Med Bull Sisli Etfal Hosp. 2019; 53(4): 361-365 | DOI: 10.14744/SEMB.2019.23434

Effects of an Additional Liquid Based Cytology Prepate on Cytological Diagnosis in High-Risk HPV Positive, PaP Test Negative Cases

Davut Sahin¹, Nermin Koc², Meryem Akbas^1
1Acýbadem Health Group Pathology Laboratory, Istanbul, Turkey
²University of Health Sciences, Zeynep Kamil Women and Children Diseases Training and Research Hospital, Pathology Laboratory, Istanbul, Turkey

Objectives: To investigate the effects of a second cytology preparation on cytological diagnosis in high-risk HPV positive and PaP smear-negative cases.
Methods: This retrospective study was conducted with 57 cases who underwent cytological evaluation and cotest in our center in 2016-2017. All of these cases were high-risk HPV positive, PaP smear-negative and had a second preparation. All preparations were re-evaluated by a cytopathologist and a pathologist. Twenty-five of the cases who had a positive diagnosis in the second preparation had a cervical biopsy.
Results: In 46 (80%) of the cases, the cytological diagnosis was the same and negative in the first and second preparations. Second preparations of 11 cases (19.2%) were positive. Twenty of 25 patients (77%) with cervical biopsy had premalignant lesion.
Conclusion: In high-risk HPV positive and PaP smear-negative cases, patient management is different from cases where these two tests are positive together. According to our results, 19.2% of high-risk HPV positive and PaP smear-negative cases were given positive cytological diagnosis by second cytology preparation. Biopsy results support our cytological findings. The incidence of positive cytological diagnosis increases in PaP smear with the second preparation. With this protocol, patient management changes, follow-up time and number can be reduced.

Keywords: Additional preparation, cytological diagnosis; high-risk HPV; smear.

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High Risk HPV Pozitif, PAP Testi Negatif Vakalarda Ýlave Bir Sývý Bazlý Sitoloji Preperatýnýn Sitolojik Tanýya Etkisi

Davut Sahin¹, Nermin Koc², Meryem Akbas^1
1Acýbadem Saðlýk Grubu Patoloji Laboratuarý, Ýstanbul
²Saðlýk Bilimleri Üniversitesi, Zeynep Kamil Kadýn ve Çocuk Hastalýklarý Eðitim Araþtýrma Hastanesi Patoloji Laboratuarý, Ýstanbul

Amaç: Yüksek riskli HPV pozitif, PAP smear sonucu negatif vakalarda, ikinci bir preparat hazýrlanmasýnýn sitolojik tanýya etkisini belirlemek.
Yöntemler: Bu retrospektif çalýþma 2016-2017döneminde merkezimizde sitolojik deðerlendirmesi ve cotesti yapýlan, yüksek riskli HPV pozitif, PAP smear sonucu negatif bulunan ve rezerv materyalden hazýrlanan ikinci bir preperatý olan 57 vaka ile yapýldý. Tüm preperatlar bir sitopatolog ve bir patolog tarafýndan tekrar deðerlendirildi. Ýkinci preperatýna pozitif taný verilen olgularýn 25’inden servikal biyopsi yapýlmýþtý.
Bulgular: Vakalarýn 46’sýnda (%80) birinci ve ikinci preparatlarda sitolojik taný ayný olup, negatif idi. 11 vakanýn (%19,2) ikinci preparatlarý pozitif taný almýþtý. Servikal biyopsi yapýlan 25 vakanýn 20’sinde premalign lezyon görülmüþtü.
Tartýþma: Yüksek riskli HPV pozitif, PAP smear sonucu negatif vakalarda hasta yönetimi, bu iki testin birlikte pozitif olduðu vakalardan farklýdýr. Sonuçlarýmýza göre ilk grupta bulunan vakalarýn %19,2 kadarý ikinci bir sývý bazlý preperat ile pozitif sitolojik taný almaktadýr. Biyopsi yapýlan olgularýn sonuçlarý sitoloji bulgularýmýzý destekler niteliktedir.
Sonuç: Ýkinci bir sývý bazlý preparat hazýrlanmasý ile yüksek riskli HPV pozitif vakalarýn smearlerinde pozitif sitolojik taný insidansý artmaktadýr. Bu protokol ile hasta yönetimi deðiþip takip süre ve sayýsý azaltýlabilir.

Anahtar Kelimeler: Ýlave preparat, sitolojik taný, yüksek riskli HPV, smear

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