Yüksek dereceli servikal intraepitelyal neoplazi tanılı hastalarda konizasyon sonrası nüks gelişimini etkileyen faktörlerin değerlendirilmesi

Yıl 2021, Cilt: 7 Sayı: 1, 38 - 44, 23.04.2021

Mehtap Yücedağ Talip Karaçor Ateş Karateke

https://doi.org/10.30569/adiyamansaglik.827750

Öz

Amaç: Yüksek dereceli servikal intraepitelyal neoplazi (CIN) lezyonlarında konizasyon cerrahisi sonrası nüks riskini arttıran faktörlerin belirlenmesini amaçladık.
Gereç ve Yöntem: Yüksek dereceli CIN lezyonu olan yüz hastaya konizasyon cerrahisi uygulandı. Aynı hastalara, bir yıl sonra smear ve kolposkopik muayene yapıldı. Muayenede anormal bulgu tespit edilen hastalara biyopsi yapıldı. Biyopsi sonucunda yüksek dereceli CIN tespit edilen hastalar nüks pozitif, biyopsi sonucu normal gelen hastalar nüks negatif olarak belirlendi. Lezyonun nüksünü etkileyen faktörleri belirlemek için hastaların demografik verileri ve patolojik sonuçları incelendi.
Bulgular: Sigara içimi, glandüler tutulum, cerrahi sınıra 1,5 mm’den daha yakın lezyon varlığı ve lezyonun konizasyon materyalinin apeksine daha yakın yerleşik olması durumunda yüksek dereceli CIN lezyonlarının daha fazla nüks ettiği saptandı
Sonuç: Yüksek dereceli CIN lezyonlarında, konizasyon ve diğer ablatif cerrahi tedaviler sonrası, nüks edebilme riskinden dolayı bu hastaların takip ve tedavisi ciddi özen ile yapılmalıdır.

Anahtar Kelimeler

Servikal smear, Konizasyon, Neoplazi

Destekleyen Kurum

yok

Proje Numarası

yok

Teşekkür

yok

Evaluation of the factors affecting the development of recurrence after conization for high-grade cervical intraepithelial neoplasia diagnosis patients

Öz

Aim: We aimed to determine the factors that increase the risk of recurrence after conization surgery in high-grade cervical intraepithelial neoplasia (CIN) lesions.
Materials and Methods: Conization surgery was performed on 100 patients with high-grade CIN lesions. Smear and colposcopic examinations were performed on the same patients one year later. Biopsy was performed in patients with abnormal findings on examination. Patients with high-grade CIN as a result of biopsy were identified as recurrence positive, and patients with no pathology after biopsy were identified as recurrence negative. Demographic data and pathological results of the patients were examined to determine the factors affecting the recurrence of the lesion.
Results: We found that high-grade CIN lesions relapse more frequently when smoking, glandular involvement, presence of lesions closer than 1.5 mm to the surgical margin and if the lesion was located closer to the apex of the conization material.
Conclusion: In high-grade CIN lesions, following conization and other ablative surgical treatments, follow-up and treatment of these patients should be done with great care because of the risk of recurrence.

Anahtar Kelimeler

Cervical smear, Conization, Neoplasia

Proje Numarası

yok

Kaynakça

• Dağlı AF, Özercan MR. Servikal Smear Tarama Programımızda Sınırlılık/Yetersizlik Oranları ve Nedenleri (1322 Olgu). Fırat Tıp Dergisi 2006;11(3):166-169.
• Wright TC, Massad LS, Dunton CJ, Spitzer M, Wilkinson EJ, Solomon D. 2006 consensus guidelines fort he management of women with cervical intraepithelial neoplasia or adenocarcinoma in situ. Am J Obstet Gynecol. 2007;3:40-45.
• Duggan BD, Felix JC, Muderspach LI, Gebhardt JA, Groshen S, Morrow CP, et alCold-knife conization versus conization by the loop electrosurgical excision prosedüre: a randomized, prospective study. Am J Obstet Gynecol. 1999;180:276-82.
• Ferlay J, Steliarova-Foucher E, Lortet-Tieulent J, et al. Cancer incidence and mortality patterns in Europe: estimates for 40 countries in 2012. Eur J Cancer, 2013;49:1374-403.
• T.C. Sağlık Bakanlığı Sağlık İstatistikleri Yıllığı 2015. Yayın No:1054. Ankara: Sistem Ofset Basım Yayın; 2016. ss.36–7.
• Bray F, Loos AH, McCarron P et al. Trends in cervical squamous cell carcinoma incidence in 13 European countries: changing risk and the effects of screening. Cancer Epidemiol Biomarkers Prev. 2005;14: 677-86.
• Patnick J. Cervical cancer control in Europe. CME Journal of Gynecologic Oncology. 2000;5: 8-12
• Yüce K. Serviks Kanserinde Risk Faktörleri. Klinik Aktüel Tıp Dergisi. 2007;12:46-50.
• Korach J, Machtinger R, Perri T, et al. Villoglandular papillary adenocarcinoma of the uterine cervix: a diagnostic challenge. Acta Obstet Gynecol Scand. 2009;88(3):355–358.
• Parazzini F, Negri E, La Vecchia C, Fedele L. Barrier methods of contraception and the risk of cervical neoplasia. Contraception. 1989;40(5):519-30.
• Castellsagué X, & Munoz N. Chapter 3: Cofactors in human papillomavirus carcinogenesis role of parity, oral contraceptives, and tobacco smoking. JNCI monographs. 2003;31:20-28.
• Lacey JV Jr, Frisch M, Brinton LA, Abbas FM, Barnes WA, Gravitt PE, et al. Associations between smoking and adenocarcinomas and squamous cell carcinomas of the uterine cervix. Cancer Causes Control. 2001;12:153–61.
• Zeng XT, Xiong PA, Wang F, Li CY, Yao J, Guo Y. Passive smoking and cervical cancer risk: a meta-analysis based on 3,230 cases and 2,982 controls. Asian Pac J Cancer Prev. 2012;13(6):2687-93.
• The Pap test and Bethesda 2014. Nayar R, Wilbur DC. Cancer Cytopathol. 2015;123(5):271-81.
• Burki TK. Atypical glandular cells and risk of cervical cancer. Lancet Oncol. 2016;17(3):e96.
• Mitchell MF, Tortolero-Luna G, Wright T, Sarkar A, Richar- ds-Kortum R, Hong WK. Cervical human papillomavirus infection and intraepithelial neoplasia: a review. J Natl Cancer Inst Monogr 1996;21:17-25.
• Jakobsson M, Gissler M, Tiitinen A, Paavonen J, Tapper AM, Treatment for cervical intraepithelial neoplasia and subsequent IVF deliveries, Human Reproduction, 2008, 23(10), 2252–2255.
• Hwang LY, Ma Y, Benningfield SM, Clayton L, Hanson EN, Jay J, Jonte J, Godwin de Medina C, Moscicki AB. Factors that influence the rate of epithelial maturation in the cervix in healthy young women. J Adolesc Health. 2009;44(2):103-110.
• Baiocchi G, Bovolim G, Goncalves B, et al 146 Predictive factors for residual disease after cone biopsy in cervical cancer: a matter of margin distance? International Journal of Gynecologic Cancer 2019;29:A67.
• Kashyap N, Krishnan N, Kaur S, Ghai S. Risk Factors of Cervical Cancer: A Case-Control Study. Asia Pac J Oncol Nurs. 2019;6(3):308-314