Is Colposcopic Examination Necessary In Women With High Risk HPV Without HPV16/18?

Öz

Aim: The aim of this study is to compare the results of colposcopy and biopsy between HPV16/18 infected patients and other high-risk HPV hr- HPV infected patients.Material and Methods: This retrospective study was carried out in January 2016-December 2017 at a tertiary referral hospital. Patients who were admitted to the gynecology clinic between the ages of 30-64 years and whose hr-HPV was detected in the cervical specimens after the evaluation were included in the study. Hr-HPV types were defined as HPV- 16,-18,-31,-45,-33,-35,-51,-52,-58,-59. Patients were divided into two groups as HPV16 /18 positive and other positive HPV types. Demographic features and histopathological findings were compared between the two groups.Result: A total of 530 patients were included in the study. 240 patients were in the HPV16/18 positive group; 290 patients were classified in the other hr-HPV positive group. There was no difference between the groups for age, gravidity, body mass index, smoking, alcohol use and systemic disease presence p=0.832,p=0.785,p=0.852,p=0.812 ,p=0.792 and p=0.880,respectively . LGSIL and HGSIL rates were significantly higher in the HPV16 /18 group than in the other hr-HPV group p=0.001,p=0.001, respectively . In the HPV16 /18 group, LGSIL rate was 25.8% and HGSIL rate was 25.4%. The rates were 19.6% for LGSIL and 12.4% for HGSIL in the other group, although not as much as in HPV16 /18 group. Cervical cancer was detected in 1 patient in both groups.Conclusion: The other hr-HPV positivity is associated with cervical precancerous lesions and cervical cancer. The colposcopic examination and biopsy are a suitable approach for these patients.

Anahtar Kelimeler

• Human papillomavirus,LGSIL,HGSIL,cervical cancer

HPV 16 / 18 Dışındaki Yüksek Riskli HPV’li Kadınlarda Kolposkopik İnceleme Gerekli Midir?

Öz

Giriş: Bu çalışmanın amacı diğer yüksek riskli HPV yr-HPV enfeksiyonu varlığında, mevcut HPV tiplerinin servikal prekanseröz lezyonlar ve servikal kanser ile ilişkisini değerlendirerek kolposkopi ve biyopsi sonuçlarını, HPV16/18 pozitif hastalar ile karşılaştırmaktır.Gereç ve Yöntemler: Bu retrospektif çalışma bir tersiyer merkezde Ocak 2016-Aralık 2017 tarihleri arasında yapılmıştır. Çalışmaya 30-64 yaş arasında jinekoloji kliniğine başvuran yapılan değerlendirme sonrasında servikal örneklerde yr-HPV tespit edilen hastalar dahil edildi. Yr-HPV tipleri HPV-16,-18,-31,-45,-33,-35,-51,-52,-58,-59 varlığı olarak tanımlandı. Hastalar HPV16/18 pozitif olanlar ve diğer yr-HPV tipleri pozitif olanlar olarak iki gruba ayrıldı. Histopatolojik sonuçlar normal, metaplazi, servisit, LGSIL, HGSIL ve serviks kanseri olarak tanımlandı. İki grup arasındaki demografik özellikler ve histopatolojik bulgular karşılaştırıldı.Bulgular: Çalışmaya toplam 530 hasta dâhil edildi. 240 hasta HPV16/18 pozitif grupta olup; 290 hasta da diğer yr-HPV pozitif grupta sınıflandırıldı. Yaş, gravida, vücut kitle indeksi, sigara kullanımı, alkol kullanımı ve sistemik hastalık varlığı açısından gruplar arasında farklılık saptanmadı p=0.832, p=0.785, p:0.852, p=0.812, p=0.792 ve p=0.880, sırasıyla . LGSIL ve HGSIL oranı HPV16/18 grubunda, diğer yr-HPV grubuna oranla anlamlı derecede yüksek saptadı p=0.001,p=0.001,sırasıyla . HPV16/18 grubunda LGSIL oranı %25.8 ve HGSIL oranı %25.4 olarak tespit edildi. Oranlar her ne kadar HPV16/18 grubundaki kadar olmasa da diğer grupta LGSIL oranı %19.6 ve HGSIL oranı %12.4 idi. Servisit oranı diğer yr-HPV grubunda, HPV16/18 grubuna oranla yüksek saptandı p=0.001 . Serviks kanseri her iki grupta 1’er hastada tespit edildi.Sonuç: Diğer yr-HPV pozitifliğinin, her ne kadar HPV16/18 kadar olmasa da, servikal prekanseröz lezyonlar ve servikal kanser ile ilişkili olduğunu ve mevcut hastalar için kolposkopik incelemenin uygun bir yaklaşım olduğunu göstermektedir.

Anahtar Kelimeler

• Human papillomavirus,LGSIL,HGSIL,servikal kanser

Kaynakça

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