Yüksek Riskli HPV Pozitif Sitolojik Sonuçların, Kolposkopik Biyopsi Sonuçları İle Karşılaştırılması

Öz

Amaç: Yüksek risk HPV pozitif, normal veya anormal sitolojik bulgusu olan hastalarda kolposkopik biyopsi sonuçların değerlendirilmesi ve bu biyopsi sonuçları ile birliktelik gösteren yüksek risk HPV tiplerinin dağılımının belirlenmesi amaçlandı.

Materyal ve Metod: Ocak 2017 ve Eylül 2017 tarihleri arasında rutin jinekolojik kontrol veya herhangi bir jinekolojik şikayetle Harran Üniversitesi Kadın Hastalıkları ve Doğum Kliniğine başvuran hastalar ile gerçekleştirildi. Hastalar 20-30, 31- 40 ve 40 yaş üstü olmak üzere 3 gruba ayrıldı. Hastalardan papsmear ve eş zamanlı olarak serviks transformasyon zonundan ve servikal eksternal os’tan HPV taraması için sürüntü alındı ve yüksek risk HPV DNA varlığı araştırıldı.  Yüksek risk HPV pozitif normal veya anormal sitolojik bulgusu olan 84 hasta çalışmaya dahil edildi.

Bulgular: Yüksek risk HPV pozitifliği olan 84 hastanın smear sonuçları; %61,9 inflamasyon, %6 ASCUS, %17,9 LGSIL, %10,7 yüksek dereceli servikal intraepitelyal lezyon, %1,2 atipik skuamoz hücreler-yüksek dereceli lezyonun ekarte edilemediği (ASC-H) ve % 2.4 atrofi olarak raporlandı. Smear sonucu inflamasyon olan hastalarda en sık kolposkopik biyopsi tanısı CIN I (%21,2), önemi bilinmeyen atipik skuamoz hücre olanlarda CIN II (%40), düşük dereceli servikal intraepitelyal lezyon olanlarda, epitelyal hiperplazi (%33,3) idi.  Smear sonucu HSIL olan hastalarda %44,4 CIN II ve CIN III, %11,1 CIN I patolojik tanıları raporlandı.  Skuamoz kanser tanısı alan iki hastada HPV 16, bir hastada ise HPV 18 pozitifliği saptanırken serviks adenokanser tanısı alan iki hastanın birinde HPV 16, diğerinde ise HPV 18 tespit edildi. 

Sonuç: Yüksek risk HPV pozitif olan hastalarda smear sonucundan bağımsız yapılan kolposkopik biyopsi ile displazik lezyonları saptama olasılığı artmaktadır. İleride daha kapsamlı çalışmalarla yüksek risk HPV taramasının tek başına smear testinin yerini alabileceğini düşünmekteyiz.

Anahtar kelimeler: HPV, Smear, Kolposkopi, Sevikal patoloji

Anahtar Kelimeler

• HPV,Kolposkopi,servikal patoloji,kanser

Comparison of Colposcopic Biopsy Results with High Risk HPV Positive Cytologic Results

Öz

Background: The aim of the present study was to evaluate the pathologic results of colposcopic examination of patients with High Risk HPV (HR-HPV) who have normal or abnormal cytologic findings and to identify the distribution of HPV types with biopsy results.

Materials and Methods: The present study was performed between January 2017 and September 2017 in patients who attended to Harran University Obstetrics and Gynecology Clinic for routine gynecological control or any gynecological complaints. Patients were divided into 3 groups of 20-30, 31-40 and over 40 years old.  Pap smear and swab samples were taken concurrently from cervical transformation zone and external cervical ostium and presence of high-risk HPV-DNA were searched. Eighty-four patients with HR-HPV who have normal or abnormal cytologic findings were included in the study.

Results: The smear results of 84 patients with HR-HPV positivity were reported as 61. 9% inflammation, 6% ASCUS, 17.9% LSIL, 17.9% HSIL, 1.2% ASC-H and 2.4% atrophy. The most common colposcopic biopsy was CIN I (21. 2%) in patients with inflammatory cytological result, CIN II (40%) in patients with ASCUS and epithelial hyperplasia (33. 3%) in patients with LSIL.  Patients with HSIL cytological result had 44.4% both CIN II and CIN III, 11.1% CIN I pathologic diagnoses.  HPV 16 was detected in two patients with squamous cancer and HPV 18 was detected in one patient with squamous cancer.  HPV 16 and HPV 18 were detected in two patients who had a cervical adenocarcinoma diagnosis. 

Conclusion: In HR-HPV positive patients, colposcopic biopsy independent of smear results is likely to detect the presence of dysplasic lesions.  With more in the future, we think   HR-HPV screening alone may take place of the smear test.

Key words: HPV, Smear, Colposcopy, Cervical pathology

Kaynakça

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