One-Year Follow-Up Outcomes in Patients Undergoing Colposcopy for HPV 16 and/or 18 Positivity with Initially Negative Findings: Persistence and CIN2+ Development Rate

Öz

Aim: This study examined the one-year follow-up results of patients who underwent colposcopy for HPV 16 and/or 18 positivity and who had no lesions detected at the initial evaluation. The persistence rate, frequency of cytologic abnormalities, and the rate of high-grade lesions (CIN2+) were evaluated. Materials and Methods: This is a retrospective study examining the clinicopathological follow-up of 366 patients who underwent colposcopy for HPV 16 and/or HPV 18 positivity at our center between January 2015 and May 2016. SPSS 22.0 was used for analysis. Binary variables were expressed as counts and percentages. Results: Of the 366 patients under follow-up, 113 (30.9%) returned for follow-up. HPV positivity was detected again in 15 (30%) of the 50 patients who underwent repeat co-testing. Twenty-five (22%) of the 113 patients with cervical cytology had abnormal results. Colposcopic biopsy results for 8 of 23 patients (35%) who underwent colposcopy were CIN2+. Conclusion: Patients with HPV 16/18 positivity who had no lesions detected at initial colposcopy may develop significant rates of persistent and high-grade lesions within one year. Therefore, re-evaluation of this patient group with Co-testing within 12 months and repeat colposcopy in the presence of persistence are clinically recommended.

HPV 16 ve/veya 18 Pozitifliği Nedeniyle Kolposkopi Yapılan ve İlk Değerlendirmede Lezyon Saptanmayan Hastalarda Bir Yıllık İzlem Sonuçları: Persistans ve CIN2+ Gelişim Oranı

Öz

Amaç: Bu çalışmada, HPV tip 16 ve/veya 18 pozitifliği nedeniyle kolposkopi yapılan ve ilk değerlendirmesinde lezyon saptanmayan hastalarda, bir yıllık takip sonuçları incelenerek persistans oranı, sitolojik anormallik sıklığı ve yüksek dereceli lezyon (CIN2+) gelişim oranı değerlendirildi. Gereç ve Yöntem: Bu çalışma Ocak 2015 ve Mayıs 2016 tarihleri arasında merkezimizde HPV tip 16 ve/veya 18 pozitifliği için kolposkopi yapılan 366 hastanın kliniko-patolojik takiplerini inceleyen retrospektif bir çalışmadır. Analiz için SPSS 22.0 kullanıldı. İkili değişkenler sayım ve yüzde olarak ifade edildi. Bulgular: Takipte olan 366 hastanın 113 ü (%30.9) kontrole geldi. Tekrar Co-test yapılan 50 hastanın 15 inde (%30) tekrar HPV pozitifliği tespit edildi. Servikal sitoloji olan 113 hastanın 25 inde (%22) sonuç anormaldi. Kolposkopi yapılan 23 hastanın 8 inin (%35) kolposkopik biyopsi sonucu CIN2+ idi. Sonuç: HPV tip 16 ve/veya 18 pozitifliği olan ve ilk kolposkopisinde lezyon saptanmayan hastalarda, bir yıl içinde anlamlı oranda persistans ve yüksek dereceli lezyon gelişebilmektedir. Bu nedenle, bu hasta grubunun 12 ay içinde Co-test ile yeniden değerlendirilmesi ve persistans varlığında kolposkopinin tekrarlanması klinik olarak önerilmektedir.

Anahtar Kelimeler

• HPV 16
• HPV 18
• colposcopy
• persistence
• CIN2
• cervical cancer screening

Kaynakça

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