Abnormal endocervical pathology and human papillomavirus prevelance in abnormal cervical cytology

Introduction: Cervical cancer is the fourth most common cancer among women in the world today, and it is important because it is a preventable cancer. For this reason, many screening programs have been developed and in our country screening is mostly done by cervical cytology and PCR for hrHPV. In many studies HPV has been reported to be positive in %96-99 of cervical cancers. There are studies showing that HPV has auxiliary cofactors other than positivity alone. In this study, we evaluated the abnormal endocervical pathology and HPV prevalence in abnormal cervical cytology, how the possible cofactors affected this condition, and the importance of endocervical specimen. Methods: In this study, 505 patients who were treated with anormal cervical cytology between January 2013 and April 2016 were evaluated in our outpatient clinic and colposcopy unit. 215 anormal cervical cytology patients and 175 control patients with HPV DNA screening and endocervical sampling were compared. Cervical cytology is included in the study without distinguishing between conventional and liquid-based (thin-prep) techniques. Cervical cytology was interpreted according to Bethesda 2001 protocol. HPV DNA was evaluated in our hospital's laboratories of pathology, microbiology and KETEM laboratories by PCR method. All endocervical samples were obtained using endocervical brush and curettage methods and evaluated in our hospital pathology section. Findings: A total of 505 people were evaluated for the study. The number dropped to 390 due to missing data. The number of anormal Pap smears participating in the study was 215 (55%) and the number of normal Pap smear was 175 (45%). The ages of the patients ranged from 24 to 69 years and the mean age was 45.5±9. Parity numbers ranged from 0 to 8, with an average of 2.2. The first coitus age was between 11 and 41 years old, with an average age of 20 years. OCP use was positive in %27.9 of the population. Menopausal patients ratio was% 31.6. Additional disease ratio was % 28.1. Age distribution of patients with abnormal Pap smears; was between 24 and 69 years old and average age was 45. The rate of smoking was %27.3. The rate of OCP use was %26.1. The prevalence of HPV positivity was %68.8. The abnormal endocervical pathology prevalence was % 40. There was no relationship between age and cervical cytolology. The prevalence of HPV positivity in the control group was %53.7. In this group, %44 of HPV positivity was HPV 16, % 9.3 was HPV 18, % 3.2 was HPV 16 and 18 association and % 43 were other HPV types. The abnormal endocervical sampling pathology prevalence was %2.8. There was a statistically significant relationship between abnormal smear cytology and HPV DNA positivity (p:0.002). There was no significant relationship between gravida, parity, first coitus age, use of OCP, smoking and abnormal cervical cytology. Statistically significant results were obtained between anormal cervical cytology and abort and curettage stories (p:0.018 and p:0.02). The relationship between HPV DNA positivity and cigarette use was statistically significant (p: 0.018). There was no statistically significant difference between HPV DNA positivity and other cofactors. There was significant correlation between HPV DNA posivity and curretage histories (p: 0.037). There is not enough work to confirm the reality of this relationship. When abnormal cervical cytology and abnormal endocervical pathology were compared statistically significant, abnormal cervical cytology grade increased the frequency of abnormal endocervical pathology and HPV DNA positivity. Abnormal endocervical pathology and HPV DNA positivity were compared and statistically significant results were found (p˂0.001). Conclusion: HPV positivity was associated with abnormal cervical cytology and abnormal endocervical pathology. Abnormal cervical cytology, abortus and dilatation-curettage relationship were statistically significant. There was no significant relationship between abnormal cervical cytology and age of gravida, parity, use of OCP, smoking, age, first sexual intercourse. When we assessed HPV positivity with co-factors, the relation with smoking was found significant. HPV positivity and dilatation-curretage correlation was found to be significant. The abnormal endocervical pathology prevalence was higher in patients with anormal cervical cytology than other studies. There was no statistically significant relationship between anormal endocervical pathology and age, gravida, parity, abortus, curettage, OCP, smoking, age of first sexual intercourse. However when we compared HPV DNA, significant results was found.