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

Abstract

Ozet Amac. Anabilim Dali’mizda incelenen ve epitel hucre anormalligi saptanan servikovajinal smear sonuclarinin degerlendirilmesi ve histopatolojik incelemesi bulunan olgularda sito-histopatolojik korelasyonun arastirilmasi. Yontem. Ocak 2008-Mayis 2011 tarihleri arasinda Cumhuriyet Universitesi Tip Fakultesi Patoloji Anabilim Dali’na gonderilen ve 2001 Bethesda sistemine gore tani alan toplam 8102 servikal smear ornegine ait raporlar retrospektif olarak incelendi. Epitel hucre anormalligi tesbit edilen 97 olgu calismaya dahil edildi. Bunlardan histopatolojik incelemesi olan 25 olguda sito-histopatolojik korelasyon arastirildi. Bulgular. Toplam 8102 servikal smear’in 97’sinde (%1.19) epitel hucre anormalligi saptandi. Epitel hucre anormalligi saptanan olgularin 54’u (%55.6) ASC-US, 14’u (%14.4) ASC-H, 14’u (%14.4) LSIL, 5’i (%5,2) HSIL, 5’i (%5,2) SCC, 3’u (%3.1) AGC ve 2’si (%2.1) adenokarsinom, NOS olarak tani almis idi. Bunlardan biyopsi tanisi olan 25 olgunun 10’unun (%40) nonneoplastik, 2’sinin CIN I (%8), 1’inin (%4) CIN II, 3’unun (%12) CIN III ve 9’unun (%36) invaziv karsinom olarak rapor edildigi saptandi. Bu sonuclara gore ASC-US, ASC-H, LSIL, HSIL, SCC, AGC ve adenokarsinomun pozitif ongorme degeri sirasiyla %0, %50, %100, %80, %100, %0 ve %100 olarak saptandi. Sonuc. Servikal smear’ de verilen karsinom, HSIL ve LSIL tanilari yuksek pozitif ongorme degerine sahip iken, serimizde bu deger ASC-US ve AGC tanilari icin dusuk bulunmus, ancak bu gruplarda takipli olgu sayisinin cok az olmasi nedeniyle bu sonuc guvenilir kabul edilmemistir. Anahtar sozcukler: Servikal smear, sito-histopatolojik korelasyon, epitel hucre anormalligi 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