Yüksek riskli HPV pozitif olan hastalarda smear sonuçlarının kolposkopi eşliğinde alınan servikal biyopsi sonuçları ile karşılaştırılması
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Tarih
2021
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Hatay Mustafa Kemal Üniversitesi
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info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışmada amacımız HPV DNA taraması sırasında yüksek riskli hpv tipi testpit edilen hastalarda, servikal sitolojisi sonuçlarının kolposkopi eşliğinde alınan servikal biyopsi sonuçları ile karşılaştırılması ve tek başına yüksek riskli HPV pozitifliğinin kolposkopiye refere edilmesinin gerekliliğini araştırmaktır. Yöntem: Prospektif olarak yaptığımız çalışmaya HR-HPV pozitif 60 hasta dahil edildi. Hastaların HPV tipi, smear sonuçları, gebelik sayısı, parite, doğum şekli, sigara kullanımı, eğitim durumu, kontraseptif yöntem, OKS kullanımı, postkoital kanama durumu, cinsel aktif süresi sorgulandı. Tüm hastalara kolposkopi işlemi uygulandı. Kolposkopik bulgular, ECC ve biyopsi sonuçları istatistiksel olarak incelendi. Bulgular: HPV 16 pozitif olan hastalarda HSIL oranı %47, HPV 18 pozitif olanlarda %0 olarak bulunurken diğer HR-HPV genotiplerinde %12.5 oranında tespit edilmiştir. Bulgularımız istatistiksel olarak anlamlı bulunmuştur (p=0,012 ). Sigara içenlerin Pap smear sonuçlarının %60,0'ında CIN 1 ve üzeri lezyon saptanmış, içmeyenlerin %31,4'ünde CIN 1 ve üzeri lezyon görülmüş ve aradaki fark anlamlı bulunmuştur (p=0,028). Sigara içme durumu ile biyopsi sonuçlarını karşılaştırdığımızda sigara kullanan hastaların %40,0'ında HSIL ve üzeri biyopsi sonucu olduğu tespit edilmiş iken, sigara kullanmayanların %5,7'sinde HSIL ve üzeri görülmüş ve sonuçlar istatistiksel olarak anlamlı bulunmuştur(p=0,003). Sonuç: Çalışmamızda HPV 16 en sık izlenen genotiptir. HPV 16 pozitif vakalarda, biyopsi sonuçlarında HSIL oranı anlamlı bulunmuştur. Sigara kullanan hastaların smear ve kolposkopik biyopsi sonuçları anlamlı bulunmuştur. HR-HPV pozitif vakaların tümüne kolposkopi yapılması ile serviksin preinvaziv lezyonları erken tanı alabilir ve hastalar serviks kanserine ilerlemeden tedavi edilebilir.
Aim: In this study, comparison of cervical cytology results with cervical biopsy results obtained with colposcopy from patients with high risk HPV type, and investigation of the necessity of referring all high risk HPV positive patients to colposcopy were aimed. Materials and Methods: Sixty HR-HPV positive patients were included in this prospective study. HPV type, smear results, gravidity, parity, mode of delivery, smoking status, education, contraceptive method, use of OC, postcoital bleeding, sexual activity duration were questioned. Colposcopy was applied to all patients. Colposcopic findings, ECC and biopsy results were analyzed. Results: While the rates of HSIL were found as 47% and 0% among HPV 16 positive and HPV 18 positive patients, respectively, it was found as 12,5% among other HR-HPV positive patients. Our findings were statistically significant (p=0.012). LSIL or higher lesions in Pap smear results were detected in 60% of smokers and 31.4% of non-smokers, and the difference was statistically significant (p = 0.028). While 40% of the smokers had HSIL or higher lesions in cervical biopsy results, only 5.7% of the non-smokers had. The difference was statistically significant (p = 0.003). Conclusion: HPV 16 was the most common genotype in this study. The rate of HSIL in the biopsy results was found to be statistically significantly higher in HPV 16 positive cases than in other types. Smear and colposcopic biopsy results of smokers were found to be significant. Colposcopic examination may be offered to other HR-HPV positive cases, not only to HPV 16 and 18 positive. Preinvasive lesions of the cervix can be diagnosed earlier with colposcopic biopsy in all HR-HPV positive cases.
Aim: In this study, comparison of cervical cytology results with cervical biopsy results obtained with colposcopy from patients with high risk HPV type, and investigation of the necessity of referring all high risk HPV positive patients to colposcopy were aimed. Materials and Methods: Sixty HR-HPV positive patients were included in this prospective study. HPV type, smear results, gravidity, parity, mode of delivery, smoking status, education, contraceptive method, use of OC, postcoital bleeding, sexual activity duration were questioned. Colposcopy was applied to all patients. Colposcopic findings, ECC and biopsy results were analyzed. Results: While the rates of HSIL were found as 47% and 0% among HPV 16 positive and HPV 18 positive patients, respectively, it was found as 12,5% among other HR-HPV positive patients. Our findings were statistically significant (p=0.012). LSIL or higher lesions in Pap smear results were detected in 60% of smokers and 31.4% of non-smokers, and the difference was statistically significant (p = 0.028). While 40% of the smokers had HSIL or higher lesions in cervical biopsy results, only 5.7% of the non-smokers had. The difference was statistically significant (p = 0.003). Conclusion: HPV 16 was the most common genotype in this study. The rate of HSIL in the biopsy results was found to be statistically significantly higher in HPV 16 positive cases than in other types. Smear and colposcopic biopsy results of smokers were found to be significant. Colposcopic examination may be offered to other HR-HPV positive cases, not only to HPV 16 and 18 positive. Preinvasive lesions of the cervix can be diagnosed earlier with colposcopic biopsy in all HR-HPV positive cases.
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Anahtar Kelimeler
Kadın Hastalıkları ve Doğum, Obstetrics and Gynecology, HPV, Smear, Kolposkopi, Serviks Kanseri, HPV, Smear, Colposcopy, Cervical Cancer
