Thinprep ve konvansiyonel servikovajinal smearlarin histopatolojik sonuçlarının karşılaştırılması

Amaç : Thinprep otomatik siste m (TİS) ve konvansiyonel yöntemle alınan servikovajinal smearlarda epitelyal hücre anormalliği tespit edilen olguların histopatolojik sonuçlarının karşılaştırılması. Gereç ve Yöntem: Ağustos 2011 - Aralık 2013 tarihleri arasında 2001 Bethesda sistemi (TBS III)’ e göre epitelyal hücre anormalliği saptanan 145 olguya kliniğimizde kolposkopik inceleme ve biyopsi yapıldı. Örneklerin 54’ ünü TİS tekniğine göre, geri kalan 91’ ini ise ko nvansiyonel yönteme göre servikovajinal smearında epitelyal hücre anormalliği saptanan olgular oluşturdu. Bunların histopatolojik inceleme sonuçları değerlendirilerek pozitif tanı oranları karşılaştırıldı. Bulgular: TİS grubunda tespit edilen ASCUS olgularında %56 pozitiflik, ASC - H’ de %50, LSIL’ de %66 ve HSIL’ de %100 pozitiflik saptandı. ASCUS olgularında en şiddetli patoloji CIN 3, LSIL olgularında mikroinvaziv karsinom, HSIL olgularında invazif serviks kanseri idi. Bu grupta sedece bir AGUS olgusu vardı ve bu olguda da kronik servisit saptandı. Konvansiyonel grupta tespit edile n ASCUS olgularında %35 pozitiflik, ASC- H’ de %60, LSIL’ de %73 ve HSIL’ de %100 pozitiflik saptandı. ASCUS olgularında en şiddetli patoloji CIN 3, LSIL olgularında mikroinvaziv karsinom, HSIL olgularında ise invazif serviks kanseri idi. Bu grupta kolposko pi yapılan dört AGUS olgusunun tümünde de kronik servisit bulguları mevcuttu. Sonuç: TİS veya konvansiyonel yöntemle alınan servikovajinal smearlarda ASC -H, LSIL ve HSIL’de olduğu gibi, ASCUS olgularında da şiddetli displazi mevcut olabilir. Pozitif tanı o ranı TİS’te tespit edilen ASCUS olgularında daha yüksek olabilir. Bu nedenle bu olgularda da mutlaka kolposkopik inceleme ve şüpheli alanlardan biyopsi alınmasını öneriyoruz.

Comparison of histopathological results of thinprep and conventional cervicovaginal smears

Objective: The comparison of colposcopy results of epithelial cell abnormalities that were detected at automatic thinprep systems (TIS) and conventional cervicovaginal smears. Material and Method : Colposcopic evaluation and biopsy were made to 145 patients that were diagnosed as epithelial cell abnormality according to the 2001 Bethesda system (TBS III) between August 2011 - December 2013. Fifty -four of these patients were evaluated by TIS and the remaining 91 by conventıonal cervıcovagınal smear. We evaluated and compared the positive diagnosis rates of histopathological examination results. Results: In TIS group, 56% positivity was identified in patients with ASCUS, 50% in ASC- H, 66% in LSIL and 100% in HSIL. The most severe pathology in patients with ASCUS was CIN-3, micro -invasive carcinoma in LSIL, invasive cervical carcinoma in HSIL. Only an AGUS case was in this group and the pathology result was chronic cervicitis. In conventıonal cervıcovagınal smears group, 35% positivity was identified in patients with ASCUS, 60% in ASC- H, %73 in LSIL and %100 in HSIL. The most severe pathology in patients with ASCUS was CIN- 3, micro -invasive carcinoma in LSIL, invasive cervical carcinoma in HSIL. Four AGUS cases were in this group and their pathology results were chronic cervicitis. Conclusion: Severe dysplasia can be found with ASCUS as ASC- H, LSIL and HSIL at that were detected with TIS and conventional cervicovagin al smears. The positivity rate of ASCUS wa s found a higher The at TIS than conventıonal cervicovaginal smears. Therefore we suggest colposcopic examination and if necessary biopsy for these patients.

Kaynakça

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