Yetersiz servikal sitolojiye sahip yüksek riskli HPV pozitif kadınların kolposkopi bulgularının analizi

Abstract

Amaç: Çalışmanın amacı Kanser Erken Tanı ve Tarama Merkezlerinden Jinekolojik Onkoloji polikliniğine sevk edilen, yetersiz servikal sitolojili ve yüksek riskli insan papilloma virüsü (HPV) pozitifliği olan kadınların kolposkopik biyopsi sonuçlarının incelemektir. Gereç ve Yöntemler: Bu retrospektif çalışmada Mart 2015-Ekim 2017 tarihleri arasında kliniğimize yönlendirilen yetersiz servikal sitoloji ve yüksek riskli HPV pozitifliği olan kadınlara kolposkopi eşliğinde servikal biyopsi ve endoservikal küretaj yapıldı. Hastalar HPV tiplerine göre gruplandırıldı. Endoservikal küretaj, servikal biyopsi ve servikal konizasyon sonuçları analiz edildi. Bulgular: Yetersiz servikal sitolojisi ve yüksek riskli HPV pozitifliği olan 46 hasta 30 aylık dönemde bu çalışmaya dahil edildi. Yirmi bir hastada (% 45,7) HPV 16 ve/veya HPV 18 ve 25 hastada (% 54,3) “16 olmayan 18 olmayan” HPV yüksek risk alt tipi mevcuttu. Servikal biyopsi sonuçları 20 hastada (% 43.5) normal histopatoloji, dört hastada (% 8.7) "HPV etkisi", 17 hastada (% 37) düşük dereceli skuamöz intraepitelyal lezyon (L-SIL) ve 5 hastada (% 10.9) yüksek dereceli skuamöz intraepitelyal lezyon (H-SIL) olarak bildirildi. Endoservikal küretaj incelemesinde üç hastada H-SIL (% 6.5) ve yedi hastada L-SIL (% 15.2) tespit edildi. Yedi (% 15.2) hastaya H-SIL nedeniyle konizasyon yapıldı ve konizasyon materyelinde üç cerrahi sınırları negatif H-SIL ve dört L-SIL bildirildi. Sonuç: Yetersiz servikal sitolojisi ve yüksek riskli HPV pozitifliği olan kadınlar için HPV alt tiplerinden bağımsız olarak H-SIL riski arttığından kolposkopi yapmak çok önemli görünmektedir.

Keywords

• servikal sürüntü
• yetersiz servikal sitoloji
• insan papilloma virüsü
• kolposkopi

Analysis of colposcopic findings of high-risk HPV positive women with unsatisfactory cervical cytology

Abstract

Aim: We aimed to analyze the colposcopic directed biopsy results of women with unsatisfactory cervical cytology and high-risk human papilloma virus (HPV) positivity, who were referred to the Gynecologic Oncology outpatient clinic from Cancer Early Diagnosis and Screening Centers. Materials and Methods: In this retrospective study, women with high-risk HPV subtypes who applied to our clinic between March 2015 and October 2017 with an inadequate cervical cytology underwent colposcopy-directed biopsy. Patients were grouped according to HPV types. The results of endocervical curettage, cervical biopsy, and cervical conization were analyzed. Results: Forty-six patients with unsatisfactory cervical cytology and high-risk HPV were included in this study during the 30-month period. Twenty-five (54.3%) of the patients had “non-16 non-18” HPV subtypes, while 21 (45.7%) had HPV 16 and/or HPV 18. Cervical biopsy results revealed high-grade squamous intraepithelial lesion (H-SIL) in 5 (10.9%) patients, low-grade squamous intraepithelial lesion (L-SIL) in 17 (37%), “HPV effect” in 4 (8.7%) and normal histopathology in 20 (43.5%) patients. The endocervical curettage revealed three (6.5%) women with H-SIL and seven (15.2%) with L-SIL. Seven (15.2%) patients underwent conization due to H-SIL and there were three H-SIL with negative margins and four L-SIL in the final histopathology report. Conclusion: Performing colposcopy seems to be crucial for women with inadequate cervical cytology and high-risk HPV regardless of HPV subtypes as there is an increased risk of H-SIL in this patient population.

Keywords

• cervical cytoloji
• unsatisfactory cervical cytology
• human papillomavirus
• colposcopy

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