),
ASC-H: 6 (54.5%), HGSIL: 4 (100%) and AGC: 2 (33.3%). More CIN 2+ lesions were
detected in cases with abnormal cytology than those with normal cytology who
are positive for HPV 16 or 18, and this difference was statistically
significant (48 (32.4%) vs 60 (15.1%), OR: 2.7 ), p<0.01). The smear test
was reported negative in 60 (55.6%) patients with CIN 2+, and three patients
(75%) of the invasive cancers.

Conclusion:
Our results support the idea of ​​performing colposcopic evaluation even if the
cytology is normal in HPV 16 or 18 positive patients.

Anahtar Kelimeler

HPV, HPV DNA screening, cervical cancer

Kaynakça

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