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Original Research

BMB. 2023; 8(1): 78-81


Cytology may not be sufficient for cervical screening in women with HPV types other than type 16-type18 Tip 16- Tip 18 dışı HPV taşıyan kadınlarda servikal kanser taraması için yeterli olmayabilir

Erhan Okuyan, Ozlem Karabay Akgul.




Abstract

Amaç: Bu çalışmanın amacı, kolposkopi ve Loop elektroensizyon prosedür (LEEP) yapılan
Human Papilloma Virüsü (HPV) pozitif kadınlarda HPV tip 16 - 18 ve diğer yüksek riskli
HPV tipleri ile final patolojisi arasındaki ilişkiyi incelemektir.
Metod: Ocak 2017-Ocak 2019 tarihleri arasında tersiyer bir merkezde tedavileri yapılan 528

HPV pozitif kadının verileri geriye dönük olarak incelendi. LEEP yapılan hastaların yaşları,

smear sonuçları, HPV tipleri, kolposkopik biyopsilerin ve LEEP materyallerinin patoloji

sonuçları değerlendirildi. HPV tip 16 ve/veya 18 olan grup yüksek risk grubu(HRG) , tip 16

ve/veya 18 dışında olup da genital kanserlere neden olabilen HPV tiplerini (31, 33, 35, 39,

45, 51, 52, 56, 58, 59 ve 68 tipleri) diğer yüksek riskli HPV grubu (OHRG) olarak

tanımladık. Gebeler çalışmaya dahil edilmedi. Vajinal enfeksiyonu olan kadınlar tedavi

sonrası çalışmaya dahil edilmiştir. Kolposkopi ve patoloji sonuçları mevcut HPV tipine göre

istatistiksel olarak değerlendirildi.

Bulgular: OHRG grubunda 322 kadın (%61) vardı. Bu grupta HPV'li kadınların yaklaşık

%75'inde kolposkopide benign bulgular, 3 ( %0.9) kadında serviks kanseri tespit edildi.

HRG grubunda en yaygın kolposkopik bulgu benign bulgulardı, CIN1 (%30) ikinci

sıklıktaydı. CIN3 ve serviks kanseri yüksek risk grubunda daha yaygındı (sırasıyla %6,8 ve

%2,9). Non-16/18 grubunda % 75 kadına LEEP yapılmadan takip yapılmıştı, LEEP yapılan (

%25) kadınlarda %18 CIN1 tespit edildi.

Sonuçlar: OHRG’de smear negatif olsa bile 2 hastada kanser görüldü; bu nedenle bu gruptaki

hastalarda da HPV 16 ve 18 pozitifliğinde olduğu gibi sitolojiden bağımsız olarak kolposkopi

yapılması gerekebilir.



Aim: The aim of this study was to examine the relationship between HPV types 16-18 and
other high risk HPV types and final pathology in Human Papilloma Virus (HPV) positive
women who underwent colposcopy and Loop electroincision procedure (LEEP).

Method: The data of 528 HPV positive women hospitalized at tertiary center between January 2017 and January 2019 were recorded retrospectively. The ages of
the patients, smear results, HPV types, pathology results of colposcopic biopsies and pathology results of LEEP material in LEEP patients were evaluated. Women with HPV DNA
type 16 and/or 18 named as high risk group (HRG) and women with high risk HPV DNA types other than type 16 and/or 18 ( 31, 33, 35, 39, 45, 51, 52, 56, 58, 59 and 68 types) named as other high risk group (OHRG).Pregnant women were not included in the study. Women with vaginal infections were included in the study after treatment. Both groups were statistically analyzed according their colposcopical and pathological findings

Results: There were 322 women (61%) in the OHRG . While there were benign findings in the
colposcopy in approximately 75% of OHRG , cervical cancer was suspected in 3 (1%) of them.
Benign colposcopic findings were the most common in the HRG, and CIN1 (30%) was the
second most common. CIN3 and cancer were more common in the HRG (6.8% and 2.9%,
respectively). 75% of the patients in the OHRG were followed up; 25% had LEEP. CIN1 was
found in 18% of the women who underwent LEEP.

Conclusion: In the OHRG, invasive cervical cancer was diagnosed in 2 patients, even if the
smear was negative; for this reason, colposcopy may be required regardless of cytology, as in
HPV 16 and 18 positivity in these patients.

Key words: Colposcopy, Cytology, Cervical cancer, Human papilloma virus, Smear






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