The cytomorphologic reflections of HPV positivity in smear samples in which syncronous hpv testing is applied

ABSTRACT Pap smear screen is important for the detection of premalignant and malignant lesions by identifying the changes in the cervical epithelium. İt has been found usefull to reduce cervical cancer incidance and mortality related to cervical cancer particularly in countries where screening programs are widely used. HPV test is recommended as primary screening test for the detection of HPV to prevent cervical cancer due to its high sensivity and specifity. In Daily practice; the HPV test is used in combination with cytology in patients older than 30 years of age and patients with atypical squamous cells of unkonown significance (ASCUS). In most cases, only high risk HPV test is used. İt is known that different cytological changes ocur at different stages of HPV infection. Although coilositosis is the characteristic sign of HPV infection, changes such as dyskeratosis and multinucleation are also frequently seen. İn our study, we aimed to detect relationship between HPV seropositivity and cytological changes in patients diagnosed as ASCUS and to detect the frequency of high risk HPV infection in our region. 1500 patients were evaluated in our study. We detect high risk HPV seropositivity in 151 patients. HPV 16, HPV 18 and other high risk HPV subtypes were detected respectively 36 (2.4%), 14 (0.9%) and 101 (6.7%) of patients. 5 patients with ASCUS and high risk hpv infection were evaluated. We detected cell with perinuclear halo in 3 of these patients, cytoplasmic cavitation in 2 of them, multinucleation in 4 of them, parakeratosis in 4 of them and minimal nuclear hyperchromasia in 1 of them. Minimal nuclear hyperchromasia was detected only HPV 16 subtype in patients diagnosed as ASCUS. We think that minimal nuclear hyperchromasia finding can suggest HPV 16 subtype in situations which HPV subtype analyses can not be made. But it is not possible to adopt this common approach to all patients due to limited number of our patients. We think that more comprehensive studies must be conducted to detect cytomorphological changes more healthy in HPV subtypes. Key words: ASCUS, HPV, PAP SMEAR