KOLPOSKOPİ YAPILAN KADINLARDA ANORMAL SERVİKAL SİTOLOJİ VE BİYOPSİ SONUÇLARINA GÖRE SAPTANAN HPV TİPLERİ

Year 2021, , 20 - 27, 15.06.2021

Derya Sivri Aydın Ahmet Çetin

https://doi.org/10.54270/atljm.2021.3

Abstract

Amaç: Kolposkopi eşliğinde servikal biyopsi ve endoservikal küretaj (ECC) yapılan hastalarda patoloji ve referans smear sonuçlarına göre saptanan HPV tiplerini belirlemek.
Gereç ve Yöntem: Bu retrospektif vaka serisinde, jinekolojik onkoloji polikliniğinde kolposkopi yapılan 520 hasta çalışmaya alındı. Hastaların yaşı, HPV sonuçları, HPV tipleri, smear sonucu, kolposkopik biyopsi ve ECC sonuçlarına, yapılan eksizyon işleminin tipine ve patolojik sonuçlara hastane kayıt sisteminden ulaşıldı. Referans smear sonuçları ve kolposkopi eşliğinde servikal biyopsi ve ECC sonuçlarına göre saptanan HPV tipleri belirlendi.
Bulgular: Çalışmaya alınan hastaların 279’unda HPV pozitifti. 25.1% hastada HPV tip 16, 12.2% hastada tip 18, 47.0% (n=131) hastada diğer yüksek riskli HPV tipleri pozitifti. Diğer yüksek riskli HPV tiplerinden en sık HPV tip 39, 7.9% hastada izlendi. Referans smear sonucu 48.8% (n=239) hastada önemi belirlenemeyen atipik skuamöz hücreler, 23.9% (n=117) hastada düşük dereceli skuamöz intraepitelyal lezyon, 3.9% (n=19) hastada yüksek dereceli skuamöz intraepitelyal lezyon iken 23.5% (n=115) hastada smear sonucu normaldi. Smear sonucu anormal olan hastalarda yüksek riskli HPV enfeksiyonu sıklığı 68.3% idi ve en sık HPV tip 16 mevcuttu (25.1%). Punch biyopsi patolojisinde 48.4% hastada CIN (servikal intraepitelyal neoplazi)1, 8.1% hastada CIN2 veya CIN3, 30.4% hastada servisit ve 1.1% hastada skuamoz hücreli karsinom, 1% hastada normal patoloji saptandı. Biyopsi sonucu CIN2-3 veya skuamoz kanser olup, HPV tiplendirilmesi yapılan 71.4% hastada HPV tip 16 pozitifti.
Sonuç: Anormal sitoloji sonucu olan kadınların 68.3%’ünde yüksek riskli HPV enfeksiyonu saptadık. En sık görülen HPV genotipi tip 16 (25.1%) idi ve 12.2% hastada tip 18, 7.9% hastada tip 39 mevcuttu. Biyopsi sonucu CIN2 ve 3 ve skuamoz kanser olan 71.4% hastada HPV tip 16 pozitifti, tip 18 ve diğer yüksek riskli HPV tipleri kalan kısmından sorumluydu.

Keywords

İnsan papilloma virüsü, servikal intraepitelyal neoplazi, serviks kanseri, kolposkopi

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