Eylem ÜNLÜBİLGİN, Sevgi KOÇ

Major Sitolojik Anormalliklerde Kolposkopik Histopatoloji Sonuçlarımız: Tersiyer bir Merkezde 5 Yıllık Deneyim

Amaç: Sitoloji sonucu AGC, ASCH ve HSIL olan kadınlardaki kolposkopik girişimler sonucu tanı konulan yüksek dereceli servikal preinvaziv lezyon ve kanser(HSIL+) oranlarını Human Papillomavirus (HPV) durumu ve yaşa bağlı olarak karşılaştırmaktı. Yöntemler: Ocak 2015-Aralık 2019 tarihleri arasında hastanemiz kolposkopi ünitesine başvuran sitoloji sonucu AGC, ASCH ve HSIL olan ve ilk kez kolposkopi yapılan 387 hasta çalışmaya alındı. Çalışmaya alınan hastalar histopatolojik HSIL ve kanser sonuçları açısından HPV durumu ve yaş grupları: 30 altı, 30-39, 40-49 ve 50 ve üstü şeklinde tabakalandırılarak karşılaştırıldı. Bulgular: AGC, ASCH ve HSIL sitoloji gruplarında HSIL oranları sırasıyla %14,7, %40,8 ve %60,4’tür; kanser oranları ise sırasıyla %9,1, %3,2 ve %12,4 olarak bulunmuştur. HPV16 ve HPV18 tiplerinin AGC, ASCH ve HSIL gruplarındaki oranları sırasıyla %56,2, %84,4 ve %88,9’dur. HPV durumuna göre HPV16/18 pozitif AGC, ASCH ve HSIL sitoloji gruplarında HSIL+ oranları sırasıyla %50, %54.8 ve %81,5’dir. Sitoloji gruplarındaki invaziv kanserler yaşa göre değerlendirildiğinde; 30 yaş altında her üç grupta da invaziv kanser saptanmamış olup 30-39, 40-49 ve 50 ve üstü gruplarda sırasıyla %5,4, %8,1 ve %9,6’dır. Sonuçlar: AGC, ASCH ve HSIL sitoloji gruplarında HSIL+ oranları literatürde olduğu gibi yüksek olup hemen kolposkopi gereklidir. Her üç grupta da en sık görülen HPV tipi HPV 16’dır. Kolposkopik histopatoloji sonuçları negatif olanlarda refleks HPV testi yararlı olabilir.

The Colposcopic Histopathology Results in Major Cytological Abnormalities: 5 Years Experience in a Tertiary Center

Objective: To compare the rates of high grade cervical preinvasive lesions and cancer (HSIL+) diagnosed as a result of colposcopic interventions in women whose cytology results are AGC, ASCH and HSIL, depending on the condition of Human Papillomavirus (HPV) and age. Method: 387 patients who had AGC, ASCH and HSIL, who applied to the Colposcopy unit of the Health Sciences University TCSB Etlik Zübeyde Hanım Gynecology Training Research Hospital between January 2015 and December 2019, and who had colposcopy for the first time, were included in the study. The patients included in the study were compared in terms of histopathological HSIL and cancer results by stratifying HPV status and age groups: under 30, 30-39, 40-49 and 50 and above. Results: HSIL ratios in AGC, ASCH and HSIL cytology groups were 14.7%, 40.8% and 60.4%, respectively; cancer rates were found to be 9.1%, 3.2% and 12.4%, respectively. The rates of HPV16 and HPV18 types in AGC, ASCH and HSIL groups are 56.2%, 84.4% and 88.9%, respectively. According to HPV status, HSIL+ rates are 50%, 54.8% and 81.5% in HPV16/18 positive AGC, ASCH and HSIL cytology groups. Invasive cancer was not detected in all three groups under the age of 30, and in groups 30-39, 40-49 and 50 and above, it was 5.4%, 8.1% and 9.6%, respectively. Conclusions: In the AGC, ASCH and HSIL cytology groups, HSIL + rates are high as in the literature, and colposcopy is required immediately. The most common HPV type in all three groups is HPV 16. Reflex HPV test may be useful in those with negative colposcopic histopathology results.

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