Epitel hücre anormalli?i saptanan servikal smear olgular?nda sitolojik tan? da??l?m? ve sito-histopatolojik korelasyon

摘要

?zet Ama?. Anabilim Dal?’m?zda incelenen ve epitel hücre anormalli?i saptanan servikovajinal smear sonu?lar?n?n de?erlendirilmesi ve histopatolojik incelemesi bulunan olgularda sito-histopatolojik korelasyonun ara?t?r?lmas?. Y?ntem. Ocak 2008-May?s 2011 tarihleri aras?nda Cumhuriyet üniversitesi T?p Fakültesi Patoloji Anabilim Dal?’na g?nderilen ve 2001 Bethesda sistemine g?re tan? alan toplam 8102 servikal smear ?rne?ine ait raporlar retrospektif olarak incelendi. Epitel hücre anormalli?i tesbit edilen 97 olgu ?al??maya dahil edildi. Bunlardan histopatolojik incelemesi olan 25 olguda sito-histopatolojik korelasyon ara?t?r?ld?. Bulgular. Toplam 8102 servikal smear’in 97’sinde (%1.19) epitel hücre anormalli?i saptand?. Epitel hücre anormalli?i saptanan olgular?n 54’ü (%55.6) ASC-US, 14’ü (%14.4) ASC-H, 14’ü (%14.4) LSIL, 5’i (%5,2) HSIL, 5’i (%5,2) SCC, 3’ü (%3.1) AGC ve 2’si (%2.1) adenokarsinom, NOS olarak tan? alm?? idi. Bunlardan biyopsi tan?s? olan 25 olgunun 10’unun (%40) nonneoplastik, 2’sinin CIN I (%8), 1’inin (%4) CIN II, 3’ünün (%12) CIN III ve 9’unun (%36) invaziv karsinom olarak rapor edildi?i saptand?. Bu sonu?lara g?re ASC-US, ASC-H, LSIL, HSIL, SCC, AGC ve adenokarsinomun pozitif ?ng?rme de?eri s?ras?yla %0, %50, %100, %80, %100, %0 ve %100 olarak saptand?. Sonu?. Servikal smear’ de verilen karsinom, HSIL ve LSIL tan?lar? yüksek pozitif ?ng?rme de?erine sahip iken, serimizde bu de?er ASC-US ve AGC tan?lar? i?in dü?ük bulunmu?, ancak bu gruplarda takipli olgu say?s?n?n ?ok az olmas? nedeniyle bu sonu? güvenilir kabul edilmemi?tir. Anahtar s?zcükler: Servikal smear, sito-histopatolojik korelasyon, epitel hücre anormalli?i Abstract Aim. To evaluate the cervicovaginal smears with epithelial cell abnormality examined in our department and to investigate the cyto-histopathological correlation of these cases with their histopathological diagnoses. Method. The reports of cervical smears diagnosed according to 2001 Bethesda System in Cumhuriyet University, Faculty of Medicine, Pathology Department between January 2008 and May 2011 were reviewed retrospectively (n: 8102). Among them, cases with epithelial cell abnormality (n: 97) were included in the study. In 25 of these patients having also histopathological examinations, cyto-histopathological correlation was investigated. . Results. Epithelial cell abnormality was detected in 97 (1.19) out of 8102 cervical smears. In the cytopathological examination, 54 patients (55.6%) had ASC-US, 14 had (14.4%) ASC-H, 14 had (14.4%) LSIL, five had (5.2%) HSIL, five had (5.2%) squamous cell carcinoma (SCC), three had (3.1%) atypical glandular cells (AGC) and two had (2.1%) adenocarcinoma, NOS. Histopathological results of 25 patients revealed that 10 patients had (40%) nonneoplastic, two had CIN I (8%), one had (4%) CIN II, three had (12%) CIN III and nine had (36%) malignant lesion. The positive predictive values for the cases with diagnoses of ASC-US, ASC-H, LSIL, HSIL, SCC, AGC and adenocarcinoma were 0%, 50%, 100%, 80%, 100%, 0% ve 100%, respectively. Conclusion. Eventhough the positive predictive values in diagnosis of carcinoma, HSIL, and LSIL had been high, those values were found to be low in diagnosis of ASC-US and AGC in our series, but since the number of follow-up cases were very few in these groups this result was accepted as not reliable.