COMPARISON OF CONVENTIONAL AND LIQUID BASED SMEAR TECHNIQUES IN HUMAN PAPİLLOMA VIRUS POSITIVE WOMEN

Yıl 2016, Cilt: 19 Sayı: 3, 107 - 112, 21.05.2018

Ümit Görkem , Cihan Toğrul Dilek Yılmaz , Cansu Nergizli Emine Arslan Tayfun Güngör

Öz

Aim: It was aimed to compare conventional (CS) and liquid-based smear (LBS) techniques in women cathegorized according to Human
Papilloma Virus (HPV) test results.
Material and methods: 140 participant women admitted to Hitit University Hospital was included into this prospective cross-sectional
study. According to HPV test results, the participants were divided into two groups; 1) HPV-negative (n=51) and 2) HPV-positive (n=89)
groups.The specimens collected by CS and LBS techniques were reported according to Bethesta 2001 system; 1- Normal, 2- Atypical
squamous cells of undetermined significance (ASC-US), 3- Atypical squamous cells- cannot exclude HSIL (ASC-H), 4- Low-grade squamous
intraepithelial lesion (L-SIL), 5- High-grade squamous intraepithelial lesion (H-SIL), 6- Atypical Glandular Cells not otherwise specified
(AGC-NOS) and 7- Inadequate specimen.
Results: HPV-positive women were living at rural area (p=0.005), had lower economical level (p=0.010) and lower educational level
(p=0.002). Both groups were statistically similar at the aspects of smoking, oral contraceptives, performing servical smear, medical history
of genital infections (p=0.315, p=0.498, p=0.329, p=0.086 and p=0.773). Past genital warts were more frequent in HPV-positive group
(p<0.001).
L-SIL was more frequently reported in LBS technique (p<0.001). Other cytologically results were found to be similar in HPV groups
(p>0.05, for all). The compatibility of the same results in both groups was not statistically different ((p=0.099).
Conclusion: In our study, LBS technique has an advantage for detecting L-SIL, and it is demonstrated that there is no difference for cytological
diagnosis. Furthermore, CS technique may be a preferable option to LBS technique due to increased costs. 

Anahtar Kelimeler

Conventional, liquid based, smear, HPV, cytology

HUMAN PAPİLLOMA VİRÜS POZİTİF KADINLARDA KONVANSİYONEL VE SIVI BAZLI SMEAR TEKNİKLERİNİN KARŞILAŞTIRMASI

Öz

Amaç: Human Papilloma Virus (HPV) test sonuçlarına göre kategorize edilmiş kadınlarda konvansiyonel smear (KS) ve sıvı bazlı smear
(SBS) tekniklerinin karşılaştırılması amaçlanmıştır.
Materyal ve Metodlar: Bu prospektif kesitsel çalışmaya Hitit Üniversitesi Hastanesi başvuran 140 kadın dahil edildi. HPV test sonuçlarına
göre katılımcılar ikiye ayrıldı: 1)HPV-negatif (n=51) ve 2)HPV-pozitif (n=89). KS ve SBS tekniklerine göre alınan örnekler Bethesta 2001sistemine
göre şu şekilde yorumlandı. 1- Normal, 2- Önemi belirsiz atipik skuamöz hücre (ASC-US), 3- Yüksek dereceli skuamöz intraepitelyal
lezyonun ekarte edilemediği atipik skuamöz hücreler (ASC-H), 4- Düşük dereceli skuamöz intraepitelyal lezyon (L-SIL), 5- Yüksek dereceli
skuamöz intraepitelyal lezyon (H-SIL), 6- Sınıflandırılamayan atipik glandüler hücreler (AGC-NOS) ve 7- Yetersiz materyal.
Bulgular: HPV pozitif katılımcıların daha çok kırsal bölgede yaşadığı (p=0.005), daha çok kötü ekonomik düzeyine (p=0.010) ve daha dü-
şük eğitim düzeyine sahip oldukları (p=0.002) belirlendi. Her iki grup sigara içme, oral kontraseptif kullanımı, smear testi yaptırma durumu,
genital enfeksiyon öyküsü istatistiksel olarak benzer idiler (p=0.315, p=0.498, p=0.329, p=0.086 ve p=0.773). Ancak geçirilmiş genital siğil
öyküsü HPV pozitif grupta daha sık idi (p<0.000).
L-SIL tanısı istatistiksel anlamlılıkla SBS tekniğinde daha sık rapor edilmişti (p<0.001). Diğer tüm tanıların sıklığının ise HPV pozitif ve
negatif gruplarda istatistiksel anlamda benzer olduğu saptandı (p>0.05). Her iki smear tekniğinde rapor edilen aynı sitolojik sonuçların
çıkma uyumluluğu açısından anlamlı bir fark gözlenmedi (p=0.099).
Sonuç: Çalışmamızda SBS tekniğinin L-SIL lezyonlarının saptanmasında daha avantajlı olduğunu ve diğer sitolojik tanılar için smear teknikleri
arasında bir fark olmadığı gösterilmiştir. Ayrıca KS, maliyet artışı konusu da dikkate alındığında SBS tekniğine iyi bir alternatif olabilir. 

Anahtar Kelimeler

sıvı bazlı, smear, HPV, konvensiyonel

Kaynakça

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