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Üçüncü Basamak Bir Merkezde Yapılan Kolposkopi Sonuçlarının İncelenmesi

Yıl 2024, Cilt: 34 Sayı: 3, 365 - 370
https://doi.org/10.54005/geneltip.1438632

Öz

Arkaplan: Kolposkopi kadınlarda alt genital sistemin (serviks uteri, vajina ve vulva) değerlendirilmesidir. Servikal sitoloji, alt genital sistemdeki malignitelerin, özellikle de rahim ağzı kanserlerinin tarama testidir. Servikal sitoloji yapılan hastaların yaklaşık %10'unda anormallik bulunabilir ve bu hastalarda ileri tetkik yapılması gerekir. Bu aşamada kolposkopiye başvurulur.
Amaç: Bu çalışmanın amacı, üçüncü basamak bir hastane olan XXXX Hastanesi'ndeki yapılan kolposkopi sonuçlarını incelemektir.
Metod: Üçüncü basamak bir sağlık merkezi olan kliniğimizde, kolposkopi incelemesi sırasında, %3 asetik asit kullanılmaktadır ve gerekli görülürse Shiller test yapılmaktadır. Uygun görülen yerlerden biyopsi yapılmaktadır. Bu çalışmada 2 yıllık süreçte yapılan kolposkopi sonuçları retrospektif olarak incelendi. Bu inceleme ırasında 189 hasta dosyası tarandı. Hastaların dosyalarından, demografik veriler, smear, human papilloma virüsü (HPV) ve biyopsi sonuçları toplanarak analiz edildi.
Bulgular: Yapılmış olan 189 kolposkopi incelemesi sırasında yapılan biyopsilerden 177'sinde anormal bir patoloji sonucu izlendi. (Anormal: atipik glandüler hücreler, akantosiz, atipik skuamöz hücreler-yüksek dereceli skuamöz intraepitelyal lezyon olarak sıfıflandırılamayan, atrofi, erozyon, yüksek dereceli skuamöz intraepitelyal lezyon, düşük dereceli skuamöz intraepitelyal lezyon, skuamöz hücreli karsinom, skuamöz metaplazi). Sadece 12 hastadan yapılan kolposkopik biyopsi sonucu normal sonuçlandı.
Sonuç: HPV'li veya HPV'siz kadınlarda malign veya premalign servikal lezyonların tedavisinde risk bazlı yönetim önerilmektedir.

Kaynakça

  • Hinselmann H. Improvement of possibility of inspection of vulva, vagina and cervix uteri. München med Wschr. 1925;77:1733.
  • Burness JV, Schroeder JM, Warren JB. Cervical colposcopy: Indications and risk assessment. American family physician. 2020;102(1):39-48.
  • Boicea A, Patrascu A, Surlin V, Iliescu D, Schenker M, Chiutu L. Correlations between colposcopy and histologic results from colposcopically directed biopsy in cervical precancerous lesions. Rom J Morphol Embryol. 2012;53(3 Suppl):735-41.
  • Rajakeerthana R, Swarnapriya K, Kavitha G. Comparison of Pap Smear and Colposcopy in the Evaluation of Unhealthy Cervix Among Women Visiting a Tertiary Care Center: A Hospital-based Descriptive Observational Study. Nepal Journal of Obstetrics and Gynaecology. 2023;18(1):13-9.
  • Dash S, Sethy PK, Behera SK. Cervical Transformation Zone Segmentation and Classification based on Improved Inception-ResNet-V2 Using Colposcopy Images. Cancer Informatics. 2023;22:11769351231161477.
  • Ureyen I, Toptas T, Uysal A. Is routine ECC necessary in patients with HPV16 and normal cytology? Diagnostic Cytopathology. 2018;46(12):1031-5.
  • Massad LS, Perkins RB, Naresh A, Nelson EL, Spiryda L, Gecsi KS, et al. Colposcopy standards: guidelines for endocervical curettage at colposcopy. Journal of lower genital tract disease. 2023;27(1):97.
  • Guido R, Perkins RB. Management of Abnormal Cervical Cancer Screening Test: A Risk-based Approach. Clinical Obstetrics and Gynecology. 2023;66(3):478-99.
  • Nazeer S, Shafi MI. Objective perspective in colposcopy. Best Practice & Research Clinical Obstetrics & Gynaecology. 2011;25(5):631-40.
  • Uner FO, Korukcu O. A qualitative exploration of fear of cancer recurrence in Turkish cancer survivors who were referred for colposcopy. Health & Social Care in the Community. 2021;29(3):729-37.
  • Correa RM, Baena A, Valls J, Colucci MC, Mendoza L, Rol M, et al. Distribution of human papillomavirus genotypes by severity of cervical lesions in HPV screened positive women from the ESTAMPA study in Latin America. Plos one. 2022;17(7):e0272205.
  • Momenimovahed Z, Mazidimoradi A, Maroofi P, Allahqoli L, Salehiniya H, Alkatout I. Global, regional and national burden, incidence, and mortality of cervical cancer. Cancer Reports. 2023;6(3):e1756.
  • Cheung LC, Egemen D, Chen X, Katki HA, Demarco M, Wiser AL, et al. 2019 ASCCP risk-based management consensus guidelines: methods for risk estimation, recommended management, and validation. Journal of lower genital tract disease. 2020;24(2):90.
  • Egemen D, Cheung LC, Chen X, Demarco M, Perkins RB, Kinney W, et al. Risk estimates supporting the 2019 ASCCP risk-based management consensus guidelines. Journal of lower genital tract disease. 2020;24(2):132.
  • Campaner AB, Fernandes GL. Evaluation of 1,030,482 Cervical Smear Results in Brazilian Population. Asian Pacific Journal of Cancer Prevention. 2023.
  • ŞAHİN B, GÜNER E, KARA OF. The evaluation of colposcopic examinations and cervical histopathology results of women with abnormal pap-smear and/or hpv positivity: A sample from amasya. Batı Karadeniz Tıp Dergisi. 2020;4(3):142-9.
  • Wang SM, Hoeppner C, Kazma J, Keegan E, Werner L, Chappell NP. Diagnostic utility of endocervical curettage during colposcopy among patients of varying risk factors. Journal of lower genital tract disease. 2022;26(4):298-303.
  • Perkins RB, Guido RS, Castle PE, Chelmow D, Einstein MH, Garcia F, et al. 2019 ASCCP Risk-Based Management Consensus Guidelines: Updates Through 2023. Journal of lower genital tract disease. 2024;28(1):3-6.
  • Welby S, Rosillon D, Feng Y, Borys D. Progression from human papillomavirus (HPV) infection to cervical lesion or clearance in women (18–25 years): Natural history study in the control arm subjects of AS04-HPV-16/18 vaccine efficacy study in China between 2008 and 2016. Expert review of vaccines. 2022;21(3):407-13.
  • Lin W, Zhang Q, Chen Y, Dong B, Xue H, Lei H, et al. Changes of the vaginal microbiota in HPV infection and cervical intraepithelial neoplasia: a cross-sectional analysis. Scientific Reports. 2022;12(1):2812.
  • Papastamelos C, Linder M. Human papillomavirus anogenital screening in solid organ transplant recipients: a narrative review. Archives of Gynecology and Obstetrics. 2023;307(4):1277-83.
  • Peres MA, Huihua L, Antunes JLF, Perea LME, Iyer NG, Peres KG. Time trend and Age-Period-Cohort analysis of potentially HPV-related oral and pharyngeal cancer incidence in Singapore between 1968 and 2017. Oral Oncology. 2023;136:106272.
  • Wentzensen N, Schiffman M, Silver MI, Khan MJ, Perkins RB, Smith KM, et al. ASCCP colposcopy standards: risk-based colposcopy practice. Journal of lower genital tract disease. 2017;21(4):230-4.
  • Silver MI, Andrews J, Cooper CK, Gage JC, Gold MA, Khan MJ, et al. Risk of cervical intraepithelial neoplasia 2 or worse by cytology, human papillomavirus 16/18, and colposcopy impression: a systematic review and meta-analysis. Obstetrics and gynecology. 2018;132(3):725.

Examination of Colposcopy Results Performed at a Single Tertiary Level Center

Yıl 2024, Cilt: 34 Sayı: 3, 365 - 370
https://doi.org/10.54005/geneltip.1438632

Öz

Backround: Colposcopy is the evaluation of the lower genital system (cervix uteri, vagina and vulva) in women. Cervical cytology is the screening test for malignancy of the lower genital system, especially cervical cancers. An abnormality may be found in approximately 10% of patients undergoing cervical cytology and further investigation is required in these patients. At this stage, colposcopy is used.
Aim: The purpose of this study was to examine the results of colposcopy performed in XXXX Hospital.
Methods: In our clinic, which is a tertiary health center, 3% acetic acid is used during colposcopy examination and Shiller test is performed if necessary. Biopsies are performed in appropriate areas. In this study, colposcopy results performed over a 2 year period were examined retrospectively. During this review, 189 patient files were scanned. Demographic data, smear, human papillomavirus (HPV) and biopsy results were collected and analyzed from the patients' files.
Results: An abnormal pathology result was observed in 177 of the biopsies performed during the 189 colposcopy examinations. (Abnormal: atypical glandular cells, acanthosis, atypical squamous cells-cannot exclude high-grade squamous intraepithelial lesion, atrophic, erosion, high-grade squamous intraepithelial lesion, low-grade squamous intraepithelial lesion, squamous cell carcinoma, squamous metaplasia). Colposcopic biopsy results were normal in only 12 patients.
Conclusion: Risk-based management is recommended for the management of malignant or premalignant cervical lesions in women with or without HPV.

Etik Beyan

Approval for this study was obtained from the Local Ethics Committee (9.30.2022 - 22/483) and all procedures complied with the provisions of the 1995 Declaration of Helsinki (Brazil as revised in 2013).

Teşekkür

Thanks to Caroline Jane WALKER for her help with English Grammar.

Kaynakça

  • Hinselmann H. Improvement of possibility of inspection of vulva, vagina and cervix uteri. München med Wschr. 1925;77:1733.
  • Burness JV, Schroeder JM, Warren JB. Cervical colposcopy: Indications and risk assessment. American family physician. 2020;102(1):39-48.
  • Boicea A, Patrascu A, Surlin V, Iliescu D, Schenker M, Chiutu L. Correlations between colposcopy and histologic results from colposcopically directed biopsy in cervical precancerous lesions. Rom J Morphol Embryol. 2012;53(3 Suppl):735-41.
  • Rajakeerthana R, Swarnapriya K, Kavitha G. Comparison of Pap Smear and Colposcopy in the Evaluation of Unhealthy Cervix Among Women Visiting a Tertiary Care Center: A Hospital-based Descriptive Observational Study. Nepal Journal of Obstetrics and Gynaecology. 2023;18(1):13-9.
  • Dash S, Sethy PK, Behera SK. Cervical Transformation Zone Segmentation and Classification based on Improved Inception-ResNet-V2 Using Colposcopy Images. Cancer Informatics. 2023;22:11769351231161477.
  • Ureyen I, Toptas T, Uysal A. Is routine ECC necessary in patients with HPV16 and normal cytology? Diagnostic Cytopathology. 2018;46(12):1031-5.
  • Massad LS, Perkins RB, Naresh A, Nelson EL, Spiryda L, Gecsi KS, et al. Colposcopy standards: guidelines for endocervical curettage at colposcopy. Journal of lower genital tract disease. 2023;27(1):97.
  • Guido R, Perkins RB. Management of Abnormal Cervical Cancer Screening Test: A Risk-based Approach. Clinical Obstetrics and Gynecology. 2023;66(3):478-99.
  • Nazeer S, Shafi MI. Objective perspective in colposcopy. Best Practice & Research Clinical Obstetrics & Gynaecology. 2011;25(5):631-40.
  • Uner FO, Korukcu O. A qualitative exploration of fear of cancer recurrence in Turkish cancer survivors who were referred for colposcopy. Health & Social Care in the Community. 2021;29(3):729-37.
  • Correa RM, Baena A, Valls J, Colucci MC, Mendoza L, Rol M, et al. Distribution of human papillomavirus genotypes by severity of cervical lesions in HPV screened positive women from the ESTAMPA study in Latin America. Plos one. 2022;17(7):e0272205.
  • Momenimovahed Z, Mazidimoradi A, Maroofi P, Allahqoli L, Salehiniya H, Alkatout I. Global, regional and national burden, incidence, and mortality of cervical cancer. Cancer Reports. 2023;6(3):e1756.
  • Cheung LC, Egemen D, Chen X, Katki HA, Demarco M, Wiser AL, et al. 2019 ASCCP risk-based management consensus guidelines: methods for risk estimation, recommended management, and validation. Journal of lower genital tract disease. 2020;24(2):90.
  • Egemen D, Cheung LC, Chen X, Demarco M, Perkins RB, Kinney W, et al. Risk estimates supporting the 2019 ASCCP risk-based management consensus guidelines. Journal of lower genital tract disease. 2020;24(2):132.
  • Campaner AB, Fernandes GL. Evaluation of 1,030,482 Cervical Smear Results in Brazilian Population. Asian Pacific Journal of Cancer Prevention. 2023.
  • ŞAHİN B, GÜNER E, KARA OF. The evaluation of colposcopic examinations and cervical histopathology results of women with abnormal pap-smear and/or hpv positivity: A sample from amasya. Batı Karadeniz Tıp Dergisi. 2020;4(3):142-9.
  • Wang SM, Hoeppner C, Kazma J, Keegan E, Werner L, Chappell NP. Diagnostic utility of endocervical curettage during colposcopy among patients of varying risk factors. Journal of lower genital tract disease. 2022;26(4):298-303.
  • Perkins RB, Guido RS, Castle PE, Chelmow D, Einstein MH, Garcia F, et al. 2019 ASCCP Risk-Based Management Consensus Guidelines: Updates Through 2023. Journal of lower genital tract disease. 2024;28(1):3-6.
  • Welby S, Rosillon D, Feng Y, Borys D. Progression from human papillomavirus (HPV) infection to cervical lesion or clearance in women (18–25 years): Natural history study in the control arm subjects of AS04-HPV-16/18 vaccine efficacy study in China between 2008 and 2016. Expert review of vaccines. 2022;21(3):407-13.
  • Lin W, Zhang Q, Chen Y, Dong B, Xue H, Lei H, et al. Changes of the vaginal microbiota in HPV infection and cervical intraepithelial neoplasia: a cross-sectional analysis. Scientific Reports. 2022;12(1):2812.
  • Papastamelos C, Linder M. Human papillomavirus anogenital screening in solid organ transplant recipients: a narrative review. Archives of Gynecology and Obstetrics. 2023;307(4):1277-83.
  • Peres MA, Huihua L, Antunes JLF, Perea LME, Iyer NG, Peres KG. Time trend and Age-Period-Cohort analysis of potentially HPV-related oral and pharyngeal cancer incidence in Singapore between 1968 and 2017. Oral Oncology. 2023;136:106272.
  • Wentzensen N, Schiffman M, Silver MI, Khan MJ, Perkins RB, Smith KM, et al. ASCCP colposcopy standards: risk-based colposcopy practice. Journal of lower genital tract disease. 2017;21(4):230-4.
  • Silver MI, Andrews J, Cooper CK, Gage JC, Gold MA, Khan MJ, et al. Risk of cervical intraepithelial neoplasia 2 or worse by cytology, human papillomavirus 16/18, and colposcopy impression: a systematic review and meta-analysis. Obstetrics and gynecology. 2018;132(3):725.
Toplam 24 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Venereoloji (Cinsel Yolla Bulaşan Hastalık Bilimi), Klinik Tıp Bilimleri (Diğer)
Bölüm Original Article
Yazarlar

Oğuzhan Günenc 0000-0003-4373-5245

Emre Uysal 0000-0001-7636-5127

Erken Görünüm Tarihi 15 Haziran 2024
Yayımlanma Tarihi
Gönderilme Tarihi 17 Şubat 2024
Kabul Tarihi 28 Mart 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 34 Sayı: 3

Kaynak Göster

Vancouver Günenc O, Uysal E. Examination of Colposcopy Results Performed at a Single Tertiary Level Center. Genel Tıp Derg. 2024;34(3):365-70.