Do we need to perform cervical colposcopy for patients with VIN 2/3?

Öz

Objective: The incidence of VIN is tremendously increasing especially in young, mid-aged women. Our aim is to evaluate cervical pathologies in patients with VIN 2/3.Methods: Clinicopathological data of patients with VIN 2/3 who were surgically treated between 2009 and 2014 were retrieved from the computerized database of Zekai Tahir Burak Women’s Health Education and Research Hospital.Results: We identified 12 patients with VIN 2/3. Three patients were postmenopausal. The most common type of lesion was bilateral and multifocal. All the postmenopausal patients had a symptom of itching and discoloration whereas premenopausal patients came to the clinic generally with a globular-warty lesion. None of the postmenopausal patients were having a positive HPV PCR result. Nevertheless seven of nine premenopausal patients were having a positive HPV test 77,7% p

Anahtar Kelimeler

• VIN,CIN,smear,HPV

VIN 2/3 Hastalarinda Servikal Kolposkopi Gerekli Midir?

Öz

Amaç: VIN insidansı özellikle genç, orta yaş bayanlarda giderek artmaktadır. Biz VIN 2/3 olan hastalarda servikal patolojileri değerlendirmek istedik. Gereç ve Yöntemler: 2009-2014 yılları arasında Zekai Tahir Burak Kadın Sağlığı Eğitim ve Araştırma Hastanesi’nde cerrahi olarak tedavi edilen VIN 2/3 hastalarının kliniko-patolojik kayıtları bilgisayar tabanlı sistemden alınarak değerlendirilmiştir.Bulgular: VIN 2/3 olan 12 hasta bulundu. Üç hasta post-menopozal idi. En sık görülen lezyon tipi bilateral ve multifokaldi. Tüm postmenopozal hastalar kaşıntı ve renk değişikliği şikayeti ile başvururken, premenopozal hastalar genellikle siğilimsi, yüzeyden kabarık lezyonla başvurdular. Hiçbir postmenopozal hastada HPV PCR pozitif bulunmazken, dokuz premenopozal hastanın yedisinde HPV testi pozitifti 77.7% p

Anahtar Kelimeler

• VIN,CIN,smear,HPV

Kaynakça

1. Wallbillich J.J., Rhodes H.E., Milbourne A.M., Munsell M.F., Frumo- vitz M, Brown J, Trimble C.L., Schmeler K.M.; Vulvar intraepithelial neoplasia (VIN 2/3): comparing clinical outcomes and evaluating risk factors for recurrence, Gynecol Oncol 2012; 127: 312-5.
2. Kaushik S, Pepas L, Nordin A, Bryant A, Dickinson H.O.; Surgical interventions for high grade vulval intraepithelial neoplasia, Co- chrane Database Syst Rev, 2014; 3: p. CD007928.
3. De Sanjose S, Alemany L, Ordi J, Tous S, Alejo M, Bigby S.M., Joura E.A., Maldonado P. et al.; Worldwide human papillomavirus genotype attribution in over 2000 cases of intraepithelial and inva- sive lesions of the vulva, Eur J Cancer, 2013; 49: 3450-61.
4. Reyes M.C. and K. Cooper; An update on vulvar intraepithelial neo- plasia: terminology and a practical approach to diagnosis, J Clin Pathol, 2014; 67: 290-4
5. Lowy D.R. and J.T. Schiller; Reducing HPV-associated cancer globally, Cancer Prev Res (Phila), 2012; 5: 18-23.
6. Sideri M, Jones R.W., Wilkinson E.J., Preti M, Heller D.S., Scurry J, Haefner H, Neill S; Squamous vulvar intraepithelial neoplasia: 2004 modified terminology, ISSVD Vulvar Oncology Subcommit- tee, J Reprod Med, 2005; 50: 807-10.
7. Judson P.L., Habermann E.B., Baxter N.N., Durham S.B., Virnig B.A.; Trends in the incidence of invasive and in situ vulvar carci- noma, Obstet Gynecol, 2006; 107: 1018-22.
8. Jones R.W., D.M. Rowan, and A.W. Stewart; Vulvar intraepithe- lial neoplasia: aspects of the natural history and outcome in 405 women, Obstet Gynecol, 2005; 106: 1319-26.

9. Van Seters M, M. van Beurden, and A.J. de Craen; Is the as- sumed natural history of vulvar intraepithelial neoplasia III based on enough evidence?, A systematic review of 3322 published pa- tients, Gynecol Oncol, 2005; 97: 645-51.
10. Jones R.W. and D.M. Rowan; Spontaneous regression of vulvar intraepithelial neoplasia 2-3, Obstet Gynecol, 2000; 96: 470-2.
11. Maniar K.P., Ronnett B.M., Vang R, Yemelyanova A; Coexisting high-grade vulvar intraepithelial neoplasia (VIN) and condyloma acuminatum: independent lesions due to different HPV types oc- curring in immunocompromised patients, Am J Surg Pathol, 2013; 37: 53-60.
12. McNally O.M., Mulvany N.J., Pagano R, Quinn M.A., Rome R.M.; VIN 3: a clinicopathologic review, Int J Gynecol Cancer, 2002; 12: 490-5.
13. Committee on Gynecologic Practice of the American College of et al.; Management of vulvar intraepithelial neoplasia, J Low Genit Tract Dis, 2012; 16: 1-3.
14. Montz F.J.; Management of high-grade cervical intraepithelial neo- plasia and low-grade squamous intraepithelial lesion and potential complications, Clin Obstet Gynecol, 2000; 43: 394-409.
15. De Sanjose S, Quint W.G., Alemany L, Geraets D.T., Klauster- meier J.E., Loveras B, Tous S, Felix A; Human papillomavirus genotype attribution in invasive cervical cancer: a retrospective cross-sectional worldwide study, Lancet Oncol, 2010; 11: 1048-56.
16. Riethdorf S, Neffen E.F., Cviko A, Loning T, Crum C.P., Riethdorf L; p16INK4A expression as biomarker for HPV 16-related vulvar neoplasias, Hum Pathol, 2004; 35: 1477-83.
17. McCluggage W.G.; Premalignant lesions of the lower female geni- tal tract: cervix, vagina and vulva, Pathology, 2013; 45: 214-28.
18. Preti M, Van Seters M, Sideri M, Van Beurden M; Squamous vulvar intraepithelial neoplasia, Clin Obstet Gynecol, 2005; 48: 845-61.
19. Baser E, Ozgu E, Erkilinc S, Togrul C, Caglar M, Gungor T; Risk factors for human papillomavirus persistence among women un- dergoing cold-knife conization for treatment of high-grade cervical intraepithelial neoplasia, Int J Gynecol Obstet, 2014; 125: 275 - 8
20. Ribeiro F, Figueiredo A, Paula T, Borrego J; Vulvar intraepithelial neoplasia: evaluation of treatment modalities, J Low Genit Tract Dis, 2012; 16: 313-7.