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BENİGN ENDİKASYONLARLA YAPILAN HİSTEREKTOMİLERDE PREOPERATİF SERVİKAL SİTOLOJİK İNCELEME YAPILMASI ZORUNLU MUDUR?

Year 2018, Volume: 51 Issue: 1, 59 - 62, 30.03.2018

Abstract

Amaç: Bu
çalışmada amacımız benign nedenlerle histerektomi yapılan olgularda preoperatif
servikal sitolojik inceleme yapılan ve yapılmayanlarda postoperatif servikal
histopatolojik bulguların karşılaştırılmasıdır.

Gereç ve yöntem:
Bu kesitsel çalışmada benign jinekolojik endikasyon ile histerektomi yapılan
215 olgu, histerektomi öncesinde servikal sitolojik inceleme yapılıp sonucunda
anormal sitolojik bulgu izlenmeyenler (Grup I, n=151) ile servikal sitolojik
inceleme yapılmamış olanlar veya smear sonucu “yetersiz materyal” nedeniyle
tanısal olmayıp sitoloji tekrarı yapılmamış olanlar (Grup II, n= 64) olarak
ikiye ayrıldı. Histerektomi öncesinde bilinen servikal intraepitelayal lezyon
veya anormal sitolojik bulgusu olan olgular ile jinekolojik malignite nedeniyle
histerektomi yapılan hastalar çalışma dışında bırakıldı. İki grubun postoperatif
servikal histopatolojik sonuçları incelendi ve anormal sonuç saptanma oranları
karşılaştırıldı. İki grup arasındaki karşılaştırmalar Bağımsız örnek T-Test,
Mann-Whitney testi ve Ki-kare testi kullanılarak yapıldı. p<0.05 değeri
istatistiksel olarak anlamlı kabul edildi.

Bulgular:
Serviksin postoperatif histopatolojik inceleme sonucunda her iki grupta da
preinvaziv lezyon saptanma oranı benzer bulundu (%7.3’e karşı %10.9, p= 0.377).
Grup 1’de 7 olguda düşük dereceli servikal intraepitalyal lezyon (LSIL/CIN 1) 3
olguda ise yüksek dereceli servikal intraepitalyal lezyon (HSIL /CIN 2-3), 1
olguda ise adenokarsinoma in situ saptandı. Grup II’de ise 4 olguda düşük
dereceli servikal intraepitelyal lezyon (LSIL/CIN 1) 3 olguda ise yüksek
dereceli servikal intraepitalyal lezyon (HSIL/CIN 2-3) saptandı. Her iki grupta
da invaziv servikal malignite izlenmedi.







Sonuç: Benign endikasyonla yapılacak histerektomi
öncesinde rutin servikal kanser tarama programı dışında servikal sitolojik
inceleme yapılmadan operasyonun uygulanması insidental servikal preinvaziv/invaziv
lezyon ile karşılaşma riskini artırmamaktadır

References

  • Referans1. Rock JA, Jones HW III, Histerektomi, In: Te Linde’s Operatif Jinekoloji 9. Basım, Çeviri Editörü: Erol Tavmergen, İzmir Güven Kitabevi 2005: Bölüm 31, Sayfa 731-755.
  • Referans2. Stang A, Merrill RM, Kuss O (2012). Prevalence-corrected hysterectomy rates by ageand indication in Germany 2005- 2006. Arch Gynecol Obstet, 286, 1193-200.
  • Referans3. Howard WJ and Rock JA (2008). Abdominal hysterectomy. In’TeLinde’s operative gynaecology 10th ed’, Eds Howard WJ and Rock JA. Lippincott: Williams & Wilkins, Philadelphia pp 727-43.
  • Referans4. Ries LA, Kosary CL, Hankey BF, et al (eds). SEER Cancer Statistics Review, 1973-1994. Bethesda, MD: National Cancer Institute; 1997. Accessed at. http://www.seer.cancer.gov/csr/1973_1994/ on 28 April 2011
  • Referans5. Gustafsson L, Ponten J, Zack M, et al. International incidence rates of invasive cervical cancer after introduction of cytological screening. Cancer Causes Control. 1997;8:755-63.
  • Referans6. Yilmaz HH, Yazihan N, Tunca D, Sevinc A, Olcayto EO, Ozgul N, Tuncer M. Cancer trends and incidence and mortality patterns in Turkey. Jpn J Clin Oncol. 2011; 41:10-6.
  • Referans7. Davey E, Barratt A, Irwig L, et al. Effect of study design and quality on unsatisfactory rates, cytology classifications, and accuracy in liquid-based versus conventional cervical cytology: a systematic review. Lancet. 2006;367:122-32.
  • Referans8. McCrory D, Matchar D, Bastian L. Evaluation of Cervical Cytology: Evidence Report/Technology Assessment No. 5. AHCPR Publication No. 99-E010. Rockville, MD: Agency for Health Care Policy and Research; 1999. Accessed at http://www.ncbi.nlm.nih.gov/books/NBK32961/ on 28 April 2011.
  • Referans9. Simavli S, Kaygusuz I, Cukur S, Aksel F. Abnormal Cervical Cytology Risk Factors in the Western Black Sea Region and the Importance of Health Insurance. Turk Patoloji Derg. 2014; 30: 11-17
  • Referans10. Atilgan R, Celik A, Boztosun A, Ilter E, Yalta T, Ozercan R. Evaluation of cervical cytological abnormalities in Turkish population. Indian J Pathol Microbiol. 2012;55:52-5.
  • Referans11. Ozgun G, Aydogdu G. Distribution of uterin cervical lesions and relation between age and parity rates in the mardin province. Turk Patoloji Derg. 2013;29:46-50.
  • Referans12. Frick AC, Walters MD, Larkin KS, Barber MD (2010). Risk of unanticipated abnormal gynecologic pathology at the time of hysterectomy for uterovaginal prolapseAm J Obstet Gynecol, 202, 507.
  • Referans13. U.S. Preventive Services Task Force. Screening for cervical cancer: recommendations and rationale. In: Guide to Clinical Preventive Services. 3rd ed. Rockville, MD: Agency for Healthcare Research and Quality; 2003.
  • Referans14. Kim HS, Back HS, Son CW, et al. False-negative cytology in cervical smears: an evaluation on 1000 cases of squamous intraepithelial lesion and squamous cell carcinoma histologically confirmed. Korean J Gynecol Oncol Colposc 1995; 6: 31-7.
  • Referans15. Joseph MG, Cragg F, Wright VC, Kontozoglou TE, Downing P, Marks FR. Cyto-histological correlates in a colposcopic clinic: a 1-year prospective study. Diagn Cytopathol 1991; 7: 477-81.
  • Referans16. Noh HT, Lee SS. The efficacy of cervicography combined with pap smear in cervical cancer screening. Korean J Gynecol Oncol Colposc 1999; 10: 13-23.
  • Referans17. Bhaumik J, Morris PG, Beer HR, et al (2004). The inadequate smear: does it matter? Cytopathology, 15, 271-5.
  • Referans18. Chundarat PA, Suwannarurk K, Bhamarapravatana K, Pattaraarchachai J, Thaweekul Y, Mairaing K, Poomtavorn Y. Incidental finding of abnormal cervical pathology in hysterectomy specimens after normal preoperative Papanicolaou smears in Thammasat University Hospital. Asian Pac J Cancer Prev. 2014;15(14):5811-4.
  • Referans19. Lee KB, Park WS,Sohn JH, et al (2009). Correlation analysis between cervicovaginal cytologic and histopathologic diagnoses in cervical squamous cell neoplasms. Korean J Pathol, 43, 157-63.
  • Referans20. Chen H, Shu HM, Chang ZL, et al (2012). Efficacy of Pap test in combination with ThinPrep cytological test in screening for cervical cancer. Asian Pac J Cancer Prev, 13, 1651-5.
  • Referans21. Hoda RS, Loukeris K, Abdul-Karim FW (2013). Gynecologic cytology on conventional and liquid-based preparations: a comprehensive review of similarities and differences. Diagn Cytopathol, 41, 257-78.
  • Referans22. Gultekin M, Zayifoglu Karaca M, Kucukyildiz I, Dundar S, Boztas G, Semra Turan H, Hacikamiloglu E, Murtuza K, Keskinkilic B, Sencan I. Initial results of population based cervical cancer screening program using HPV testing in one million Turkish women. Int J Cancer. 2017 Dec 13. doi: 10.1002/ijc.31212.
Year 2018, Volume: 51 Issue: 1, 59 - 62, 30.03.2018

Abstract

References

  • Referans1. Rock JA, Jones HW III, Histerektomi, In: Te Linde’s Operatif Jinekoloji 9. Basım, Çeviri Editörü: Erol Tavmergen, İzmir Güven Kitabevi 2005: Bölüm 31, Sayfa 731-755.
  • Referans2. Stang A, Merrill RM, Kuss O (2012). Prevalence-corrected hysterectomy rates by ageand indication in Germany 2005- 2006. Arch Gynecol Obstet, 286, 1193-200.
  • Referans3. Howard WJ and Rock JA (2008). Abdominal hysterectomy. In’TeLinde’s operative gynaecology 10th ed’, Eds Howard WJ and Rock JA. Lippincott: Williams & Wilkins, Philadelphia pp 727-43.
  • Referans4. Ries LA, Kosary CL, Hankey BF, et al (eds). SEER Cancer Statistics Review, 1973-1994. Bethesda, MD: National Cancer Institute; 1997. Accessed at. http://www.seer.cancer.gov/csr/1973_1994/ on 28 April 2011
  • Referans5. Gustafsson L, Ponten J, Zack M, et al. International incidence rates of invasive cervical cancer after introduction of cytological screening. Cancer Causes Control. 1997;8:755-63.
  • Referans6. Yilmaz HH, Yazihan N, Tunca D, Sevinc A, Olcayto EO, Ozgul N, Tuncer M. Cancer trends and incidence and mortality patterns in Turkey. Jpn J Clin Oncol. 2011; 41:10-6.
  • Referans7. Davey E, Barratt A, Irwig L, et al. Effect of study design and quality on unsatisfactory rates, cytology classifications, and accuracy in liquid-based versus conventional cervical cytology: a systematic review. Lancet. 2006;367:122-32.
  • Referans8. McCrory D, Matchar D, Bastian L. Evaluation of Cervical Cytology: Evidence Report/Technology Assessment No. 5. AHCPR Publication No. 99-E010. Rockville, MD: Agency for Health Care Policy and Research; 1999. Accessed at http://www.ncbi.nlm.nih.gov/books/NBK32961/ on 28 April 2011.
  • Referans9. Simavli S, Kaygusuz I, Cukur S, Aksel F. Abnormal Cervical Cytology Risk Factors in the Western Black Sea Region and the Importance of Health Insurance. Turk Patoloji Derg. 2014; 30: 11-17
  • Referans10. Atilgan R, Celik A, Boztosun A, Ilter E, Yalta T, Ozercan R. Evaluation of cervical cytological abnormalities in Turkish population. Indian J Pathol Microbiol. 2012;55:52-5.
  • Referans11. Ozgun G, Aydogdu G. Distribution of uterin cervical lesions and relation between age and parity rates in the mardin province. Turk Patoloji Derg. 2013;29:46-50.
  • Referans12. Frick AC, Walters MD, Larkin KS, Barber MD (2010). Risk of unanticipated abnormal gynecologic pathology at the time of hysterectomy for uterovaginal prolapseAm J Obstet Gynecol, 202, 507.
  • Referans13. U.S. Preventive Services Task Force. Screening for cervical cancer: recommendations and rationale. In: Guide to Clinical Preventive Services. 3rd ed. Rockville, MD: Agency for Healthcare Research and Quality; 2003.
  • Referans14. Kim HS, Back HS, Son CW, et al. False-negative cytology in cervical smears: an evaluation on 1000 cases of squamous intraepithelial lesion and squamous cell carcinoma histologically confirmed. Korean J Gynecol Oncol Colposc 1995; 6: 31-7.
  • Referans15. Joseph MG, Cragg F, Wright VC, Kontozoglou TE, Downing P, Marks FR. Cyto-histological correlates in a colposcopic clinic: a 1-year prospective study. Diagn Cytopathol 1991; 7: 477-81.
  • Referans16. Noh HT, Lee SS. The efficacy of cervicography combined with pap smear in cervical cancer screening. Korean J Gynecol Oncol Colposc 1999; 10: 13-23.
  • Referans17. Bhaumik J, Morris PG, Beer HR, et al (2004). The inadequate smear: does it matter? Cytopathology, 15, 271-5.
  • Referans18. Chundarat PA, Suwannarurk K, Bhamarapravatana K, Pattaraarchachai J, Thaweekul Y, Mairaing K, Poomtavorn Y. Incidental finding of abnormal cervical pathology in hysterectomy specimens after normal preoperative Papanicolaou smears in Thammasat University Hospital. Asian Pac J Cancer Prev. 2014;15(14):5811-4.
  • Referans19. Lee KB, Park WS,Sohn JH, et al (2009). Correlation analysis between cervicovaginal cytologic and histopathologic diagnoses in cervical squamous cell neoplasms. Korean J Pathol, 43, 157-63.
  • Referans20. Chen H, Shu HM, Chang ZL, et al (2012). Efficacy of Pap test in combination with ThinPrep cytological test in screening for cervical cancer. Asian Pac J Cancer Prev, 13, 1651-5.
  • Referans21. Hoda RS, Loukeris K, Abdul-Karim FW (2013). Gynecologic cytology on conventional and liquid-based preparations: a comprehensive review of similarities and differences. Diagn Cytopathol, 41, 257-78.
  • Referans22. Gultekin M, Zayifoglu Karaca M, Kucukyildiz I, Dundar S, Boztas G, Semra Turan H, Hacikamiloglu E, Murtuza K, Keskinkilic B, Sencan I. Initial results of population based cervical cancer screening program using HPV testing in one million Turkish women. Int J Cancer. 2017 Dec 13. doi: 10.1002/ijc.31212.
There are 22 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Original research article
Authors

Hüseyin Aydoğmuş

Publication Date March 30, 2018
Submission Date February 11, 2018
Published in Issue Year 2018 Volume: 51 Issue: 1

Cite

AMA Aydoğmuş H. BENİGN ENDİKASYONLARLA YAPILAN HİSTEREKTOMİLERDE PREOPERATİF SERVİKAL SİTOLOJİK İNCELEME YAPILMASI ZORUNLU MUDUR?. Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi. March 2018;51(1):59-62.