BibTex RIS Kaynak Göster

Yıl 2012, Cilt: 34 Sayı: 3, 319 - 324, 24.01.2012

Hatice Özer Ersin Tuncer Ayşe Çiftçi Hande Keser Handan Aker , Şahande Elagöz , Abdullah Boztosun

Öz

Kaynakça

  • Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin 2005; 55: 74-108.
  • Wright TC, Kurman RJ, Ferenczy A. Precancerous Lesions of the Cervix. In: Kurman RJ editor Blaustein’s Pathology of the Female Genital Tract. 5th Edition New York, Springer-Verlag 2002; 253-324.
  • Solomon D, Davey D, Kurman R, Moriarty A, O'Connor D, Prey M, Raab S, Sherman M, Wilbur D, Wright T Jr, Young N; Forum Group Members; Bethesda 2001 Workshop. The 2001 Bethesda System: terminology for reporting results of cervical cytology. JAMA 2002; 287: 2114-219.
  • Gupta DK, Komaromy-Hiller G, Raab SS, Nath ME. Interobserver and intraobserver variability in the cytologic diagnosis of normal and abnormal metaplastic squamous cells in pap smears. Acta Cytol 2001; 45: 697-703.
  • Sebastião AP, Noronha L, Pinheiro DL, Collaço LM, de Carvalho NS, Bleggi- Torres LF. Influence of specimen adequacy on the diagnosis of ASCUS. Diagn Cytopathol 2004; 31: 155-8.
  • Ettler HC, Joseph MG, Downing PA, Suskin NG, Wright VC. Atypical squamous cells of undetermined significance: A cytohistological study in a colposcopy clinic. Diagn Cytopathol 1992; 21: 211-6.
  • Quddus MR, Sung CJ, Steinhoff MM, Lauchlan SC, Singer DB, Hutchinson ML. Atypical squamous metaplastic cells: reproducibility, outcome, and diagnostic features on ThinPrep Pap test. Cancer 2001; 93: 16-22.
  • Zuna RE, Sienko A, Lightfoot S, Gaiser M. Cervical smear interpretations in women with a histologic diagnosis of severe dysplasia: factors associated with discrepant interpretations. Cancer Cytopathol 2002; 96: 218-24.
  • Grenko RT, Abendroth CS, Frauenhoffer EE, Ruggiero FM, Zaino RJ. Variance in the interpretation of cervical biopsy specimens obtained for atypical squamous cells of undetermined significance. Am J Clin Pathol 2000; 114: 735-40.
  • Sherman ME, Solomon D, Schiffman M; ASCUS LSIL Triage Study Group. Qualification of ASCUS. A comparison of equivocal LSIL and equivocal HSIL cervical cytology in the ASCUS LSIL triage study. Am J Clin Pathol 2001; 116: 386-94.
  • Renshaw AA, Genest DR, Cibas ES. Should atypical squamous cells of undetermined significance (ASCUS) be subcategorized? Accuracy analysis of Papanicolaou smears using receiver operating characteristic curves and implications for the ASCUS/squamous intraepithelial lesion ratio. Am J Clin Pathol 2001; 116: 692-5.
  • Raab SS. Subcategorization of Papanicolaou tests diagnosed as atypical squamous cells of undetermined significance. Am J Clin Pathol 2001; 116: 631-4.
  • Kruse AJ, Baak JP, Helliesen T, Kjellevold KH, Robboy SJ. Prognostic value and reproducibility of koilocytosis in cervical intraepithelial neoplasia. Int J Gynecol Pathol 2003; 22: 236-9.
  • Nasiell K, Roger V, Nasiell M. Behavior of mild cervical dysplasia during long- term follow-up. Obstet Gynecol 1986; 67: 665-9.
  • Abali R, Bacanakgıl BH, Celık S, Aras O, Koca P, Boran B, Dursun N. Histopathological correlation of squamous cell abnormalities detected on cervical cytology. Turk Jour Pathol 2011; 27: 144-8.
  • Nasuti JF, Fleisher SR, Gupta PK. Atypical glandular cells of undetermined significance (agus): clinical considerations and cytohistologic correlation. Diagn Cytopathol 2002; 26: 186-90.
  • Obenson K, Abreo F, Grafton WD. Cytohistologic correlation between AGUS and biopsy-detected lesions in postmenopausal women. Acta Cytol 2000; 44: 41- 5.
  • 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.

Epitel hücre anormalliği saptanan servikal smear olgularında sitolojik tanı dağılımı ve sito-histopatolojik korelasyon

Yıl 2012, Cilt: 34 Sayı: 3, 319 - 324, 24.01.2012

Hatice Özer Ersin Tuncer Ayşe Çiftçi Hande Keser Handan Aker , Şahande Elagöz , Abdullah Boztosun

Öz

Özet

Amaç. Anabilim Dalı’mızda incelenen ve epitel hücre anormalliği saptanan servikovajinal smear sonuçlarının değerlendirilmesi ve histopatolojik incelemesi bulunan olgularda sito-histopatolojik korelasyonun araştırılması. Yöntem. Ocak 2008-Mayıs 2011 tarihleri arasında Cumhuriyet Üniversitesi Tıp Fakültesi Patoloji Anabilim Dalı’na gönderilen ve 2001 Bethesda sistemine göre tanı alan toplam 8102 servikal smear örneğine ait raporlar retrospektif olarak incelendi. Epitel hücre anormalliği tesbit edilen 97 olgu çalışmaya dahil edildi. Bunlardan histopatolojik incelemesi olan 25 olguda sito-histopatolojik korelasyon araştırıldı. Bulgular. Toplam 8102 servikal smear’in 97’sinde (%1.19) epitel hücre anormalliği saptandı. Epitel hücre anormalliği saptanan olguların 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 tanı almış idi. Bunlardan biyopsi tanısı 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 edildiği saptandı. Bu sonuçlara göre ASC-US, ASC-H,  LSIL, HSIL, SCC, AGC ve adenokarsinomun pozitif öngörme değeri sırasıyla %0, %50, %100, %80, %100, %0 ve %100 olarak saptandı. Sonuç. Servikal smear’ de verilen karsinom, HSIL ve LSIL tanıları yüksek pozitif öngörme değerine sahip iken, serimizde bu değer ASC-US ve AGC tanıları için düşük bulunmuş, ancak bu gruplarda takipli olgu sayısının çok az olması nedeniyle bu sonuç güvenilir kabul edilmemiştir.

Anahtar sözcükler: Servikal smear, sito-histopatolojik korelasyon, epitel hücre anormalliği

 

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.

Keywords: Cervical smear, cyto-histopathological correlation, epithelial cell abnormality

Anahtar Kelimeler

Servikal smear sito-histopatolojik korelasyon epitel hücre anormalliği

Kaynakça

  • Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin 2005; 55: 74-108.
  • Wright TC, Kurman RJ, Ferenczy A. Precancerous Lesions of the Cervix. In: Kurman RJ editor Blaustein’s Pathology of the Female Genital Tract. 5th Edition New York, Springer-Verlag 2002; 253-324.
  • Solomon D, Davey D, Kurman R, Moriarty A, O'Connor D, Prey M, Raab S, Sherman M, Wilbur D, Wright T Jr, Young N; Forum Group Members; Bethesda 2001 Workshop. The 2001 Bethesda System: terminology for reporting results of cervical cytology. JAMA 2002; 287: 2114-219.
  • Gupta DK, Komaromy-Hiller G, Raab SS, Nath ME. Interobserver and intraobserver variability in the cytologic diagnosis of normal and abnormal metaplastic squamous cells in pap smears. Acta Cytol 2001; 45: 697-703.
  • Sebastião AP, Noronha L, Pinheiro DL, Collaço LM, de Carvalho NS, Bleggi- Torres LF. Influence of specimen adequacy on the diagnosis of ASCUS. Diagn Cytopathol 2004; 31: 155-8.
  • Ettler HC, Joseph MG, Downing PA, Suskin NG, Wright VC. Atypical squamous cells of undetermined significance: A cytohistological study in a colposcopy clinic. Diagn Cytopathol 1992; 21: 211-6.
  • Quddus MR, Sung CJ, Steinhoff MM, Lauchlan SC, Singer DB, Hutchinson ML. Atypical squamous metaplastic cells: reproducibility, outcome, and diagnostic features on ThinPrep Pap test. Cancer 2001; 93: 16-22.
  • Zuna RE, Sienko A, Lightfoot S, Gaiser M. Cervical smear interpretations in women with a histologic diagnosis of severe dysplasia: factors associated with discrepant interpretations. Cancer Cytopathol 2002; 96: 218-24.
  • Grenko RT, Abendroth CS, Frauenhoffer EE, Ruggiero FM, Zaino RJ. Variance in the interpretation of cervical biopsy specimens obtained for atypical squamous cells of undetermined significance. Am J Clin Pathol 2000; 114: 735-40.
  • Sherman ME, Solomon D, Schiffman M; ASCUS LSIL Triage Study Group. Qualification of ASCUS. A comparison of equivocal LSIL and equivocal HSIL cervical cytology in the ASCUS LSIL triage study. Am J Clin Pathol 2001; 116: 386-94.
  • Renshaw AA, Genest DR, Cibas ES. Should atypical squamous cells of undetermined significance (ASCUS) be subcategorized? Accuracy analysis of Papanicolaou smears using receiver operating characteristic curves and implications for the ASCUS/squamous intraepithelial lesion ratio. Am J Clin Pathol 2001; 116: 692-5.
  • Raab SS. Subcategorization of Papanicolaou tests diagnosed as atypical squamous cells of undetermined significance. Am J Clin Pathol 2001; 116: 631-4.
  • Kruse AJ, Baak JP, Helliesen T, Kjellevold KH, Robboy SJ. Prognostic value and reproducibility of koilocytosis in cervical intraepithelial neoplasia. Int J Gynecol Pathol 2003; 22: 236-9.
  • Nasiell K, Roger V, Nasiell M. Behavior of mild cervical dysplasia during long- term follow-up. Obstet Gynecol 1986; 67: 665-9.
  • Abali R, Bacanakgıl BH, Celık S, Aras O, Koca P, Boran B, Dursun N. Histopathological correlation of squamous cell abnormalities detected on cervical cytology. Turk Jour Pathol 2011; 27: 144-8.
  • Nasuti JF, Fleisher SR, Gupta PK. Atypical glandular cells of undetermined significance (agus): clinical considerations and cytohistologic correlation. Diagn Cytopathol 2002; 26: 186-90.
  • Obenson K, Abreo F, Grafton WD. Cytohistologic correlation between AGUS and biopsy-detected lesions in postmenopausal women. Acta Cytol 2000; 44: 41- 5.
  • 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.
Toplam 18 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Cerrahi Tıp Bilimleri Araştırma Yazıları
Yazarlar

Hatice Özer

Ersin Tuncer

Ayşe Çiftçi

Hande Keser

Handan Aker

Şahande Elagöz

Abdullah Boztosun

Yayımlanma Tarihi 24 Ocak 2012
Yayımlandığı Sayı Yıl 2012Cilt: 34 Sayı: 3

Kaynak Göster

AMA Özer H, Tuncer E, Çiftçi A, Keser H, Aker H, Elagöz Ş, Boztosun A. Epitel hücre anormalliği saptanan servikal smear olgularında sitolojik tanı dağılımı ve sito-histopatolojik korelasyon. CMJ. Aralık 2012;34(3):319-324.