TY - JOUR T1 - Pamukkale Üniversitesi Hastanesi Kadın Hastalıkları ve Doğum Polikliniği'ne başvuran hastaların servikal smear sonuçlarının değerlendirilmesi TT - Evaluation of cervical smear results of patients who were admitted to Pamukkale University Hospital Obstetrics and Gynecology Outpatient Clinic AU - Koşar Can, Özlem PY - 2022 DA - January Y2 - 2021 DO - 10.31362/patd.1004496 JF - Pamukkale Medical Journal JO - Pam Tıp Derg PB - Pamukkale University WT - DergiPark SN - 1308-0865 SP - 125 EP - 131 VL - 15 IS - 1 LA - tr AB - Amaç: Bu çalışma Pamukkale Üniversitesi Hastanesi Kadın Hastalıkları ve Doğum Polikliniği’ne başvuran hastalardan alınan pap smear sonuçlarını değerlendirmek için planlandı.Gereç ve yöntem: Pamukkale Üniversitesi Hastanesi Kadın Hastalıkları ve Doğum Polikliniği’ne Haziran 2018 ile Ağustos 2021 tarihleri arasında başvuran kadınların Sure Path yöntemiyle hazırlanan, Bethesda 2014 Sistemi’ne göre raporlandırılmış pap smear sonuçları retrospektif olarak incelendi.Bulgular: Çalışmaya dahil edilen 9982 vakanın yaş dağılımı 17-91 arasında ve yaş ortalaması 43,98±12,21 idi. Toplam 9572 (%95,89) kadının sonucu normal olarak saptandı. Bu çalışmada, anormal smear oranı %1,97; önemi belirsiz atipik skuamoz hücreler, yüksek dereceli lezyonun dışlanamadığı atipik skuamoz lezyon, düşük dereceli skuamöz intraepitelial lezyon, yüksek dereceli skuamöz intraepitelial lezyon ve atipik glandüler hücreler oranı sırasıyla %0,98, %0,25, %0,56, %0,17 ve %0,01 idi.Sonuç: Bu çalışmada anormal smear oranı (%1,97) Türk Servikal Kanser ve Servikal Sitoloji Araştırma Grubu’nun 2009 yılında yayınlanan 33 merkezin dahil olduğu çalışmaya göre yüksek bulunmuştur. Bunun nedeni Pamukkale Üniversitesi'nin Kanser Erken Teşhis Tarama ve Eğitim Merkezi'nin riskli hastaları sevk ettiği bir merkez olması olabilir. Türkiye'deki anormal smear oranını güncelleyerek daha etkin ve yaygın tarama stratejilerinin geliştirilmesine olanak sağlayacak çok merkezli yeni çalışmalara ihtiyaç vardır. KW - Papanicolaou smear KW - servikal kanser KW - tarama KW - sıvı bazlı sitoloji N2 - Purpose: This study was designed to evaluate the pap smear results obtained from patients who admitted to Pamukkale University Hospital Gynecology and Obstetrics outpatient clinic.Material and methods: Pap smear results prepared by Sure Path method and reported according to Bethesda 2014 System of women who were applied to Pamukkale University Hospital Gynecology and Obstetrics outpatient clinic between June 2018 and August 2021 were analyzed retrospectively.Results: The age distribution of the 9982 cases included in the study was between 17-91 and the mean age was 43.98±12.21. Results of a total of 9572 (95.89%) women were found to be normal. In the present study, the abnormal smear rate was 1.97%; The rates of atypical squamous cells of undetermined significance, atypical squamous cells cannot exclude high grade squamous intraepithelial lesion, low grade squamous intraepithelial lesion, high grade squamous intraepithelial lesion and atypical glandular cells were 0.98%, 0.25%, 0.56%, 0.17% and 0.01%, respectively.Conclusion: In this study, the abnormal smear rate (1.97%) was found to be higher than the study of the Turkish Cervical Cancer and Cervical Cytology Research Group, which included 33 centers published in 2009. This might be due to Pamukkale University is a center where Cancer Early Diagnosis Screening and Education Center refers risky patients. New multicenter studies that will enable the development of more effective and widespread screening strategies by updating the abnormal smear rate in Turkey are required. CR - 1. Sung H, Ferlay J, Siegel RL et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin 2021;71:209-249. doi: 10.3322/caac.21660 CR - 2. Türkyılmaz M, Öztürk M, Dündar S ve ark. Türkiye kanser istatistikleri 2017. Ed.Kara F, Keskinkılıç B. In: Sağlık Bakanlığı Kanser Daire Başkanlığı, Ankara: 2021;23-30. https://hsgm.saglik.gov.tr/depo/birimler/kanser-db/istatistik/Turkiye_Kanser_Istatistikleri_2017.pdf (Erişim tarihi:10 Eylül 2021). CR - 3. Muñoz N, Bosch FX, de Sanjosé S et al. International Agency for Research on Cancer Multicenter Cervical Cancer Study Group. Epidemiologic classification of human papillomavirus types associated with cervical cancer. N Engl J Med. 2003;348:518-527. doi: 10.1056/NEJMoa021641 CR - 4. Hamankaya İ. Comparison of Cervical Smear and Biopsy Results, Journal of Contemporary Medicine. 2020;10:613-616. doi: 10.16899/jcm.715815 CR - 5. Kitchener HC, Castle PE, Cox JT. Chapter 7: Achievements and limitations of cervical cytology screening. Vaccine, 2006;24:63-70. doi:10.1016/j.vaccine.2006.05.113 CR - 6. ARC, Cervix Cancer Screening. IARC Handbook of Cancer Prevention. Vol. 10. 2005, Lyon: IARC Press. 311. CR - 7. Saslow D, Solomon D, Lawson HW et al. ACS-ASCCP-ASCP Cervical Cancer Guideline Committee. American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer. CA Cancer J Clin 2012;62:147-172. doi: 10.3322/caac.21139. CR - 8. Nayar R, Wilbur DC. The Pap test and Bethesda 2014. Cancer Cytopathol 2015;123:271-281. doi: 10.1002/cncy.21521 CR - 9. Nayar R, Wilbur DC. The Pap Test and Bethesda 2014: "The reports of my demise have been greatly exaggerated. (after a quotation from Mark Twain)". J Low Genit Tract Dis 2015;19:175-184. doi: 10.1159/000381842. CR - 10. Sasieni, P, Adams J, Cuzick J. Benefit of cervical screening at different ages: evidence from the UK audit of screening histories. Br J Cancer 2003;89:88-93. doi: 10.1038/sj.bjc.6600974 CR - 11. Fontham ETH, Wolf AMD, Church TR et al. Cervical cancer screening for individuals at average risk: 2020 guideline update from the American Cancer Society. CA Cancer J Clin 2020;70:321-346. doi: 10.3322/caac.21628 CR - 12. WHO guideline for screening and treatment of cervical pre-cancer lesions for cervical cancer prevention, second edition [Internet]. Geneva: World Health Organization; 2021. CR - 13. Türkmen İÇ, Başsüllü N, Korkmaz P et al. Patients with epithelial cell abnormality in PAP smears: correlation of results with follow-up smears and cervical biopsies. Turk Patoloji Derg 2013;29:179-184. doi: 10.5146/tjpath.2013.01182 CR - 14. Nascimento AF, Cibas ES. The ASC/SIL ratio for cytopathologists as a quality control measure. Am J Clin Pathol 2007;128:653-656. doi: 10.1309/APTVNLP1P0X00CUQ CR - 15. Şahin S, Seçkin S, Seçkin L, Çağlayan E.K, Kara M, Üstün Y. Bozok Üniversitesi’nde incelenen 2279 olguya ait servikal pap smear sonucunun istatistiksel analizi. Bozok Tıp Derg 2014;4:29-32. doi: 10.16919/btd.38037 CR - 16. Insinga RP, Glass AG, Rush BB. Diagnoses and outcomes in cervical cancer screening: A population based study. Am J Obstet Gynecol 2004;191:105-113. doi:10.1016/j.ajog.2004.01.043 CR - 17. Yalti S, Gürbüz B, Bilgiç R, Cakar Y, Eren S. Evaluation of cytologic screening results of cervix. Int J Gynecol Cancer 2005;15:292-294. doi: 10.1111/j.1525-1438.2005.15218.x. CR - 18. Gupta S, Sodhani P, Hadler K et al. Spectrum of epithelial cell abnormalities of uterine cervix in a cervical cancer screening program: Implications for resource limited settings. Eur J Obstet Gynecol Reprod Biol 2007;134:238-242. doi: 10.1016/j.ejogrb.2006.07.022 CR - 19. Fonn S, Bloch B, Mabina M et al. Prevalence of pre-cancerous lesions and cervical cancer in South Africa-a multicenter study. S Afr Med J 2002;92:148-156. CR - 20. Ghazai-Aswad S, Gargash H, Badrioatlı P et al. Cervical smear abnormalities in the United Arab Emirates: a pilot study in the Arabian Gulf. Acta Cytol 2006;50:41-47. doi: 10.1159/000325893 CR - 21. Bacanakgil H, Bozkurt T, Çelik S, Dursun N, Pirusa S, Boran B. Servikal smear tarama profil ve sonuçları (4122 olgu). İstanbul Tıp Dergisi 2008;4:178-181. CR - 22. Jones BA, Davey DD. Quality management in gynecologic cytology using interlaboratory comparison. Arch Patbol Lab Med 2000;124:672-81. doi: 10.5858/2000-124-0672-QMIGCU CR - 23. Atilgan R, Celik A, Boztosun A, Ilter E, Yalta T. Ozercan R. Evaluation of cervical cytological abnormalities in Turkish population. Indıan J Pathol Mıcr 2012;55:52-55. doi: 10.4103/0377-4929.94856 CR - 24. Turkish Cervical Cancer and Cervical Cytology Research Group. Prevalence of cervical cytological abnormalities in Turkey. Int J Gynaecol Obstet 2009;106:206-209. doi: 10.1016/j.ijgo.2009.04.003 CR - 25. Kuo DY, Goldberg GL. Screening of cervical cancer: Where do we go from here? Cancer Invest 2003;21:157-161. doi: 10.1081/cnv-120016410 CR - 26. National Cancer Institute, Surveillance Epidemiology and End Results. Available at:http:// seer.cancer.gov/statfacts/html/cervix.html.(Accessed September 10,2021) CR - 27. Koç N. Zeynep Kâmil Kadın Doğum ve Çocuk Hastanesindeki 50645 Servikal Smear Sonucunun Değerlendirilmesi, Zeynep Kâmil Tıp Bülteni, 2016;47:3. doi:10.16948/zktb.36577 CR - 28. Özgül N. Türkiye’de serviks kanserinin durumu ve servikal kanser tarama çalışmaları. Tuncer AM. Türkiye’de Kanser Kontrolü. 1. Baskı. Onur Matbaacılık, Ankara: 2007;349-358. CR - 29. Tekin YB, Güvendağ Güven ES, Mete Ural Ü, Üstüner I, Balık G, Güçer H. Doğu karadeniz bölgesindeki kadınlarda anormal servikal sitoloji sonuçlarının değerlendirilmesi. Türk jinekolojik onkoloji dergisi 2014;2:20-24. CR - 30. Seven A, Koçak C, Yüksel KB et al. The evaluation of cervical pap-smear results of the patients who admitted to Obstetrics and Gynecology Clinic of Dumlupınar University Kütahya Evliya Çelebi Training and Research Hospital. Turkısh Journal of Clinics and Laboratory 2015;7:1-4. doi: 10.18663/tjcl.64385. UR - https://doi.org/10.31362/patd.1004496 L1 - https://dergipark.org.tr/en/download/article-file/2008996 ER -