Yıl: 2017 Cilt: 2 Sayı: 3 Sayfa Aralığı: 62 - 65 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Management of abnormal cytology results and correlation of cytopathologic results accompanied by colposcopy in our clinic

Öz:
Amaç: Pap smear testi serviks kanserinin erken tanı ve tedavisinde çok önemli bir tarama yöntemidir. Bu çalışmanın amacı, smear testinde anormallik saptanan olguların yönetiminde kolposkopi ve patolojik incelemenin öneminin belirlenebilmesidir. Gereç ve yöntemler: Bu çalışmada 2014-2016 yılları arasında Düzce Atatürk Devlet Hastanesi Jinekoloji Polikliniği'ne başvuran 12.381 hastanın Bethesda sınıflamasına göre Pap Smear testi sonuçları ve kolposkopi eşliğinde alınan sitopatoloji sonuçları değerlendirilmiş ve karşılaştırılmıştır. Bulgular: 12.381 olgunun 498'inde anormal sitolojik bulgular saptandı (% 4,02). Anormal sitolojilerin içerisinde önemi bilinmeyen hücreler (ASCUS) % 1,9, Atipik Glanduler Hücreler (AGUS) % 0,4, Düşük Dereceli Skuamöz İntraepitelyal Lezyon (LGSIL) %1, Yüksek Dereceli İntraepitelyal Lezyon (HGSIL) % 0,1, Atipik Skuamöz Hücrelerin Dışlanmadığı Grup (ASC-H) % 0,4 olarak saptanırken, anormal sitolojilerin servikal intraepitelyal lezyonlara oranı 2,1 olarak saptandı. Pap Smear'de anormal sitolojik bulgu saptanan olguların pozitif öngörü değerleri ASCUS için %21,7, LGSIL için %41,9, HGSIL için %100, AGUS için %12,5 ve ASC-H için %50 olarak hesaplandı. Sonuç: Pap Smear testi, ucuz ve kolay bir yöntemdir. Serviks kanserinin erken tanısı Pap smear testi sayesinde mümkündür. Servikal sitolojinin klinik uygulamalarda güvenilir şekilde kullanımı ise biyopsi doğrulaması ile mümkündür. Farklı toplumlarda epitel hücre anomalisi oranı değişken olabildiği için atipik skuamöz hücre (ASH) / servikal skuamöz intraepitelyal lezyon (SIL) oranı kalite yöntemi açısından daha net bir veri olarak değerlendirilmektedir.
Anahtar Kelime:

Konular: Genel ve Dahili Tıp

Kliniğimizdeki anormal servikal smear sonuçlarının yönetimi ve kolposkopi eşliğinde alınan sitopatoloji sonuçlarının korelasyonu

Öz:
Aim: Pap smear test is a major screening test for early diagnosis and treatment of cervix cancer. The aim of our study was to assess the value of colposcopy and histopathologic examination in the management of patients with abnormal cervical cytology by Bethesda Classification. Methods: In this study, we aimed to compare and evaluate the diagnosis of 12,381 cytology material examined in our gynecology clinic during the years between 2014 and 2016 with their cytopathology results. Results: 498 of 12,381 patients had abnormal cytological findings (4.02%). The rates of Atypical Squamous Cells of Undetermined Significance (ASC-US), Atypical Glandular Cells of Undetermined Significance (AG-US), Low Grade Squamous Intraepithelial Lesions (LGSIL) and High Grade Squamous Intraepithelial Lesions (HG-SIL) were found to be 1.9%, 0.4%, 1% and % 0.1, respectively. Atypical squamous cell cannot exclude HSIL (ASC-H) rate were found as % 0.4. The rate of abnormal cytology in cervical intraepithelial lesions was 2.1. Positive predictive values of abnormal smear results were 21.7% for ASC-US, 41.9% for LGSIL, 100% for HGSIL, 12.5% for AGUS and 50% for ASC-H. Conclusion: The Pap smear test is a cheap and easily applied screening test. Early diagnosis of cervix cancer can be made by routine Pap smear testing. The efficiency in clinical use of the cervical cytology screening test is determined by biopsy verification. As the ratio of epithelial cell abnormality is variable in different populations, the ASC (Atypical Squamous Cell) / SIL (Squamous Intraepithelial Lesion) is a more definite variable to be used for quality assurance.
Anahtar Kelime:

Konular: Genel ve Dahili Tıp
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Smith RA, Cokkinides V, Brooks D, Saslow D, Shah M, Brawley OW. Cancer screening in the United States, 2011: A review of current American Cancer Society guidelines and issues in cancer screening. CA Cancer J Clin 2011; 61: 8-30.
  • 2. Jemal A, Bray F, Center M, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin 2011; 61: 69-90.
  • 3. Özer H, Tuncer E, Çiftçi A, Keser H, Aker H, Elagöz, Ş, et al. Distribution of cytological diagnoses in cervical smears with epithelial cell abnormality and cyto-histopathological correlation. Cumhuriyet Med J 2012; 34: 319-24.
  • 4. Türkmen İ., Başsüllü N, Korkmaz P, Günenç B, Baykal C. Patients with Epithelial Cell Abnormality in PAP Smears: Correlation of Results with Follow-Up Smears and Cervical Biopsies. Turk Patoloji Derg 2013, 29:179-84.
  • 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 Cancer J Clin 2002; 52: 342-62.
  • 6. Kuo DY, Goldberg GL. Screening of cervical cancer: where do we go from here? Cancer Invest 2003; 21: 157-61.
  • 7. Benedet J, Matisic J, Bertrand M. An analysis of 84,244 patients from the British Columbia cytology-colposcopy program. Gynecol Oncol 2004; 92: 127-34.
  • 8. Destegül E, Gençdal S, Ekmekçi E, Aydoğmuş H, Özdemir O. Evaluation of cervicovaginal smear results at postmenopausal period Adv Mod Oncol Res 2016; 2: 45-9.
  • 9. Zweizig S, Noller K, Reale F, Collis S, Resseguie L. Neoplasia associated with atypical glandular cells of undetermined significance on cervical cytology. Gynecol Oncol 1997; 65: 314-8.
  • 10. Güçkan R.,Kılınç Ç ,Gözdemir E, Gürçağlar A, Nergiz Ö. Prevalence and distribution of high-risk human papillomavirus in Amasya region, Turkey. Biomed Res 2016; 27: 769-72.
  • 11. Human papillomavirus testing for triage of women with cytological evidence of low-grade squamous intraepithelial lesions: baseline data from a randomized trial. The Atypical Squamous Cells of Undetermined Significance/ Low-Grade Squamous Intraepithelial Lesions Triage Study (ALTS) Group. J Natl Cancer Inst 2000; 92: 397-402.
  • 12. ACOG Practice Bulletin on Clinical Management Guidelines for Obstetricians-Gynecologists. Management of abnormal cervical cytology and histology. In: ACOG Women's Health Care Physician's Compendium of Selected Publications, practice bulletinnumber 66, September 2005.Washington (DC): ACOG Distribution Center, 2006; 603-22.
  • 13. Boztosun A, Mutlu A, Özer H, Aker H, Yankı A. Serviko vajinal smearde epitelyal hücre anomalisi saptanan hastaların kolposkopik biyopsi sonuçlarının değerlendirilmesi. TürkJinekolojik Onkoloji Dergisi 2012; 1: 13-9.
  • 14. Isaoglu U, Yilmaz M, Delibas İ, Bilici A, Kabalar M. Evaluation of 37,438 consecutive cervical smear results in the Turkish population. Arch Med Sci 2015; 11: 402-5.
  • 15. Turkistanlı EC, Sogukpinar N, Saydam BK, Aydemir G. Cervical cancer prevention and early detection - the role of nurses and midwives. Acian Pac J Cancer Prev 2003; 4: 15-21.
  • 16. Soler ME, Gaffikin L, Blumenthal PD. Cervical cancer screening in developing countries. Prim Care Update Ob Gyns 2000; 7: 118-23.
  • 17. Waxman AG. Guidelines for cervical cancer screening, history and scientific rationale. Clin Obstet Gynecol 2005; 48: 77-97.
  • 18. Saraiya UB. Preventable but not prevented: the reality of cervical cancer. J Obstet Gynecol Res 2003; 29: 351-9.
  • 19. Seven A, Koçak C, Yüksel K, Kucur S, Gözükara İ. The evaluation of cervical pap-smear results of the patients who admitted to Obstetrics and Gynecology Clinic of Dumlupinar University Kutahya Evliya Celebi Training and Research Hospital. Turk J Clin Lab 2015; 7: 1-4.
  • 20. American College of Obstetricians and Gynecologists. ACOG practice bulletin. Cervical Cytology screening. Number 45, August 2003. Int J Gynaecol Obstet 2003; 83: 237-47.
  • 21. Gokaslan H, Uyar EE. Screening cervical cancer with Pap smear. Turk Aile Hek Derg 2004; 8: 105-10.
  • 22. Biedka M, Makarewicz R, Kopczynska E, Marszalek A, Goralewska A, Kardymowicz H. Angiogenesis and lymphangiogenesis as prognostic factors after therapy in patients with cervical cancer. Contemp Oncol (Pozn) 2012; 16: 6-11.
  • 23. Belinson J, Qiao YL, Pretorius R, Zhang WH, Elson P, Li L, et al. Shanxi province cervical cancer screening study: a cross-sectional comparative trial of multiple techniques to detect cervical neoplasia. Gynecol Oncol 2001; 83: 439-44.
  • 24. Celik C, Gezginc K, Toy H, Findik S, Yilmaz O. A comparison of liquid-based cytology with conventional cytology. Int J Gynecol Obstet 2008; 100: 163-6.
  • 25. Atilgan R, Celik A, Boztosun A, Ilter E, Yalta T, Ozercan R. Evaluation of cervical cytological abnormalities in Turkish population. Indian J Pathol Microbiol 2012; 55: 52-5.
  • 26. Keskin HL, Seçen Eİ, Taş E, Kaya S, Avşar AF. Servikal smear sitolojisi ile kolposkopi eşliğinde servikal biyopsi korelasyonu. Türk Jinekolojik Onkoloji Dergisi 2011; 3: 71-5.
APA doğan o, YILDIZ A, PULATOGLU C (2017). Management of abnormal cytology results and correlation of cytopathologic results accompanied by colposcopy in our clinic. , 62 - 65.
Chicago doğan ozan,YILDIZ Ahmet,PULATOGLU Cigdem Management of abnormal cytology results and correlation of cytopathologic results accompanied by colposcopy in our clinic. (2017): 62 - 65.
MLA doğan ozan,YILDIZ Ahmet,PULATOGLU Cigdem Management of abnormal cytology results and correlation of cytopathologic results accompanied by colposcopy in our clinic. , 2017, ss.62 - 65.
AMA doğan o,YILDIZ A,PULATOGLU C Management of abnormal cytology results and correlation of cytopathologic results accompanied by colposcopy in our clinic. . 2017; 62 - 65.
Vancouver doğan o,YILDIZ A,PULATOGLU C Management of abnormal cytology results and correlation of cytopathologic results accompanied by colposcopy in our clinic. . 2017; 62 - 65.
IEEE doğan o,YILDIZ A,PULATOGLU C "Management of abnormal cytology results and correlation of cytopathologic results accompanied by colposcopy in our clinic." , ss.62 - 65, 2017.
ISNAD doğan, ozan vd. "Management of abnormal cytology results and correlation of cytopathologic results accompanied by colposcopy in our clinic". (2017), 62-65.
APA doğan o, YILDIZ A, PULATOGLU C (2017). Management of abnormal cytology results and correlation of cytopathologic results accompanied by colposcopy in our clinic. Archives of Clinical and Experimental Medicine, 2(3), 62 - 65.
Chicago doğan ozan,YILDIZ Ahmet,PULATOGLU Cigdem Management of abnormal cytology results and correlation of cytopathologic results accompanied by colposcopy in our clinic. Archives of Clinical and Experimental Medicine 2, no.3 (2017): 62 - 65.
MLA doğan ozan,YILDIZ Ahmet,PULATOGLU Cigdem Management of abnormal cytology results and correlation of cytopathologic results accompanied by colposcopy in our clinic. Archives of Clinical and Experimental Medicine, vol.2, no.3, 2017, ss.62 - 65.
AMA doğan o,YILDIZ A,PULATOGLU C Management of abnormal cytology results and correlation of cytopathologic results accompanied by colposcopy in our clinic. Archives of Clinical and Experimental Medicine. 2017; 2(3): 62 - 65.
Vancouver doğan o,YILDIZ A,PULATOGLU C Management of abnormal cytology results and correlation of cytopathologic results accompanied by colposcopy in our clinic. Archives of Clinical and Experimental Medicine. 2017; 2(3): 62 - 65.
IEEE doğan o,YILDIZ A,PULATOGLU C "Management of abnormal cytology results and correlation of cytopathologic results accompanied by colposcopy in our clinic." Archives of Clinical and Experimental Medicine, 2, ss.62 - 65, 2017.
ISNAD doğan, ozan vd. "Management of abnormal cytology results and correlation of cytopathologic results accompanied by colposcopy in our clinic". Archives of Clinical and Experimental Medicine 2/3 (2017), 62-65.