Mehtap YÜCEDAĞ, Talip KARAÇOR, Ateş KARATEKE

Yüksek dereceli servikal intraepitelyal neoplazi tanılı hastalarda konizasyon sonrası nüks gelişimini etkileyen faktörlerin değerlendirilmesi

Amaç: Yüksek dereceli servikal intraepitelyal neoplazi (CIN) lezyonlarında konizasyon cerrahisi sonrası nüks riskini arttıran faktörlerin belirlenmesini amaçladık.Gereç ve Yöntem: Yüksek dereceli CIN lezyonu olan yüz hastaya konizasyon cerrahisi uygulandı. Aynı hastalara, bir yıl sonra smear ve kolposkopik muayene yapıldı. Muayenede anormal bulgu tespit edilen hastalara biyopsi yapıldı. Biyopsi sonucunda yüksek dereceli CIN tespit edilen hastalar nüks pozitif, biyopsi sonucu normal gelen hastalar nüks negatif olarak belirlendi. Lezyonun nüksünü etkileyen faktörleri belirlemek için hastaların demografik verileri ve patolojik sonuçları incelendi.Bulgular: Sigara içimi, glandüler tutulum, cerrahi sınıra 1,5 mm’den daha yakın lezyon varlığı ve lezyonun konizasyon materyalinin apeksine daha yakın yerleşik olması durumunda yüksek dereceli CIN lezyonlarının daha fazla nüks ettiği saptandıSonuç: Yüksek dereceli CIN lezyonlarında, konizasyon ve diğer ablatif cerrahi tedaviler sonrası, nüks edebilme riskinden dolayı bu hastaların takip ve tedavisi ciddi özen ile yapılmalıdır.

Anahtar Kelimeler:

Servikal smear, Konizasyon, Neoplazi

Evaluation of the factors affecting the development of recurrence after conization for high-grade cervical intraepithelial neoplasia diagnosis patients

Aim: We aimed to determine the factors that increase the risk of recurrence after conization surgery in high-grade cervical intraepithelial neoplasia (CIN) lesions.Materials and Methods: Conization surgery was performed on 100 patients with high-grade CIN lesions. Smear and colposcopic examinations were performed on the same patients one year later. Biopsy was performed in patients with abnormal findings on examination. Patients with high-grade CIN as a result of biopsy were identified as recurrence positive, and patients with no pathology after biopsy were identified as recurrence negative. Demographic data and pathological results of the patients were examined to determine the factors affecting the recurrence of the lesion.Results: We found that high-grade CIN lesions relapse more frequently when smoking, glandular involvement, presence of lesions closer than 1.5 mm to the surgical margin and if the lesion was located closer to the apex of the conization material.Conclusion: In high-grade CIN lesions, following conization and other ablative surgical treatments, follow-up and treatment of these patients should be done with great care because of the risk of recurrence.

Keywords:

Cervical smear, Conization, Neoplasia,

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