Öz
Abstract
Aim. Cervical cancer is one of the most common female malignancy with high mortality rates in developing countries. Our purpose is to present cervical cytologic abnormalities and the detection rate of epithelial abnormalities by cervical cytology (CC). Method. A total of 8972 conventional pap smear tests collected between August 2010 and August 2012 from Çankırı State Hospital were retrospectively analyzed and results were based on the 2001 Bethesda system. Results. Total of 129 (1.4%) cases had epithelial abnormalities. The numbers and rates of epithelial abnormalities were as the followings: Atypical squamous cell of undetermined significance (ASCUS; n=75 [0.8%]); atypical squamous cell suspicious for high-grade squamous intraepithelial lesion (ASC-H; n=10 [0.11%]); atypical glandular cell of undetermined significance (AGUS; n=8 [0.08%]); low- grade squamous intraepithelial lesion (LSIL; n=22 [0.24%]); high-grade squamous intraepithelial lesion (HSIL; n=14 [0.15%]). Conclusion. The prevelence of cervical cytological abnormality in our study was 1.4% and the most of them were diagnosed as atypical squamous cell of undetermined significance (ASCUS). Our results partly correspond with the studies that were carried out on the large amounts of Turkish population.
Keywords: Cervical cancer, cytology, PAP smear
Özet
Amaç. Serviks kanseri gelişmekte olan ülkelerde kadınlarda yüksek mortalite oranına sahip en sık görülen malignitedir. Çalışmadaki amacımız Çankırı popülasyonunda servikal sitoloji materyallerinde epitelyal anormalliklerin saptanması ve dökümante edilmesidir. Yöntem. Çalışmada Çankırı Devlet Hastanesinde 2010-2012 ağustos tarihleri arasında toplanmış 8972 servikal pap smear retrospektif olarak 2001 Bethesda sistemi esas alınarak değerlendirilmiştir. Bulgular. Toplam 129 vakada (%1,4) epitelyal anormalite izlenmiş, bunların 75’inde (%0,8) önemi belirlenemeyen atipik skuamöz hücreler (ASCUS), 10’unda (%0,11) yüksek gradeli atipik intraepitelial lezyon şüpheli atipik skuamöz hücreler (ASC-H), 8’inde (%0,08) önemi belirlenemeyen atipik glandüler hücreler (AGUS), 22’sinde (%0,24) düşük dereceli skuamöz intraepitelyal lezyon (LSIL), 14’ünde (%0,15) yüksek dereceli skuamöz intraepitelyal lezyon (HSIL) saptanmıştır. Sonuç. Çalışmamızda servikal sitolojik anormalite prevalansı %1,4 olarak bulunmuş, bunlar arasında en yüksek oranı önemi belirlenemeyen atipik skuamoz hücrelerin (ASCUS) oluşturduğu saptanmıştır. Sonuçlar Türkiye genelinde daha geniş popülasyonda yapılan mevcut çalışmalarla kısmen örtüşmektedir.
Anahtar sözcükler: Servikal kanser, sitoloji, PAP smear
Anahtar Kelimeler
Kaynakça
- Pisani P, Parkin DM, Bray F, Ferlay J. Estimates of the worldwide mortality from 25 cancers in 1990. Int J Cancer 1999; 83: 18-29.
- Ferlay J, Bray F, Pisani P, Parkin DM. Cancer incidence, mortality and prevalence worldwide. Lyon, France: International agency for research on cancer (IARC); Cancer Base 2002.
- Yılmaz HH, Yazıhan N, Tunca D, Sevinç A, Olcayto EÖ, Ozgül N, Tuncer M. Cancer trends and Incidence and mortality patterns in Turkey. Jpn J Clin Oncol 2011; 41: 10-6.
- Karnon J, Peters J, Platt J, Chilcott J, McGoogan E, Brewer N. Liquid-based cytology in cervical screening: An updated rapid and systematic review and economic analysis. Health Technol Assess 2004; 8: iii, 1-78.
- Boyle P, Ferlay J. Cancer incidence and mortality in Europe, 2004. Ann Oncol 2005; 16: 481-8.
- Gustafsson L, Pontén J, Bergström R, Adami HO. International incidence rates of invasive cervical cancer before cytological screening. Int J Cancer 1997; 71: 159- 65.
- Dorn HF, Cutler SJ. Morbidity from cancer in the United States. Public health monograph, Washington, DC: US Department of Health, Education, and Welfare; 1959.
- Sadjadi A, Malekzadeh R, Derakhshan MH, Sepehr A, Nouraie M, Sotoudeh M, Yazdanbod A, Shokoohi B, Mashayekhi A, Arshi S, Majidpour A, Babaei M, Mosavi A, Mohagheghi MA, Alimohammadian M Cancer occurrence in Ardabil: results of a population-based cancer registry from Iran. Int J Cancer 2003; 107: 113-8.
- Stanley M. Pathology and epidemiology of HPV infection in females. Gynecol Oncol 2010; 117: S5-10.
- 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.
- Kjellberg L, Hallmans G, Ahren AM, Johansson R, Bergman F, Wadell G, Angström T, Dillner J. Smoking, diet, pregnancy and oral contraceptive use as risk factors for cervical intra-epithelial neoplasia in relation to human papillomavirus infection. Br J Cancer 2000; 82: 1332-8.
- IARC Monographs on the evaluation of carcinogenic risks humans. Human Papillomaviruses. Lyon: IARC; 2005 (Accessed on October 12, 2012).
- Kuo DY, Goldberg GL. Screening of cervical cancer: Where do we go from here? Cancer Invest 2003; 21: 157-61.
- www.cancer.org/…/FindCancerEarly/CancerScreeningGuidelines/americancance r- society-guidelines-for-the-early-detection-of-cancer (Accessed on October 12, 2012).
- Beerman H, van Dorst EB, Kuenen-Boumeester V, Hogendoorn PC. Superior performance of liquid-based versus conventional cytology in a population-based cervical cancer screening program. Gynecol Oncol 2009; 112: 572-6.
- Davey E, Barratt A, Irwig L, Chan SF, Macaskill P, Mannes P, Saville AM. Effect of study design and quality on unsatisfactory rates, cytology classifications, and accuracy in liquid-based versus conventional cervical cytology: A systematic review. Lancet 2006; 367: 122-32.
- Lawson HW, Lee NC, Thames SF, Henson R, Miller DS. Cervical cancer screening among low-income women: Results of a national screening program, 1991-1995. Obstet Gynecol 1998; 92: 745-52.
- Abdullah LS. Pattern of abnormal pap smears in developing countries: A report from a large referral hospital in Saudi Arabia using the revised 2001 Bethesda system. Ann Saudi Med 2007; 27: 268-72.
- Inal MM, Köse S, Yildirim Y, Ozdemir Y, Töz E, Ertopçu K, Ozelmas I, Tinar S. The relationship between human papillomavirus infection and cervical intraepithelial neoplasia in Turkish women. Int J Gyneacol Cancer 2007; 17: 1266-70.
- Coskun A, Köstü B, Kiran G, Arikan DC, Analan A. Pap smear screening result in Kahramanmaras. Gynecol Obstet Reprod Med 2008; 14: 182-5.
- Colgan TJ, McLachlin CM, Cotterchio M, Howlett R, Seidenfeld AM, Mai VM. Results of the implementation of liquid-based cytology-SurePath in the Ontario screening program. Cancer 2004; 102: 362-7.
- Stany MP, Bidus MA, Reed EJ, Kaplan KJ, McHale MT, Rose GS, Elkas JC. The prevalence of HR-HPV DNA in ASC-US Pap smears: A military population study. Gynecol Oncol 2006; 101: 82-5.
- Turkish Cervical Cancer and Cervical Cytology Research Group. Turkish Cervical Cancer and Cervical Cytology Research Group. Prevalence of cervical cytological abnormalities in Turkey. Int J Gyneacol Obstet 2009; 106: 206-9.
- Karabulut A, Alan T, Ali Ekiz M, Iritaş A, Kesen Z, Yahşi S. Evaluation of cervical screening results in a population at normal risk. Int J Gyneacol Obstet 2010; 110: 40-2.
- Celik C, Gezginç K, Toy H, Findik S, Yilmaz O. A comparison of liquid-based cytology with conventional cytology. Int J Gyneacol Obstet 2008; 100: 163-6.
- National Cancer Institute, surveillance epidemiology and end results. Available from: http://seer.cancer.gov/statfacts/html/cervix.html (Accesed on December 4, 2012).
Öz
Amaç. Serviks kanseri gelişmekte olan ülkelerde kadınlarda yüksek mortalite oranına sahip en sık görülen malignitedir. Çalışmadaki amacımız Çankırı popülasyonunda servikal sitoloji materyallerinde epitelyal anormalliklerin saptanması ve dökümante edilmesidir. Yöntem. Çalışmada Çankırı Devlet Hastanesinde 2010-2012 ağustos tarihleri arasında toplanmış 8972 servikal pap smear retrospektif olarak 2001 Bethesda sistemi esas alınarak değerlendirilmiştir. Bulgular. Toplam 129 vakada (%1,4) epitelyal anormalite izlenmiş, bunların 75’inde (%0,8) önemi belirlenemeyen atipik skuamöz hücreler (ASCUS), 10’unda (%0,11) yüksek gradeli atipik intraepitelial lezyon şüpheli atipik skuamöz hücreler (ASC-H), 8’inde (%0,08) önemi belirlenemeyen atipik glandüler hücreler (AGUS), 22’sinde (%0,24) düşük dereceli skuamöz intraepitelyal lezyon (LSIL), 14’ünde (%0,15) yüksek dereceli skuamöz intraepitelyal lezyon (HSIL) saptanmıştır. Sonuç. Çalışmamızda servikal sitolojik anormalite prevalansı %1,4 olarak bulunmuş, bunlar arasında en yüksek oranı önemi belirlenemeyen atipik skuamoz hücrelerin (ASCUS) oluşturduğu saptanmıştır. Sonuçlar Türkiye genelinde daha geniş popülasyonda yapılan mevcut çalışmalarla kısmen örtüşmektedir
Anahtar Kelimeler
Kaynakça
- Pisani P, Parkin DM, Bray F, Ferlay J. Estimates of the worldwide mortality from 25 cancers in 1990. Int J Cancer 1999; 83: 18-29.
- Ferlay J, Bray F, Pisani P, Parkin DM. Cancer incidence, mortality and prevalence worldwide. Lyon, France: International agency for research on cancer (IARC); Cancer Base 2002.
- Yılmaz HH, Yazıhan N, Tunca D, Sevinç A, Olcayto EÖ, Ozgül N, Tuncer M. Cancer trends and Incidence and mortality patterns in Turkey. Jpn J Clin Oncol 2011; 41: 10-6.
- Karnon J, Peters J, Platt J, Chilcott J, McGoogan E, Brewer N. Liquid-based cytology in cervical screening: An updated rapid and systematic review and economic analysis. Health Technol Assess 2004; 8: iii, 1-78.
- Boyle P, Ferlay J. Cancer incidence and mortality in Europe, 2004. Ann Oncol 2005; 16: 481-8.
- Gustafsson L, Pontén J, Bergström R, Adami HO. International incidence rates of invasive cervical cancer before cytological screening. Int J Cancer 1997; 71: 159- 65.
- Dorn HF, Cutler SJ. Morbidity from cancer in the United States. Public health monograph, Washington, DC: US Department of Health, Education, and Welfare; 1959.
- Sadjadi A, Malekzadeh R, Derakhshan MH, Sepehr A, Nouraie M, Sotoudeh M, Yazdanbod A, Shokoohi B, Mashayekhi A, Arshi S, Majidpour A, Babaei M, Mosavi A, Mohagheghi MA, Alimohammadian M Cancer occurrence in Ardabil: results of a population-based cancer registry from Iran. Int J Cancer 2003; 107: 113-8.
- Stanley M. Pathology and epidemiology of HPV infection in females. Gynecol Oncol 2010; 117: S5-10.
- 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.
- Kjellberg L, Hallmans G, Ahren AM, Johansson R, Bergman F, Wadell G, Angström T, Dillner J. Smoking, diet, pregnancy and oral contraceptive use as risk factors for cervical intra-epithelial neoplasia in relation to human papillomavirus infection. Br J Cancer 2000; 82: 1332-8.
- IARC Monographs on the evaluation of carcinogenic risks humans. Human Papillomaviruses. Lyon: IARC; 2005 (Accessed on October 12, 2012).
- Kuo DY, Goldberg GL. Screening of cervical cancer: Where do we go from here? Cancer Invest 2003; 21: 157-61.
- www.cancer.org/…/FindCancerEarly/CancerScreeningGuidelines/americancance r- society-guidelines-for-the-early-detection-of-cancer (Accessed on October 12, 2012).
- Beerman H, van Dorst EB, Kuenen-Boumeester V, Hogendoorn PC. Superior performance of liquid-based versus conventional cytology in a population-based cervical cancer screening program. Gynecol Oncol 2009; 112: 572-6.
- Davey E, Barratt A, Irwig L, Chan SF, Macaskill P, Mannes P, Saville AM. Effect of study design and quality on unsatisfactory rates, cytology classifications, and accuracy in liquid-based versus conventional cervical cytology: A systematic review. Lancet 2006; 367: 122-32.
- Lawson HW, Lee NC, Thames SF, Henson R, Miller DS. Cervical cancer screening among low-income women: Results of a national screening program, 1991-1995. Obstet Gynecol 1998; 92: 745-52.
- Abdullah LS. Pattern of abnormal pap smears in developing countries: A report from a large referral hospital in Saudi Arabia using the revised 2001 Bethesda system. Ann Saudi Med 2007; 27: 268-72.
- Inal MM, Köse S, Yildirim Y, Ozdemir Y, Töz E, Ertopçu K, Ozelmas I, Tinar S. The relationship between human papillomavirus infection and cervical intraepithelial neoplasia in Turkish women. Int J Gyneacol Cancer 2007; 17: 1266-70.
- Coskun A, Köstü B, Kiran G, Arikan DC, Analan A. Pap smear screening result in Kahramanmaras. Gynecol Obstet Reprod Med 2008; 14: 182-5.
- Colgan TJ, McLachlin CM, Cotterchio M, Howlett R, Seidenfeld AM, Mai VM. Results of the implementation of liquid-based cytology-SurePath in the Ontario screening program. Cancer 2004; 102: 362-7.
- Stany MP, Bidus MA, Reed EJ, Kaplan KJ, McHale MT, Rose GS, Elkas JC. The prevalence of HR-HPV DNA in ASC-US Pap smears: A military population study. Gynecol Oncol 2006; 101: 82-5.
- Turkish Cervical Cancer and Cervical Cytology Research Group. Turkish Cervical Cancer and Cervical Cytology Research Group. Prevalence of cervical cytological abnormalities in Turkey. Int J Gyneacol Obstet 2009; 106: 206-9.
- Karabulut A, Alan T, Ali Ekiz M, Iritaş A, Kesen Z, Yahşi S. Evaluation of cervical screening results in a population at normal risk. Int J Gyneacol Obstet 2010; 110: 40-2.
- Celik C, Gezginç K, Toy H, Findik S, Yilmaz O. A comparison of liquid-based cytology with conventional cytology. Int J Gyneacol Obstet 2008; 100: 163-6.
- National Cancer Institute, surveillance epidemiology and end results. Available from: http://seer.cancer.gov/statfacts/html/cervix.html (Accesed on December 4, 2012).
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Bölüm | Cerrahi Tıp Bilimleri Araştırma Yazıları |
| Yazarlar | |
| Yayımlanma Tarihi | 23 Ağustos 2012 |
| Yayımlandığı Sayı | Yıl 2012Cilt: 34 Sayı: 4 |