Yüksek riskli HPV pozitif ve ASCUS tanılı hastalarda kolposkopik inceleme ne kadar gerekli?

Is it Really Necessary to Perform Colposcopy in Patients with Ascus and HR HPV Positivity?

Özet

Pap smear rahim ağzı kanseri veya buna yol açabilecek hücre değişikliklerinin tespiti için çok önemli bir tarama yöntemidir. Önemi belirsiz atipik skuamöz hücreler (ASCUS),tüm servikal sitolojiler arasında %4-5 görülme sıklığı ile en sık görülen anormalliktir.İnsan papilloma virüsü (HPV) enfeksiyonu ,servikal intraepitelyal neoplazi (CIN) ve rahim ağzı kanserinin başlıca nedeni olarak kabul edilir.Servikal kanser taramasında yüksek dereceli skuamöz intraepitelyal lezyon (HSIL) gelen hastalara kolposkopi önerilir.Kolposkopi aynı zamanda yüksek riskli HPV pozitif ve ASCUS tanılı hastalara da önerilir.Bu çalışmanın amacı ASCUS ve yüksek riskli HPV pozitifliği olan hastalarda kolposkopinin önemini değerlendirmektir.

Abstract

Introduction: Papanicolaou (Pap) smear is a very important screening method for detection of cervİcal cancer or cell changes that can lead to it. Atypical squamous cells of undetermined significance (ASCUS) is the most common abnormality seen among all cervical cytologies with the percentage of 4-5% . Human papillomavirus (HPV) infection is regarded as a major cause of cervical intraepithelial neoplasia (CIN) and cervical cancer. Colposcopy is recommended for all women with high-grade squamous intraepithelial lesion (HSIL) and atypical squamous cells-cannot exclude high-grade squamous intraepithelial lesion (ASC-H) for cervical cancer screening . It is also recommended for high-risk HPV (HR HPV) positive women with ASCUS. The aim of this study is to evaluate the importance of colposcopy in patients with ASCUS and HR HPV positivity. Materials and Methods: We performed a retrospective study approved by the ethics committee of Acıbadem University. Women with diagnosis of ASCUS and HR HPV positivity who underwent colposcopic evaluation at 2 different gynecologic oncology clinics of our university from January 2011 to January 2019 were included in our study. The age range was from 21 to 48 and the mean age of patients’was 29. Subjects who were pregnant, hysterectomized or had previous cytological abnormalities were excluded. Conclusion: In this study, we aimed to evaluate the significance of colposcopy in patients with ASCUS and high-risk HPV positivity, especially strains 16 and 18. As mentioned in some other studies, immediate colposcopy is an expensive screening procedure for further evaluation of ASCUS .