Kolposkopi Yapılan Kadınlarda Anormal Servikal Sitoloji ve Biyopsi Sonuçlarına Göre Saptanan HPV Tipleri

Abstract

Amaç: Kolposkopi eşliğinde servikal biyopsi ve endoservikal küretaj (ECC) yapılan hastalarda patoloji ve referans smear sonuçlarına göre saptanan HPV tiplerini belirlemek. Gereç ve Yöntem: Bu retrospektif vaka serisinde, jinekolojik onkoloji polikliniğinde kolposkopi yapılan 520 hasta çalışmaya alındı. Hastaların yaşı, HPV sonuçları, HPV tipleri, smear sonucu, kolposkopik biyopsi ve ECC sonuçlarına, yapılan eksizyon işleminin tipine ve patolojik sonuçlara hastane kayıt sisteminden ulaşıldı. Referans smear sonuçları ve kolposkopi eşliğinde servikal biyopsi ve ECC sonuçlarına göre saptanan HPV tipleri belirlendi. Bulgular: Çalışmaya alınan hastaların 279’unda HPV pozitifti. 25.1% hastada HPV tip 16, 12.2% hastada tip 18, 47.0% (n=131) hastada diğer yüksek riskli HPV tipleri pozitifti. Diğer yüksek riskli HPV tiplerinden en sık HPV tip 39, 7.9% hastada izlendi. Referans smear sonucu 48.8% (n=239) hastada önemi belirlenemeyen atipik skuamöz hücreler, 23.9% (n=117) hastada düşük dereceli skuamöz intraepitelyal lezyon, 3.9% (n=19) hastada yüksek dereceli skuamöz intraepitelyal lezyon iken 23.5% (n=115) hastada smear sonucu normaldi. Smear sonucu anormal olan hastalarda yüksek riskli HPV enfeksiyonu sıklığı 68.3% idi ve en sık HPV tip 16 mevcuttu (25.1%). Punch biyopsi patolojisinde 48.4% hastada CIN (servikal intraepitelyal neoplazi)1, 8.1% hastada CIN2 veya CIN3, 30.4% hastada servisit ve 1.1% hastada skuamoz hücreli karsinom, 1% hastada normal patoloji saptandı. Biyopsi sonucu CIN2-3 veya skuamoz kanser olup, HPV tiplendirilmesi yapılan 71.4% hastada HPV tip 16 pozitifti. Sonuç: Anormal sitoloji sonucu olan kadınların 68.3%’ünde yüksek riskli HPV enfeksiyonu saptadık. En sık görülen HPV genotipi tip 16 (25.1%) idi ve 12.2% hastada tip 18, 7.9% hastada tip 39 mevcuttu. Biyopsi sonucu CIN2 ve 3 ve skuamoz kanser olan 71.4% hastada HPV tip 16 pozitifti, tip 18 ve diğer yüksek riskli HPV tipleri kalan kısmından sorumluydu.

To determine human papilloma virus (HPV) types detected based on pathology and reference smear results in patients who underwent colposcopy-guided cervical biopsy and endocervical curettage (ECC). Materials and Methods: In this retrospective case series, 520 patients who underwent colposcopy in the gynecological oncology outpatient clinic were included in the study. Patients’ age, HPV results, HPV types, smear results, colposcopic biopsy and ECC results, type of excision procedure and pathological results were obtained from the hospital registry system. HPV types determined based on reference smear results and colposcopy guided cervical biopsy and ECC results were identified. Results: HPV was positive in 279 of the patients included in the study. HPV type 16 in 25.1% patients, type 18 in 12.2%, and other high-risk HPV types in 47.0% (n = 131) patients were positive. Among the other high-risk HPV types, the most common HPV type was type 39, 7.9% of the patients. Reference smear result 48.8% (n = 239) of the patients was atypical squamous cells of undetermined significance, 23.9% (n = 117) of the patients was low-grade squamous intraepithelial lesions, 3.9% (n = 19) of the patients was high-grade squamous intraepithelial lesions and 23.5% (n = 115) of the patients smear result was normal. In patients with abnormal smear results, the frequency of high-risk HPV positivity was 68.3% and the most common HPV was type 16 (25.1%). In punch biopsy pathology, 48.4% was CIN (cervical intraepithelial neoplasia)1, 8.1% was CIN2 or CIN3, 30.4% was cervicitis and 1.1% was squamous cell carcinoma, and 1% was normal pathology. HPV type 16 was positive in 71.4% of the patients with CIN2-3 or squamous cancer. Result: We found that high-risk HPV infection rate was 68.3% of women with abnormal cytology results. The most common HPV genotype was type 16 (25.1%) and 12.2% of the patients had type 18 and 7.9% of the patients had type 39. HPV type 16 was positive in 71.4% of the patients with CIN2 and 3 biopsy and squamous cancer, type 18 and other high-risk HPV types were responsible for the remaining part.