Yüksek Riskli HPV Pozitif Sitolojik Sonuçların, Kolposkopik Biyopsi Sonuçları İle Karşılaştırılması

Year 2019, , 540 - 544, 25.12.2019

Talip Karaçor , Sibel Sak , Mert Ulaş Barut , Nurullah Peker Muhammet Erdal Sak

https://doi.org/10.35440/hutfd.649689

Abstract

Amaç: Yüksek risk HPV pozitif, normal veya anormal sitolojik bulgusu olan
hastalarda kolposkopik biyopsi sonuçların değerlendirilmesi ve bu biyopsi
sonuçları ile birliktelik gösteren yüksek risk HPV tiplerinin dağılımının
belirlenmesi amaçlandı.

Materyal ve
Metod: Ocak 2017 ve Eylül 2017
tarihleri arasında rutin jinekolojik kontrol veya herhangi bir jinekolojik
şikayetle Harran Üniversitesi Kadın Hastalıkları ve Doğum Kliniğine başvuran
hastalar ile gerçekleştirildi. Hastalar 20-30, 31- 40 ve 40 yaş üstü olmak
üzere 3 gruba ayrıldı. Hastalardan papsmear ve eş zamanlı olarak serviks
transformasyon zonundan ve servikal eksternal os’tan HPV taraması için sürüntü
alındı ve yüksek risk HPV DNA varlığı araştırıldı.  Yüksek risk HPV pozitif normal veya anormal
sitolojik bulgusu olan 84 hasta çalışmaya dahil edildi.

Bulgular: Yüksek risk HPV pozitifliği olan 84 hastanın smear sonuçları; %61,9
inflamasyon, %6 ASCUS, %17,9 LGSIL, %10,7 yüksek dereceli servikal
intraepitelyal lezyon, %1,2 atipik skuamoz hücreler-yüksek dereceli lezyonun
ekarte edilemediği (ASC-H) ve % 2.4 atrofi olarak raporlandı. Smear sonucu
inflamasyon olan hastalarda en sık kolposkopik biyopsi tanısı CIN I (%21,2),
önemi bilinmeyen atipik skuamoz hücre olanlarda CIN II (%40), düşük dereceli
servikal intraepitelyal lezyon olanlarda, epitelyal hiperplazi (%33,3)
idi.  Smear sonucu HSIL olan hastalarda
%44,4 CIN II ve CIN III, %11,1 CIN I patolojik tanıları raporlandı.  Skuamoz kanser tanısı alan iki hastada HPV 16,
bir hastada ise HPV 18 pozitifliği saptanırken serviks adenokanser tanısı alan
iki hastanın birinde HPV 16, diğerinde ise HPV 18 tespit edildi. 

Sonuç: Yüksek risk HPV pozitif olan hastalarda smear sonucundan bağımsız
yapılan kolposkopik biyopsi ile displazik lezyonları saptama olasılığı
artmaktadır. İleride daha kapsamlı çalışmalarla yüksek risk HPV taramasının tek
başına smear testinin yerini alabileceğini düşünmekteyiz.

Anahtar
kelimeler: HPV, Smear, Kolposkopi,
Sevikal patoloji

Keywords

HPV, Kolposkopi, servikal patoloji, kanser

Comparison of Colposcopic Biopsy Results with High Risk HPV Positive Cytologic Results

Abstract

Background: The aim of the present study was to evaluate the pathologic results of
colposcopic examination of patients with High Risk HPV (HR-HPV) who have normal
or abnormal cytologic findings and to identify the distribution of HPV types
with biopsy results.

Materials and Methods: The present study was performed between
January 2017 and September 2017 in patients who attended to Harran University
Obstetrics and Gynecology Clinic for routine gynecological control or any
gynecological complaints. Patients were divided into 3 groups of 20-30, 31-40
and over 40 years old.  Pap smear and
swab samples were taken concurrently from cervical transformation zone and
external cervical ostium and presence of high-risk HPV-DNA were searched.
Eighty-four patients with HR-HPV who have normal or abnormal cytologic findings
were included in the study.

Results: The
smear results of 84 patients with HR-HPV positivity were reported as 61. 9%
inflammation, 6% ASCUS, 17.9% LSIL, 17.9% HSIL, 1.2% ASC-H and 2.4% atrophy.
The most common colposcopic biopsy was CIN I (21. 2%) in patients with
inflammatory cytological result, CIN II (40%) in patients with ASCUS and
epithelial hyperplasia (33. 3%) in patients with LSIL.  Patients with HSIL cytological result had
44.4% both CIN II and CIN III, 11.1% CIN I pathologic diagnoses.  HPV 16 was detected in two patients with
squamous cancer and HPV 18 was detected in one patient with squamous
cancer.  HPV 16 and HPV 18 were detected
in two patients who had a cervical adenocarcinoma diagnosis. 

Conclusion: In HR-HPV positive patients, colposcopic biopsy independent of smear
results is likely to detect the presence of dysplasic lesions.  With more in the future, we think   HR-HPV screening alone may take place of the
smear test.

Key words: HPV, Smear, Colposcopy, Cervical pathology

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