Effectiveness of hpv dna testing combined with vaginal cytology in the screening and management of cervical pathologies and the place of hpv dna subgroups in management

Aim: To examine the effecƟveness of HPV DNA tesƟng in addiƟon to vaginal cytology in the diagnosis and treatment of cervical preinvasive lesions and to determine the place of high-risk HPV DNA subgroups in management. Materials and Methods: Our study included 949 paƟents who came to Cerrahpaşa Gynecological Oncology outpaƟent clinic for screening of cervical pathologies between January 2015 and January 2024 and underwent at least one colposcopic punch biopsy and/or LEEP. RetrospecƟvely, the paƟents' age, menopause status, vaginal cytology, HPV, punch biopsy and LEEP pathology result data were scanned through the ISHOP computer system. Results: Of the 949 cases included in the study, cytology result informaƟon for 908 and HPV DNA result informaƟon for 716 were obtained. Colposcopic biopsy was performed in 935 (98.5%) of the cases and LEEP procedure was performed in 462 (48.7%). Of the 638 HPV DNA posiƟve cases included in the study, 265 were HPV 16 posiƟve (37%), 67 were HPV 18 (9.4%) and 295 (41.2%) were other high-risk HPV DNA posiƟve paƟents. Among the cytology posiƟve and negaƟve paƟent groups, HPV 16/18 posiƟve paƟents and non-HPV 16/18 posiƟve paƟents were compared in terms of the risk of CIN 2 and above lesion development, and a staƟsƟcally significant high risk was detected in HPV 16/18 posiƟve paƟents. PaƟents with high-risk HPV posiƟvity other than HPV 16/18; cytology posiƟve and cytology negaƟve groups were compared in terms of the risk of developing CIN 2+. The detecƟon rate of CIN 2+ lesions in paƟents with posiƟve cytology was found to be staƟsƟcally significantly higher than in paƟents with negaƟve cytology. Conclusion: HPV DNA and its subtypes, which play a fundamental role in the pathophysiology of cervical preinvasive lesions, were evaluated together with cytological and histopathological data and their importance in disease prevenƟon, screening programs and diagnosis was emphasized. Keywords: HPV, cervical intraepithelial neoplasia (CIN), colposcopy, LEEP, vaginal cytology, HPV subtypes.