Yüksek Dereceli Lezyonların Dışlanamayacağı Atipik Skuamöz Hücrelerin Klinik Önemi; Anadolu’daki Bir Üçüncül Hastanenin Deneyimi

Year 2020, Volume: 42 Issue: 4, 412 - 417, 13.07.2020

Yusuf Çakmak Tufan Öge

https://doi.org/10.20515/otd.603831

Abstract

Çalışmamızın öncelikli amacı servikal sitolojide
yüksek dereceli skuamöz lezyonların dışlanamadığı atipik skuamöz hücre (ASC-H)
tanısı almış hastaların histolojik sonuçlarının değerlendirilmesi ve bu durumun
klinik öneminin ortaya çıkarılmasıdır. Yirmibin
yüzaltmışüç hastanın smear sonuçları değerlendirildi. Yetmiş altı (0.376 %)
hastada ASC-H tanısı kondu. ASCH tanısı konan hastaların dosyaları retrospektif
olarak gözden geçirildi. ASCH tanısı konan tüm hastalara kolposkopik muayene
işlemi yapıldı. Kolposkopik muayenede gerekli görülen hastalara eksizyonel
işlemler ile servikal ve endoservikal biyopsi işlemleri uygulandı. Hastaların
klinik patolojik bilgileri dosyalarından incelenip toplandı. Gözden geçirilen
20163 smear sonucunda 1188 (5.8%) hastada servikal anormal sitoloji tespit edildi. Bu
anormal servikal sitolojilerin 76 tanesinde ASCH (0.37% ) tespit
edildi. ASCH tanısı alan 76 hastanın 36 (47.3%) tanesinde anormal servikal
displazi tespit edildi. Bunlarında 20 (20/76-26.3%) tanesinde yüksek dereceli servikal
intraepitelyal neoplazi (CIN2-3) ,12 (12/76-15.7%) tanesinde düşük dereceli
servikal intraepitelyal neoplazi(CIN1) ve 4 (4 /76-5%) tanesinde servikal
invazif kanser tespit edildi. ASCH
tanısı önemli oranda prekanseröz ve kanseröz lezyonlarla ilişkilidir. Bu
nedenle ASCH hastalarının yönetiminde ileri değerlendirme yapılırken gerekli
özen ve dikkat sağlanmalıdır.

Keywords

ASCH, Servikal sitoloji, Servikal intraepitelyal neoplazi

Clinical Significance of Atypical Squamous Cells in Which High Grade Lesions Cannot Be Excluded; Experience of aTertiary Hospital in Anatolia

Abstract

The primary aim of our study
was to evaluate the histological results of patients diagnosed with atypical
squamous cells, cannot exclude high-grade lesion (ASC-H) by cervical cytology
and to reveal the clinical importance of ASC-H.Twenty thousand one hundred sixty three cervicovaginal smears were
evaluated. Seventy six (0.376 %) patients were
diagnosed as ASC-H. Files of patients diagnosed with ASC-H were
retrospectively reviewed. We referred patients who were diagnosed as ASC-H according
to the Bethesda classification system after cervicovaginal smear for
colposcopic examination. İf it is necessary, cervical biopsy, endocervical and
endometrial curettage were performed by the colposcopy guide.
Clinicopathological features of the patients were examined and recorded. Smear results of 20163 patients reviewed. Abnormal
cytological results were found in 1188 (5.8%) patients. The abnormal
cytological results were ASC-H in 76 (0.37% ) patients. Abnormal cervical
dysplasia was detected in 36 (47.3%) of 76 patients diagnosed as ASC-H. Twenty
(20/76-26.3%) of these abnormal lesions were high-grade cervical
intraepithelial neoplasia (CIN2 / 3), 12 (12/76-15.7%) of them were low-grade
cervical intraepithelial neoplasia (CIN 1) and 4 (4 /76-5%) of them were
cervical carcinoma. ASC-H is a diagnosis with significant association with
precancerous and cancerous lesions. Therefore, further evaluation of ASC-H
patients should be performed with the necessary care and attention

Keywords

ASC-H, Cervical cytology, Cervical intraepithelial neoplasia

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