2-Year Follow-Up Of HPV DNA Positive Women Who Were Histopathologically Diagnosed As LSIL

Yıl 2018, Cilt: 15 Sayı: 3, 114 - 116, 01.07.2018

İbrahim Yalçın Mustafa Erkan Sarı Hanifi Şahin Mehmet Mutlu Meydanlı Tayfun Güngör

Öz

Aim: To analyze 2-year follow-up results of HPV DNA positive women who were histopathologically diagnosed as low-grade squamous intraepithelial lesion LSIL .Material and Methods: This study was conducted in Gynecological Oncology Clinic of Zekai Tahir Burak Women’s Health Training and Research Hospital. The records of HPV DNA positive patients who were diagnosed as LSIL after colposcopic biopsy in 2015, were retrospectively reviewed.Results: Out of 183 women in total, 82 of them were in follow up. 38 of 82 patients were followed up for 2 years, 44 patients were lost in follow up after one year. The median age of the patients were 46 years. Colposcopy was performed in 13 patients due to abnormal cervical cytology during the follow-up period. The colposcopic biopsy results were normal, koilocytosis, LSIL, high-grade squamous intraepithelial lesion HSIL and neoplastic tissue fragments for 2, 1, 5, 4 and 1 patients, respectively. All patients histopathologically reported as HSIL and cervical carcinoma were positive for HPV 16.Conclusion: At the time of initial admission, HPV 16 positive cases who were histopathologically diagnosed as LSIL should be followed very carefully.

Anahtar Kelimeler

Cytology, human papillomavirus, low-grade squamous intraepithelial lesion

Yüksek Riskli HPV DNA Pozitif Olup Histopatolojik Olarak LSIL Tanısı Alan Kadınların 2 Yıllık Takibi

Öz

Amaç: Yüksek riskli Human Papilloma virüs HPV DNA pozitif olup histopatolojik olarak düşük grade skuamöz intraepitelyal lezyon LSIL tanısı alan kadınların 2 yıllık takip sonuçlarının analiz edilmesi.Gereç ve Yöntemler: Bu çalışma Zekai Tahir Burak Kadın Sağlığı Eğitim ve Araştırma Hastanesi Jinekolojik Onkoloji Kliniğinde gerçekleştirildi. 2015 yılında yüksek riskli HPV DNA pozitif olup kolposkopik biyopsi tanısı LSIL olan hastaların kayıtları retrospektif olarak incelendi. Standart istatistiksel analizler kullanıldı.Bulgular: Tanı alan 183 hastanın 82 tanesinin takipte olduğu izlendi. 82 hastanın 38 adeti 2 yıl boyunca takipte kalırken, 44 hasta bir yıl sonrasında takipten çıktı. Hastaların ortanca yaşı 46 idi. Takip sürecinde anormal servikal sitoloji sebebiyle 13 hastaya kolposkopi yapıldı. Kolposkopik biyopsi sonuçları 2 hasta normal, 1 hasta koilositoz, 5 hasta LSIL, 4 hasta yüksek grade skuamöz intraepitelyal lezyon HSIL ve 1 hasta neoplastik doku fragmanları olarak raporlandı. HSIL ve servikal karsinom olarak bildirilen histopatoloji sonucuna sahip bütün hastalar HPV 16 pozitifti.Sonuç: İlk başvuru esnasında HPV 16 pozitif olup histopatolojik olarak LSIL tanısı alan olgular çok dikkatli bir şekilde takip edilmelidir.

Anahtar Kelimeler

Düşük grade skuamöz intraepitelyal lezyon, human papilloma virüs, sitoloji

Kaynakça

• Elit L, Levine MN, Julian JA, Sellors JW, Lytwyn A, Chong S, et al. Ex- pectant management versus immediate treatment for low-grade cervical intraepithelial neoplasia : a randomized trial in Canada and Brazil. Cancer 2011;117:1438-45.
• Katki HA, Gage JC, Schiffman M, Castle PE, Fetterman B, Poitras NE, et al. Follow-up testing after colposcopy: five-year risk of CIN 2+ af- ter a colposcopic diagnosis of CIN 1 or less. J Low Genit Tract Dis 2013;17:69-77.
• Wright TC, Jr., Massad LS, Dunton CJ, Spitzer M, Wilkinson EJ, Solomon D, et al. 2006 consensus guidelines for the management of women with cervical intraepithelial neoplasia or adenocarcinoma in situ. J Low Genit Tract Dis 2007;11:223-39.
• Cox JT, Schiffman M, Solomon D, Group A-LTS. Prospective follow-up suggests similar risk of subsequent cervical intraepithelial neoplasia grade 2 or 3 among women with cervical intraepithelial neoplasia gra- de 1 or negative colposcopy and directed biopsy. Am J Obstet Gynecol 2003;188:1406-12.
• Darragh TM, Colgan TJ, Thomas Cox J, Heller DS, Henry MR, Luff RD, et al. The Lower Anogenital Squamous Terminology Standardization project for HPV-associated lesions: background and consensus recommendati- ons from the College of American Pathologists and the American Society for Colposcopy and Cervical Pathology Int J Gynecol Pathol 2013;32:76- 115.
• Nayar R, Wilbur DC. The Pap test and Bethesda 2014. Cancer Cytopathol 2015;123:271-81.
• Massad LS, Einstein MH, Huh WK, Katki HA, Kinney WK, Schiffman M, et al. 2012 updated consensus guidelines for the management of abnormal cervical cancer screening tests and cancer precursors. J Low Genit Tract Dis 2013;17:S1-S27.
• Pretorius RG, Peterson P, Azizi F, Burchette RJ. Subsequent risk and presentation of cervical intraepithelial neoplasia (CIN) 3 or cancer af- ter a colposcopic diagnosis of CIN 1 or less. Am J Obstet Gynecol. 2006;195(5):1260-5.
• Skare GB, Lönnberg S, Bjİrge T, Trope A. The Norwegian Cervical Cancer Screening Programme. Annual Report 2015. Oslo: Cancer Registry of Norway 2016.