Research Article
BibTex RIS Cite

Yüksek Riskli HPV Pozitif Sitolojik Sonuçların, Kolposkopik Biyopsi Sonuçları İle Karşılaştırılması

Year 2019, Volume: 16 Issue: 3, 540 - 544, 25.12.2019
https://doi.org/10.35440/hutfd.649689

Abstract

Amaç: Yüksek risk HPV pozitif, normal veya anormal sitolojik bulgusu olan
hastalarda kolposkopik biyopsi sonuçların değerlendirilmesi ve bu biyopsi
sonuçları ile birliktelik gösteren yüksek risk HPV tiplerinin dağılımının
belirlenmesi amaçlandı.

Materyal ve
Metod
: Ocak 2017 ve Eylül 2017
tarihleri arasında rutin jinekolojik kontrol veya herhangi bir jinekolojik
şikayetle Harran Üniversitesi Kadın Hastalıkları ve Doğum Kliniğine başvuran
hastalar ile gerçekleştirildi. Hastalar 20-30, 31- 40 ve 40 yaş üstü olmak
üzere 3 gruba ayrıldı. Hastalardan papsmear ve eş zamanlı olarak serviks
transformasyon zonundan ve servikal eksternal os’tan HPV taraması için sürüntü
alındı ve yüksek risk HPV DNA varlığı araştırıldı.  Yüksek risk HPV pozitif normal veya anormal
sitolojik bulgusu olan 84 hasta çalışmaya dahil edildi.

Bulgular: Yüksek risk HPV pozitifliği olan 84 hastanın smear sonuçları; %61,9
inflamasyon, %6 ASCUS, %17,9 LGSIL, %10,7 yüksek dereceli servikal
intraepitelyal lezyon, %1,2 atipik skuamoz hücreler-yüksek dereceli lezyonun
ekarte edilemediği (ASC-H) ve % 2.4 atrofi olarak raporlandı. Smear sonucu
inflamasyon olan hastalarda en sık kolposkopik biyopsi tanısı CIN I (%21,2),
önemi bilinmeyen atipik skuamoz hücre olanlarda CIN II (%40), düşük dereceli
servikal intraepitelyal lezyon olanlarda, epitelyal hiperplazi (%33,3)
idi.  Smear sonucu HSIL olan hastalarda
%44,4 CIN II ve CIN III, %11,1 CIN I patolojik tanıları raporlandı.  Skuamoz kanser tanısı alan iki hastada HPV 16,
bir hastada ise HPV 18 pozitifliği saptanırken serviks adenokanser tanısı alan
iki hastanın birinde HPV 16, diğerinde ise HPV 18 tespit edildi. 

Sonuç: Yüksek risk HPV pozitif olan hastalarda smear sonucundan bağımsız
yapılan kolposkopik biyopsi ile displazik lezyonları saptama olasılığı
artmaktadır. İleride daha kapsamlı çalışmalarla yüksek risk HPV taramasının tek
başına smear testinin yerini alabileceğini düşünmekteyiz.









Anahtar
kelimeler:
HPV, Smear, Kolposkopi,
Sevikal patoloji

References

  • Kaynaklar1. Peto J, Gilham C, Fletcher O, Matthews FE. The cervical cancer epidemic that screening has prevented in the UK. The Lancet 2004;364(9430):249-256.
  • 2. Nanda K, McCrory DC, Myers ER, Bastian LA, Hasselblad V, Hickey JD et al. Accuracy of the papanicolaou test in screening for and follow-up of cervical cytologic abnormalities a systematic review. Annals of internal medicine 2000;132(10):810-819.
  • 3. Meijer C, Helmerhorst TJ, Rozendaal L, Van der Linden J, Voorhorst F, Walboomers J. HPV typing and testing in gynaecological pathology: has the time come? Histopathology 1998;33(1):83-86.
  • 4. Lizard G, Roignot P, Brunet-Lecomte P, Chardonnet Y. Morphological analysis of in situ hybridization signals in cervical intraepithelial neoplasia containing human papillomavirus type 16 or 18: relationship with histological grade and DNA content. Cytometry 1998;34(4):180-186.
  • 5. Saslow D, Runowicz CD, Solomon D, Moscicki AB, Smith RA, Eyre HJ et al. American Cancer Society guideline for the early detection of cervical neoplasia and cancer. CA: a cancer journal for clinicians 2002;52(6):342-362.
  • 6. Saslow D, Solomon D, Lawson HW, Killackey M, Kulasingam SL, Cain J et al. American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer. CA: a cancer journal for clinicians 2012;62(3):147-172.
  • 7. Berkowitz RP. 2012 updated consensus guidelines for the management of abnormal cervical cancer screening tests and cancer precursors. Obstetrics & Gynecology 2013;122(2, PART 1):393.
  • 8. Rodríguez AC, Schiffman M, Herrero R, Wacholder S, Hildesheim A, Castle PE et al. Rapid clearance of human papillomavirus and implications for clinical focus on persistent infections. Journal of the National Cancer Institute 2008;100(7):513-517.
  • 9. Benedet J, Matisic J, Bertrand M. An analysis of 84, 244 patients from the British Columbia cytology–colposcopy program. Gynecologic oncology 2004;92(1):127-134.
  • 10. Valdespino VM, Valdespino VE. Cervical cancer screening: state of the art. Current Opinion in Obstetrics and Gynecology 2006;18(1):35-40.
  • 11. Kyrgiou M, Koliopoulos G, Martin-Hirsch P, Arbyn M, Prendiville W, Paraskevaidis E. Obstetric outcomes after conservative treatment for intraepithelial or early invasive cervical lesions: systematic review and meta-analysis. The Lancet 2006;367(9509):489-498.
  • 12. Arbyn M, Kyrgiou M, Simoens C, Raifu A, Koliopoulos G, Martin-Hirsch P et al. Perinatal mortality and other severe adverse pregnancy outcomes associated with treatment of cervical intraepithelial neoplasia: meta-analysis. Bmj 2008;337:a1284.
  • 13. Cancer TC, Group CCR. Prevalence of cervical cytological abnormalities in Turkey. International Journal of Gynecology & Obstetrics 2009;106(3):206-209.
  • 14. Keskin HL, Seçen Eİ, Taş EE, Kaya S, Avşar AF. Servikal smear sitolojisi ile kolposkopi eşliğinde servikal biyopsi korelasyonu. Türk Jinekolojik Onkoloji Dergisi 2011;3:71-75.
  • 15. Mete Ö, Yavuz E, Tuzlalı S, İlhan R, Özlük Y, Topuz S et al. Kolposkopik biyopsi yapılan 112 hastanın retrospektif incelemesi: Sitolojik bulguların histoloji ile karşılaştırılması. Turk Patoloji Derg 2007;23:33-37.
  • 16. Davey DD, Austin RM, Birdsong G, Buck HW, Cox JT, Darragh TM et al. ASCCP Patient Management Guidelines* Pap Test Specimen Adequacy and Quality Indicators. American journal of clinical pathology 2002;118(5):714-718.
  • 17. Castle PE, Schiffman M, Wheeler CM, Solomon D. Evidence for frequent regression of cervical intraepithelial neoplasia-grade 2. Obstetrics and gynecology 2009;113(1):18.
  • 18. Andersson S, Wallin K, Hellström A, Morrison L, Hjerpe A, Auer G et al. Frequent gain of the human telomerase gene TERC at 3q26 in cervical adenocarcinomas. British journal of cancer 2006;95(3):331-338.
  • 19. Gage JC, Sadorra M, LaMere BJ, Kail R, Aldrich C, Kinney W et al. A comparison of the cobas® HPV test with Hybrid Capture 2 and Linear Array HPV DNA tests. Journal of clinical microbiology 2011:JCM. 05989-05911.
  • 20. Ergünay K, Misirlioğlu M, Firat P, Tuncer Zs, Tuncer S, Ustaçelebi Ş. Sitolojik Olarak Anomali Saptanan Serviks Örneklerinde Insan Papilloma Virus Dna’sinin Araştirilmasi Ve Virusun Tiplendirilmesi. Mikrobiyol Bült 2007; 41: 219-226
  • 21. Bell MC, Schmidt-Grimminger D, Patrick S, Ryschon T, Linz L, Chauhan SC. There is a high prevalence of human papillomavirus infection in American Indian women of the Northern Plains. Gynecologic oncology 2007;107(2):236-241.
  • 22. Wentzensen N, Schiffman M, Dunn T, Zuna RE, Gold MA, Allen RA et al. Multiple human papillomavirus genotype infections in cervical cancer progression in the study to understand cervical cancer early endpoints and determinants. International journal of cancer 2009;125(9):2151-2158.
  • 23. Bülbül M, Dilbaz B, Türk BA, Hatipoğlu F, Boyar E. Human Papilloma Virus Genotype Distribution in Women with Cervical Intraepithelial Neoplasia. Journal of Clinical Obstetrics & Gynecology. 2018;28(3):112-20.

Comparison of Colposcopic Biopsy Results with High Risk HPV Positive Cytologic Results

Year 2019, Volume: 16 Issue: 3, 540 - 544, 25.12.2019
https://doi.org/10.35440/hutfd.649689

Abstract

Background: The aim of the present study was to evaluate the pathologic results of
colposcopic examination of patients with High Risk HPV (HR-HPV) who have normal
or abnormal cytologic findings and to identify the distribution of HPV types
with biopsy results.

Materials and Methods: The present study was performed between
January 2017 and September 2017 in patients who attended to Harran University
Obstetrics and Gynecology Clinic for routine gynecological control or any
gynecological complaints. Patients were divided into 3 groups of 20-30, 31-40
and over 40 years old.  Pap smear and
swab samples were taken concurrently from cervical transformation zone and
external cervical ostium and presence of high-risk HPV-DNA were searched.
Eighty-four patients with HR-HPV who have normal or abnormal cytologic findings
were included in the study.

Results: The
smear results of 84 patients with HR-HPV positivity were reported as 61. 9%
inflammation, 6% ASCUS, 17.9% LSIL, 17.9% HSIL, 1.2% ASC-H and 2.4% atrophy.
The most common colposcopic biopsy was CIN I (21. 2%) in patients with
inflammatory cytological result, CIN II (40%) in patients with ASCUS and
epithelial hyperplasia (33. 3%) in patients with LSIL.  Patients with HSIL cytological result had
44.4% both CIN II and CIN III, 11.1% CIN I pathologic diagnoses.  HPV 16 was detected in two patients with
squamous cancer and HPV 18 was detected in one patient with squamous
cancer.  HPV 16 and HPV 18 were detected
in two patients who had a cervical adenocarcinoma diagnosis. 

Conclusion: In HR-HPV positive patients, colposcopic biopsy independent of smear
results is likely to detect the presence of dysplasic lesions.  With more in the future, we think   HR-HPV screening alone may take place of the
smear test.









Key words: HPV, Smear, Colposcopy, Cervical pathology

References

  • Kaynaklar1. Peto J, Gilham C, Fletcher O, Matthews FE. The cervical cancer epidemic that screening has prevented in the UK. The Lancet 2004;364(9430):249-256.
  • 2. Nanda K, McCrory DC, Myers ER, Bastian LA, Hasselblad V, Hickey JD et al. Accuracy of the papanicolaou test in screening for and follow-up of cervical cytologic abnormalities a systematic review. Annals of internal medicine 2000;132(10):810-819.
  • 3. Meijer C, Helmerhorst TJ, Rozendaal L, Van der Linden J, Voorhorst F, Walboomers J. HPV typing and testing in gynaecological pathology: has the time come? Histopathology 1998;33(1):83-86.
  • 4. Lizard G, Roignot P, Brunet-Lecomte P, Chardonnet Y. Morphological analysis of in situ hybridization signals in cervical intraepithelial neoplasia containing human papillomavirus type 16 or 18: relationship with histological grade and DNA content. Cytometry 1998;34(4):180-186.
  • 5. Saslow D, Runowicz CD, Solomon D, Moscicki AB, Smith RA, Eyre HJ et al. American Cancer Society guideline for the early detection of cervical neoplasia and cancer. CA: a cancer journal for clinicians 2002;52(6):342-362.
  • 6. Saslow D, Solomon D, Lawson HW, Killackey M, Kulasingam SL, Cain J et al. American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer. CA: a cancer journal for clinicians 2012;62(3):147-172.
  • 7. Berkowitz RP. 2012 updated consensus guidelines for the management of abnormal cervical cancer screening tests and cancer precursors. Obstetrics & Gynecology 2013;122(2, PART 1):393.
  • 8. Rodríguez AC, Schiffman M, Herrero R, Wacholder S, Hildesheim A, Castle PE et al. Rapid clearance of human papillomavirus and implications for clinical focus on persistent infections. Journal of the National Cancer Institute 2008;100(7):513-517.
  • 9. Benedet J, Matisic J, Bertrand M. An analysis of 84, 244 patients from the British Columbia cytology–colposcopy program. Gynecologic oncology 2004;92(1):127-134.
  • 10. Valdespino VM, Valdespino VE. Cervical cancer screening: state of the art. Current Opinion in Obstetrics and Gynecology 2006;18(1):35-40.
  • 11. Kyrgiou M, Koliopoulos G, Martin-Hirsch P, Arbyn M, Prendiville W, Paraskevaidis E. Obstetric outcomes after conservative treatment for intraepithelial or early invasive cervical lesions: systematic review and meta-analysis. The Lancet 2006;367(9509):489-498.
  • 12. Arbyn M, Kyrgiou M, Simoens C, Raifu A, Koliopoulos G, Martin-Hirsch P et al. Perinatal mortality and other severe adverse pregnancy outcomes associated with treatment of cervical intraepithelial neoplasia: meta-analysis. Bmj 2008;337:a1284.
  • 13. Cancer TC, Group CCR. Prevalence of cervical cytological abnormalities in Turkey. International Journal of Gynecology & Obstetrics 2009;106(3):206-209.
  • 14. Keskin HL, Seçen Eİ, Taş EE, Kaya S, Avşar AF. Servikal smear sitolojisi ile kolposkopi eşliğinde servikal biyopsi korelasyonu. Türk Jinekolojik Onkoloji Dergisi 2011;3:71-75.
  • 15. Mete Ö, Yavuz E, Tuzlalı S, İlhan R, Özlük Y, Topuz S et al. Kolposkopik biyopsi yapılan 112 hastanın retrospektif incelemesi: Sitolojik bulguların histoloji ile karşılaştırılması. Turk Patoloji Derg 2007;23:33-37.
  • 16. Davey DD, Austin RM, Birdsong G, Buck HW, Cox JT, Darragh TM et al. ASCCP Patient Management Guidelines* Pap Test Specimen Adequacy and Quality Indicators. American journal of clinical pathology 2002;118(5):714-718.
  • 17. Castle PE, Schiffman M, Wheeler CM, Solomon D. Evidence for frequent regression of cervical intraepithelial neoplasia-grade 2. Obstetrics and gynecology 2009;113(1):18.
  • 18. Andersson S, Wallin K, Hellström A, Morrison L, Hjerpe A, Auer G et al. Frequent gain of the human telomerase gene TERC at 3q26 in cervical adenocarcinomas. British journal of cancer 2006;95(3):331-338.
  • 19. Gage JC, Sadorra M, LaMere BJ, Kail R, Aldrich C, Kinney W et al. A comparison of the cobas® HPV test with Hybrid Capture 2 and Linear Array HPV DNA tests. Journal of clinical microbiology 2011:JCM. 05989-05911.
  • 20. Ergünay K, Misirlioğlu M, Firat P, Tuncer Zs, Tuncer S, Ustaçelebi Ş. Sitolojik Olarak Anomali Saptanan Serviks Örneklerinde Insan Papilloma Virus Dna’sinin Araştirilmasi Ve Virusun Tiplendirilmesi. Mikrobiyol Bült 2007; 41: 219-226
  • 21. Bell MC, Schmidt-Grimminger D, Patrick S, Ryschon T, Linz L, Chauhan SC. There is a high prevalence of human papillomavirus infection in American Indian women of the Northern Plains. Gynecologic oncology 2007;107(2):236-241.
  • 22. Wentzensen N, Schiffman M, Dunn T, Zuna RE, Gold MA, Allen RA et al. Multiple human papillomavirus genotype infections in cervical cancer progression in the study to understand cervical cancer early endpoints and determinants. International journal of cancer 2009;125(9):2151-2158.
  • 23. Bülbül M, Dilbaz B, Türk BA, Hatipoğlu F, Boyar E. Human Papilloma Virus Genotype Distribution in Women with Cervical Intraepithelial Neoplasia. Journal of Clinical Obstetrics & Gynecology. 2018;28(3):112-20.
There are 23 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Research Article
Authors

Talip Karaçor 0000-0001-7401-3945

Sibel Sak

Mert Ulaş Barut 0000-0002-7008-8218

Nurullah Peker This is me 0000-0002-3285-9990

Muhammet Erdal Sak 0000-0002-6570-1057

Publication Date December 25, 2019
Submission Date November 21, 2019
Acceptance Date December 16, 2019
Published in Issue Year 2019 Volume: 16 Issue: 3

Cite

Vancouver Karaçor T, Sak S, Barut MU, Peker N, Sak ME. Yüksek Riskli HPV Pozitif Sitolojik Sonuçların, Kolposkopik Biyopsi Sonuçları İle Karşılaştırılması. Harran Üniversitesi Tıp Fakültesi Dergisi. 2019;16(3):540-4.

Harran Üniversitesi Tıp Fakültesi Dergisi  / Journal of Harran University Medical Faculty