Kanser erken teşhis ve tarama eğitim merkezleri'ne KETEM başvuran kadınlarda Human Papillomavirüs HPV sıklığının değerlendirilmesi ve genotiplerin analizi

Öz

Amaç: Serviks kanseri Türkiye’de en sık görülen jinekolojik kanserler arasındadır. Human papillomavirüs HPV genotipleri ile servikal maligniteler arasında kuvvetli bir neden sonuç ilişkisi mevcuttur ve bölgeler arasında bu genotiplerin dağılımı farklılıklar göstermektedir. HPV dağılımı üzerine yapılmış populasyon temelli epidemiyolojik çalışmaların eksikliği sebebiyle prevalans ile ilgili veriler kısıtlıdır. Çalışmanın amacı, Çorum ilindeki human papillomavirüs HPV pozitiflik oranlarının ve yüksek riskli HPV tiplerinin dağılımlarının incelenerek Türkiye genelinde HPV haritası çıkarılmasıdır.Yöntem: Çorum ili Kanser Erken Teşhis ve Tarama Eğitim Merkezleri KETEM ’ne, Ağustos 2014 ile Ocak 2018 yılları arasında başvuran toplam 33.649 kadın dahil edilmiştir. Çalışma öncesi üniversite etik kurulundan gerekli onamlar alınmıştır. Servikal sürüntü örnekleri HPV-DNA inceleme için toplanmış ve polimeraz zincir reaksiyonu PCR yöntemi ile HPV DNA araştırılmıştır. HPV DNA sonucunun pozitif olduğu belirlenen olgularda genotiplendirme için yeniden analiz yapılmıştır. Ek olarak, HPV pozitif olan olgularda sitolojik inceleme sonuçları karşılaştırılmıştır.of the patients. HPV DNA was positive in 1108 cases, The highest risk subtypes for cervical cancer, Type 16 and 18, were 14.69% and 1.17%, respectively. When cytological results of HPV DNA positive women were examined; 66.52% of the patients had no precancerous lesion and infection-related cytology results were observed in 41.34% of these patients. The most frequent cytologic abnormal result was LGSIL with Conclusion: HPV typing studies are increasingly important in cervical cancer screening. Considering the regional differences and the heterogeneity of the studies, the results of the Ministry of Health’s screening program in 2019 will guide the assessment of the prevalence. By mapping HPV genotypes and evaluating advanced data across all country, appropriate vaccination and prevention policies can be developed.Sonuç: HPV tiplendirme serviks kanseri tarama programlarında giderek önem kazanmaktadır. Bölgesel farklılıklar ve literatürde yer alan çalışmaların metodolojisindeki heterojen dağılım düşünüldüğünde; Sağlık beklenen Türkiye geneli tarama programı sonuçları HPV prevalansının ve bölgeler arasındaki dağılımın değerlendirilmesinde yol gösterici olacaktır. HPV genotiplerinin yaygınlığının değerlendirilmesi ve ülkenin her bölgesinden edinilen verilerin analizi ile uygun aşılama ve korunma politikaları geliştirilebilir.Bakanlığı’nın yılında yayımlaması

Anahtar Kelimeler

• Human papillomavirüs, serviks kanseri, genotip, Türkiye

Evaluation of the frequency of Human Papillomavirus HPV in women admitted to cancer early diagnosis and screening training centers KETEM and analysis of HPV genotypes

Öz

Objective: CCervical cancer is one of the most common gynecologic cancers among women in Turkey. Human papillomavirus genotypes HPV are strongly associated with cervical malignancies, and the distribution of HPV genotypes varies regionally. Data on prevalence are limited due to the lack of population based epidemiological studies on HPV distribution. The purpose of the study was to assess HPV positivity rates, detect high- risk HPV types in Corum and obtain HPV mapping of Turkey.Methods: A total of 33.649 patients who applied to Cancer Early Diagnosis, Screening and Training Centers KETEM between August 2014 and January 2018 were included in this study. Prior to the study, permission was obtained from the ethics committee of the university. Cervical swab samples were collected for HPV-DNA examination and polymeraze chain reaction PCR method used to detect HPV DNA. Genotyping was performed in HPV DNA positive samples. In addition, cytologic examination results were also recorded in patients with HPV positives.Results: HPV DNA positivity was found in 3.29% Serviks kanseri kadınlarda en sık görülen dördüncü kanser olup tüm dünyada kanser ilişkili kadın ölümlerinin önemli bir kısmını oluşturmaktadır 1 . Dünya genelinde, büyük kısmı aşı ile önlenebilecek, yılda yaklaşık yarım milyon serviks kanseri olgusunun tanı aldığı düşünülmektedir 2 . Ülkemizde ise Sağlık Bakanlığı Kanser Dairesi verilerine göre yılda 1695 kadın serviks kanseri tanısı almaktadır ve kadınlarda görülen en sık 10. kanser konumundadır 3 . Serviks kanserlerinin tamamına yakınında sebep yüksek riskli human papilloma virüs HPV pozitifliği ve persistan HPV enfeksiyonudur 4 . HPV, 200’den of the patients. HPV DNA was positive in 1108 cases, The highest risk subtypes for cervical cancer, Type 16 and 18, were 14.69% and 1.17%, respectively. When cytological results of HPV DNA positive women were examined; 66.52% of the patients had no precancerous lesion and infection-related cytology results were observed in 41.34% of these patients. The most frequent cytologic abnormal result was LGSIL with Conclusion: HPV typing studies are increasingly important in cervical cancer screening. Considering the regional differences and the heterogeneity of the studies, the results of the Ministry of Health’s screening program in 2019 will guide the assessment of the prevalence. By mapping HPV genotypes and evaluating advanced data across all country, appropriate vaccination and prevention policies can be developed

Anahtar Kelimeler

• Human papilomavirus, cervical cancer, genotype, Turkey

Kaynakça

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