DÖRTLÜ HPV AŞISININ VULVAR KONDİLOM NÜKSÜ ÜZERİNE ETKİSİ

Abstract

Amaç: Dörtlü HPV aşısının vulvar kondilomlar üzerine proflaktik ve olası terapotik etkilerini değerlendirmeyi amaçladık. Materyal ve Metod: Vulvovajinal kondilomu ve beraberinde değişik derecelerde servikal intraepitelyal lezyonu olan otuzüç hasta Zeynep Kamil Kadın ve Çocuk Hastalıkları Hastanesinde 2006-2014 yılları arasında kondilomları elektrokoterize edilerek tedavi edildi. Kondilom koterizasyonu sonrasında tüm hastalara 0, 2 ve 6 aylarda dörtlü HPV aşısı uygulandı. Hastalar 48 ay boyunca smear ve jinekolojik muayene ile takip edildi. Sonuçlar: Tedavi edilen 33 kondilomlu hastadan 6’sında(%18) HGSIL, 4 hastada (%12) ASCUS, 8 hastada (%24) LGSIL ve 15 hastada (%46) normal sınırlarda smear incelemesi bulundu. Kolposkopi eşliğinde biyopsi sonucunda 3 hastada (%9) CIN1, 1 hastada (%3) CIN 3, 19 hastada (%88) normal histopatoloji bulundu. HPV tiplendirmeleri sonucunda 2 hastada (%6) HPV tip 16, 1 hastada (%3) HPV tip 35, 1 hastada (%3) HPV tip 56, 11 hastada (%54) düşük riskli HPV tipleri bulundu. Onsekiz hastada (%54) negatif HPV sonuçları bulundu. Kondilom rekürrensi 4 hastada (%12) izlendi. Takip süresinde sadece bir hastada LGSIL bulundu.

Keywords

• HPV, Aşı, Kondilom

EFFICACY OF QUADRIVALENT HPV VACCINE FOR VULVAR CONDYLOMA RECURRENCE

Abstract

Aim: We tried to assess both prophylactic and therapeutic efficacies of quadrivalent vaccine for vulvar condylomas. Material and Methods: Thirty three women with vulvovaginal condylomas and variable degree of cervical preinasive lesions were treated with cauterization at gynecological oncology clinic of Zeynep Kamil Women and childrens health Training and Research hospital between 2006 to 2014. After cauterization treatment, subjects were vaccinated by quadrivalent HPV vaccine at 0, 2 and 6th months from the treatment. Subjects were followed for 48 months by repeat cervical smears/year and routine urogenital examination. Results: Among 33 cases with vulvar condylomas, there were 6 (18 %) cases with HGSIL, 4 (12 %) cases with ASCUS, 8 (24 %) cases with LGSIL and 15 (46 %) cases with normal cervical smear. Colposcopy directed biopsy revealed 3 (9 %) cases with CIN1, 1 (3 %) case with CIN 3, 29 (88 %) cases with normal histopathology. Distribution of HPV screening results were as follows:HPV 16 in 2 (6 %) cases, HPV 35 in 1 (3 %) case, HPV 56 in 1 (3 %) case, there were 18 (54 %) cases with HPV negative result and 11 (34 % ) cases with low risk HPV type. Condyloma recurrence was observed in 4 (12 %) cases. There was only 1 (3 %) case of women with abnormal smear (LGSIL) in control smears during 48 months of follow up. Conclusion: In our study, we included only regularly followed women through 48 months period, and our data revealed lowered condyloma recurrence after cauterization and quadrivalent vaccination

Keywords

• HPV, Vaccine, Condyloma