Ümit GÖRKEM, Cihan TOĞRUL, Dilek YILMAZ, Cansu NERGİZLİ, Emine ARSLAN, Tayfun GÜNGÖR

HUMAN PAPİLLOMA VİRÜS POZİTİF KADINLARDA KONVANSİYONEL VE SIVI BAZLI SMEAR TEKNİKLERİNİN KARŞILAŞTIRMASI

Amaç: Human Papilloma Virus (HPV) test sonuçlarına göre kategorize edilmiş kadınlarda konvansiyonel smear (KS) ve sıvı bazlı smear (SBS) tekniklerinin karşılaştırılması amaçlanmıştır. Materyal ve Metodlar: Bu prospektif kesitsel çalışmaya Hitit Üniversitesi Hastanesi başvuran 140 kadın dahil edildi. HPV test sonuçlarına göre katılımcılar ikiye ayrıldı: 1)HPV-negatif (n=51) ve 2)HPV-pozitif (n=89). KS ve SBS tekniklerine göre alınan örnekler Bethesta 2001sistemine göre şu şekilde yorumlandı. 1- Normal, 2- Önemi belirsiz atipik skuamöz hücre (ASC-US), 3- Yüksek dereceli skuamöz intraepitelyal lezyonun ekarte edilemediği atipik skuamöz hücreler (ASC-H), 4- Düşük dereceli skuamöz intraepitelyal lezyon (L-SIL), 5- Yüksek dereceli skuamöz intraepitelyal lezyon (H-SIL), 6- Sınıflandırılamayan atipik glandüler hücreler (AGC-NOS) ve 7- Yetersiz materyal. Bulgular: HPV pozitif katılımcıların daha çok kırsal bölgede yaşadığı (p=0.005), daha çok kötü ekonomik düzeyine (p=0.010) ve daha dü- şük eğitim düzeyine sahip oldukları (p=0.002) belirlendi. Her iki grup sigara içme, oral kontraseptif kullanımı, smear testi yaptırma durumu, genital enfeksiyon öyküsü istatistiksel olarak benzer idiler (p=0.315, p=0.498, p=0.329, p=0.086 ve p=0.773). Ancak geçirilmiş genital siğil öyküsü HPV pozitif grupta daha sık idi (p<0.000). L-SIL tanısı istatistiksel anlamlılıkla SBS tekniğinde daha sık rapor edilmişti (p<0.001). Diğer tüm tanıların sıklığının ise HPV pozitif ve negatif gruplarda istatistiksel anlamda benzer olduğu saptandı (p>0.05). Her iki smear tekniğinde rapor edilen aynı sitolojik sonuçların çıkma uyumluluğu açısından anlamlı bir fark gözlenmedi (p=0.099). Sonuç: Çalışmamızda SBS tekniğinin L-SIL lezyonlarının saptanmasında daha avantajlı olduğunu ve diğer sitolojik tanılar için smear teknikleri arasında bir fark olmadığı gösterilmiştir. Ayrıca KS, maliyet artışı konusu da dikkate alındığında SBS tekniğine iyi bir alternatif olabilir.

Anahtar Kelimeler:

sıvı bazlı, smear, HPV, konvensiyonel

COMPARISON OF CONVENTIONAL AND LIQUID BASED SMEAR TECHNIQUES IN HUMAN PAPİLLOMA VIRUS POSITIVE WOMEN

Aim: It was aimed to compare conventional (CS) and liquid-based smear (LBS) techniques in women cathegorized according to Human Papilloma Virus (HPV) test results. Material and methods: 140 participant women admitted to Hitit University Hospital was included into this prospective cross-sectional study. According to HPV test results, the participants were divided into two groups; 1) HPV-negative (n=51) and 2) HPV-positive (n=89) groups.The specimens collected by CS and LBS techniques were reported according to Bethesta 2001 system; 1- Normal, 2- Atypical squamous cells of undetermined significance (ASC-US), 3- Atypical squamous cells- cannot exclude HSIL (ASC-H), 4- Low-grade squamous intraepithelial lesion (L-SIL), 5- High-grade squamous intraepithelial lesion (H-SIL), 6- Atypical Glandular Cells not otherwise specified (AGC-NOS) and 7- Inadequate specimen. Results: HPV-positive women were living at rural area (p=0.005), had lower economical level (p=0.010) and lower educational level (p=0.002). Both groups were statistically similar at the aspects of smoking, oral contraceptives, performing servical smear, medical history of genital infections (p=0.315, p=0.498, p=0.329, p=0.086 and p=0.773). Past genital warts were more frequent in HPV-positive group (p<0.001). L-SIL was more frequently reported in LBS technique (p<0.001). Other cytologically results were found to be similar in HPV groups (p>0.05, for all). The compatibility of the same results in both groups was not statistically different ((p=0.099). Conclusion: In our study, LBS technique has an advantage for detecting L-SIL, and it is demonstrated that there is no difference for cytological diagnosis. Furthermore, CS technique may be a preferable option to LBS technique due to increased costs.

Keywords:

Conventional liquid based, smear, HPV, cytology,

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