Tokalıoğlu Abdurrahman Alp, Alcı Aysun, Oktar Okan, Ünsal Mehmet, Yalçın Necim, Aytekin Okan, Çelik Fatih, Tiryaki Güner Gülşah, Ersak Burak, Kılıç Fatih, Ayhan Sevgi, Akar İnan Serra, Çakır Caner, Yalçın Hakan, Korkmaz Vakkas, Koç Sevgi, Boran Nurettin, Kimyon Cömert Günsu, Toptaş Tayfun, Üreyen Işın, Türkmen Osman, Moraloğlu Tekin Özlem, Erdoğan Fazlı, Engin-Üstün Yaprak, Turan Taner
Clinic of Gynecologic Oncology, University of Health Sciences Turkey, Ankara City Hospital, Ankara, Turkey.
Clinic of Gynecologic Oncology, University of Health Sciences Turkey, Antalya Training and Research Hospital, Antalya, Turkey.
J Turk Ger Gynecol Assoc. 2024 Jun 13;25(2):90-95. doi: 10.4274/jtgga.galenos.2024.2023-9-9.
To determine whether patients with atypical squamous cells, cannot exclude high grade squamous intraepithelial neoplasia (ASC-H) cytology have a correlation between high-risk human papillomavirus (HPV) type and CIN 2+ lesion in final pathology.
The study was conducted retrospectively, using data from three tertiary gynecologic oncology centers located in various regions of Turkey. Data from 5,271 patients who had colposcopy between January 2003 and January 2021 were analyzed.
A total of 163 patients who had ASC-H cervical cytology test results, based on the Bethesda 2014 classification were eligible, and of these 83 (50.9%) who tested positive for HPV were included in the study. There was no correlation between the occurrence of CIN 2+ lesions and age (p=0.053). If there was any HPV 16 positivity (only HPV 16, HPV 16 and 18, HPV 16 and others) the presence of CIN 2+ lesions in the final pathology increased significantly. In HPV 16 positive ASC-H patients, the probability of CIN 2+ lesions in the final pathology were 72.5% while this rate was 48.1% in HPV 16 negative group (p=0.033).
The guidelines do not provide a comprehensive definition of the role of the HPV test in managing ASC-H. Positive high-risk HPV types, especially HPV 16, together with an ASC-H smear result should bring to mind the possibility of high-grade dysplasia.
确定非典型鳞状细胞、不能排除高级别鳞状上皮内瘤变（ASC-H）细胞学患者的高危人乳头瘤病毒（HPV）类型与最终病理检查中CIN 2+病变之间是否存在相关性。
本研究为回顾性研究，使用来自土耳其不同地区的三个三级妇科肿瘤中心的数据。分析了2003年1月至2021年1月期间5271例接受阴道镜检查患者的数据。
根据2014年贝塞斯达分类，共有163例ASC-H宫颈细胞学检查结果的患者符合条件，其中83例（50.9%）HPV检测呈阳性被纳入研究。CIN 2+病变的发生与年龄之间无相关性（p=0.053）。如果存在任何HPV 16阳性（仅HPV 16、HPV 16和18、HPV 16和其他类型），最终病理检查中CIN 2+病变的发生率显著增加。在HPV 16阳性的ASC-H患者中，最终病理检查中CIN 2+病变的概率为72.5%，而在HPV 16阴性组中这一比例为48.1%（p=0.033）。
指南未对HPV检测在ASC-H管理中的作用提供全面定义。高危HPV阳性类型，尤其是HPV 16，结合ASC-H涂片结果应使人想到高级别发育异常的可能性。
