Cervical Biopsy, Smear Evaluation and Comparison of Human Papilloma Virus Subtypes Result

Year 2016, Volume: 17 Issue: 1, 17 - 21, 01.04.2016

Murat Arı Fürüzan Kaçar Döğer Sevin Kırdar Hasan Yüksel

Abstract

Objective: The aim of this study was to investigate the relationship between human papilloma virüs (HPV) types which was worked with polymerase chain reaction (PCR) and immunohistochemistry methods and cvtology and biyopsy results. Materials and Methods: A total of 100 cases from hospital between 2010-2013 participitated in this study. Linear Array HPV genotyping test was worked with PCR, tissue biopsies was evaluated with light microscopy, HPV was detected with immunohistochemistry (IHK) method and results were compared evaluating of conventional smear preparations according to Bethesda. Results: While 61 cases included high risk (61%), 39 cases included low risk HPV (39%). HPV types with high risk such as HPV16, HPV6, HPV11, HPV18, HPV31 respectively detected in 24, 19, 9, 7, 2 cases. HPV types with low risk such as HPV66 detected in 7 cases. HPV16 was observed epithelial cell abnormality such as 9 ASCUS, 3 LSIL,1 ASC-H, 1 AGUS in 14/24 ratio (58%) and ILMAN was observed 10/24 ratio (42%). Between cytological diagnosis results and HPV types are significant relationship according to chi-square test (p=0.001). When the results of the biopsy tissue analyzed, 38 patients were diagnosed intraepithelial neoplasia and malignant, 62 cases were diagnosed inflammation and other benign featured. The relationship between tissue diagnosis and HPV types is significant according to chi-square test (p<0.001). HPV in tissue was positive in 44 cases. The relationship between HPV types and tissue HPV results are significant (p<0.001). The cytological tissue diagnosis of 19 patients with ASCUS has been reported as follows; 10 CIN1, 3 CIN2, 2 CIN3 and 4 inflammation. Negative and positive HPV results studied in tissue are not significant results with cytological diagnosis (p=0.02) and tissue diagnosis results (p=0.02). Conclusion: The important of HPV detection is obvious, but tissue changes as well as HPV detection are important. Thus combined use of testing, even in evaluation with the biopsy results may give more realistic results for all types of cancers worldwide.

Keywords

Cervical cancer, HPV, cervical cytology, cervical biopsy

Servikal Biyopsi, Smear Değerlendirmesi ve İnsan Papilloma Virüsü Alt Tiplendirme Sonuçlarının Karşılaştırılması

Abstract

Amaç: Bu çalışmada, polimeraz zincir reaksiyonu (PZR) yöntemi ve doku immünhistokimyasal yöntemi ile çalışılan insan (human) papilloma virüsü (HPV) tipleri ile sitoloji ve biyopsi sonuçları arasındaki ilişkiyi tanımlamak amaçlanmıştır.Gereç ve Yöntemler: 2010-2014 tarihleri arasında hastaneye gelen 100 olgu ile çalışma yapılmıştır. PZR ile Lineer Array HPV genotiplendirme testi, doku biyopsisinin ışık mikroskopu ile değerlendirmesinin yanı sıra immünohistokimyasal yöntemle HPV tespiti ve konvansiyonel smear preparatlarının Bethesda’ya göre değerlendirmesi yapılarak sonuçlar karşılaştırılmıştır.Bulgular: Olguların 61 tanesinde yüksek riskli HPV (%61), 39 tanesinde düşük riskli HPV (%39) tespit edilmiştir. Yüksek riskli HPV tiplerinden HPV16; 24 olguda, HPV6; 19 olguda, HPV11; 9 olguda, HPV18; 7 olguda, HPV31; 2 olguda tespit edilmiştir. Düşük riskli HPV tiplerinden HPV66 (7 olgu) en sık izlenen tipti. Yirmi dört tane HPV16’lı olgunun 14‘ünde epitelyal hücre anomalisi görülmüştür (%58) (9 ASCUS, 3 LSIL, 1 ASC-H, 1 AGUS), 10’u İLMAN’dı (%42). Sitolojik tanı sonuçları ile HPV tipleri arasında ki-kare testine göre anlamlı bir ilişki vardır (p=0,001). Biyopsi doku sonuçlarına bakıldığında ise 38 olguda intraepitelyal neoplazi ve malign tanısı konulurken, 62 olguda enflamasyon ve diğer benign özellikli tanılar konulmuştur. Doku tanısı ile HPV tipleri arasındaki ilişki ki-kare testine göre anlamlıdır (p<0,001). Dokuda HPV, 44 olguda pozitifti. HPV tipleri ile doku HPV sonuçları arasındaki ilişki anlamlıdır (p<0,001). Sitoljik tanısı ASCUS olan 19 olgunun doku tanıları; 10 tanesinde CIN1, 3 tanesinde CIN2, 2 tanesinde CIN3, 4 tanesi de enflamasyon olarak raporlanmıştır. Dokuda çalışılan negatif ve pozitif HPV sonuçları, sitolojik tanı ile (p=0,02) ve doku tanı sonuçları ile (p=0,02) ilişkili bulunamamıştır. Sonuç: HPV saptanmasının önemi açıktır. Ancak HPV tiplemesinin yanı sıra doku değişiklikleri de önemlidir, bu nedenle testlerin kombine kullanılmasının hatta biyopsi sonuçları ile birlikte değerlendirilmesinin tüm dünyada yaygın olarak görülen bu kanser için daha gerçekçi sonuçlar verebileceği görüşündeyiz

Keywords

Servikal kanser, HPV, servikal sitoloji, servikal biyopsi

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