Evaluation of Pap-Smear Colposcopy and Leep Results of Hpv Infected Patients

INTRODUCTION: To determine the correlation between the results of Pap Smear and colposcopic examination and cervical sampling of HPV positive patients.
METHODS: Between January 2014 and June 2016, 148 patients, aged 25-80 years, who were admitted to Adnan Menderes University Obstetrics and Gynecology Outpatient Clinic were included in the study. Descriptive characteristics of patients such as age, body mass index, gravida, parity, smoking, menopausal status and comorbidities, and HPV-DNA, Pap Smear, colposcopy and LEEP results were recorded.
RESULTS: Cytology results of 56(%34,57) patients were ASCUS, LSIL of 50(%30,86), HSIL of 15(%9,26), HPV-DNA test results were positive for type 16 and / or 18 in eighty (%49,38) and positive for other HPV types in fifty (%30,86). Colposcopic examination revealed pathological findings in 122 (75.31%) patients. As a result of cytology, normal pathological examination rates in patients with ASCUS and LSIL, CIN 2-3 rates in patients with ASC-H and cervical cancer rates in AGC patients were significantly higher than others (p<0.001). No significant correlation was found between HPV-DNA results and cervical biopsy results according to HPV negativity or types (p=0.132). Normal pathological examination rates were significantly higher in patients without abnormal findings on colposcopic examination(p=0.001).
DISCUSSION AND CONCLUSION: We believe that the results of our study will contribute to the literature on the prevalence and type distribution of HPV in our region, the relationship between Pap Smear, HPV-DNA, colposcopy results and final pathological examination results. Multicenter studies with sufficient sample size and control groups are needed in this field.

Hpv Ýle Enfekte Hastalarýn Pap-Smear Kolposkopi Ve Leep Sonuçlarýnýn Deðerlendirilmesi

GÝRÝÞ ve AMAÇ: HPV taramasý yapýlmýþ hastalarýn Pap-smear ve kolposkopik inceleme sonuçlarýnýn servikal örnekleme sonucu ile iliþkisini belirlemektir.
YÖNTEM ve GEREÇLER: Ocak 2014-Haziran 2016 tarihleri arasýnda, Adnan Menderes Üniversitesi Kadýn Hastalýklarý ve Doðum Polikinliði'ne baþvuran, 25-80 yaþ arasý, 148 hasta çalýþmaya dahil edildi. Hastalarýn, yaþ, vücut kitle indeksi, gravida, parite, sigara kullanýmý, menopoz durumu ve ek hastalýklarý gibi tanýmlayýcý özellikleri ve HPV-DNA, Pap Smear, kolposkopi ve LEEP sonuçlarý kaydedildi.
BULGULAR: Hastalarýn, 56 (%34,57)’sýnýn sitoloji sonucu ASCUS, 50 (%30,86)’sinin LSIL, 15(%9,26)’inin HSIL, 80(%49,38)’inin HPV-DNA sonucu 16 ve/veya 18 pozitif, 50 (%30,86)’sinde diðer HPV tipleri pozitifti. Yapýlan kolposkopik incelemede 122(%75,31) hastada patolojik bulgu saptanmýþtý. Sitoloji sonucu, ASCUS ve LSIL olan hastalarda normal patolojik inceleme sonucuna sahip olma oranlarý, ASC-H saptanan hastalarda patolojik incelemede CIN 2-3 oranlarý, AGC olan hastalarda patolojik incelemede servikal kanser oranlarý diðerlerine göre anlamlý olarak daha fazlaydý (p <0.001). HPV-DNA sonuçlarý ile servikal biyopsi sonuçlarý arasýnda HPV negatifliði veya tiplerine göre anlamlý iliþki saptanamadý (p=0.132). Kolposkopik incelemede anormal bulgu izlenmeyen hastalarda, normal patolojik inceleme oranlarý anlamlý olarak daha fazlaydý (p=0,001).
TARTIÞMA ve SONUÇ: Çalýþmamýzda elde ettiðimiz verilerin bölgemizdeki HPV prevalansý ve tip daðýlýmýnýn, Pap-smear, HPV-DNA ve kolposkopi sonuçlarýnýn nihai patolojik inceleme sonuçlarý ile iliþkileri konusunda literatüre katký saðlayacaðýný düþünmekteyiz. Alanda çok merkezli, yeterli örneklem boyutuna sahip ve kontrol gruplarý içeren çalýþmalara ihtiyaç duyulmaktadýr.