Management of abnormal cytology results and correlation of cytopathologic results accompanied by colposcopy in our clinic.

Yıl 2017, Cilt: 2 Sayı: 3, 62 - 65, 01.12.2017

Ozan Doğan , Ahmet Yıldız Çiğdem Pulatoğlu

https://doi.org/10.25000/acem.342233

Öz

Aim: Pap
smear test is a major screening test for early diagnosis and treatment of
cervix cancer. The aim of our study was to assess the value of colposcopy and
histopathologic examination in the management of patients with abnormal
cervical cytology by Bethesda Classification.

Methods: In
this study, we aimed to compare and evaluate the diagnosis of 12,381 cytology
material examined in our gynecology clinic during the years between 2014 and
2016 with their cytopathology results.

Results: 498 of 12,381 patients had abnormal cytological
findings (4.02%). The rates of Atypical Squamous Cells of Undetermined
Significance (ASC-US), Atypical Glandular Cells of Undetermined Significance
(AG-US), Low Grade Squamous Intraepithelial Lesions (LG-SIL) and High Grade
Squamous Intraepithelial Lesions (HG-SIL) were found to be 1.9%, 0.4%, 1% and %
0.1, respectively. Atypical squamous cell cannot exclude HSIL (ASC-H) rate were
found as % 0.4. The rate of abnormal cytology in cervical intraepithelial
lesions was 2.1. Positive predictive values of abnormal smear results were 21.7%
for ASC-US, 41.9% for LGSIL, 100% for HGSIL, 12.5% for AGUS and 50% for ASC-H.

Conclusion:
The Pap smear test is a cheap and easily applied screening test. Early
diagnosis of cervix cancer can be made by routine Pap smear testing. The
efficiency in clinical use of the cervical cytology screening test is
determined by biopsy verification. As the ratio of epithelial cell abnormality
is variable in different populations, the ASC (Atypical Squamous Cell) / SIL (Squamous
Intraepithelial Lesion) is a more definite variable to be used for quality
assurance.

Anahtar Kelimeler

Colposcopy, Cytology, Cervical Smears

Kliniğimizdeki anormal servikal smear sonuçlarının yönetimi ve kolposkopi eşliğinde alınan sitopatoloji sonuçlarının korelasyonu

Öz

Amaç: Pap smear testi serviks kanserinin
erken tanı ve tedavisinde çok önemli bir tarama yöntemidir. Bu çalışmanın
amacı, smear testinde anormallik saptanan olguların yönetiminde kolposkopi ve
patolojik incelemenin öneminin belirlenebilmesidir.

Yöntemler: Bu çalışmada
2014-2016 yılları arasında Düzce Atatürk Devlet Hastanesi Jinekoloji
Polikliniği’ne başvuran 12.381 hastanın Bethesda sınıflamasına göre Pap Smear testi
sonuçları ve kolposkopi eşliğinde alınan sitopatoloji sonuçları
değerlendirilmiş ve karşılaştırılmıştır.

Bulgular: 12.381 olgunun 498’inde anormal sitolojik bulgular saptandı (% 4,02).
Anormal sitolojilerin içerisinde önemi bilinmeyen hücreler (ASCUS) % 1,9, Atipik
Glanduler Hücreler (AGUS) % 0,4, Düşük Dereceli Skuamöz İntraepitelyal Lezyon
(LGSIL) %1, Yüksek Dereceli İntraepitelyal Lezyon (HGSIL) % 0,1, Atipik Skuamöz
Hücrelerin Dışlanmadığı Grup (ASC-H) % 0,4 olarak saptanırken, anormal
sitolojilerin servikal intraepitelyal lezyonlara oranı 2,1 olarak saptandı. Pap
Smear’de anormal sitolojik bulgu saptanan olguların pozitif öngörü değerleri
ASCUS için %21,7, LGSIL için %41,9, HGSIL için %100, AGUS için %12,5 ve ASC-H için
%50 olarak hesaplandı.

Sonuç: Pap Smear testi, ucuz ve kolay bir yöntemdir. Serviks kanserinin erken
tanısı Pap smear testi sayesinde mümkündür. Servikal sitolojinin klinik
uygulamalarda güvenilir şekilde kullanımı ise biyopsi doğrulaması ile
mümkündür. Farklı toplumlarda epitel hücre anomalisi oranı değişken olabildiği
için atipik skuamöz hücre  (ASH) / servikal
skuamöz intraepitelyal lezyon (SIL) oranı kalite yöntemi açısından daha net bir
veri olarak değerlendirilmektedir.  

Anahtar Kelimeler

Kolposkopi, Servikal Smear, Sitoloji

Kaynakça

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