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

Yıl 2018, Cilt: 15 Sayı: 3, 102 - 105, 01.07.2018

İlknur Çöl Madendağ Yusuf Madendağ Erdem Şahin Mefkure Eraslan Şahin Gökhan Açmaz

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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