4. Hrvatski kongres kliniËke citologije 4th Croatian Congress ... - Penta

Clinical Cytology - Oral Presentations
CERVICAL CYTOLOGY AND HPV TEST IN FOLLOW-UP AFTER CONISATION OR LLETZ
Verša Ostojić D1 , Vrdoljak-Mozetič D1 , Štemberger-Papić S1 , Finderle A2 , Eminović S3 1 Department of Gynecological Cytology, University Department of Gynecology and Obstetrics,
University Hospital Center Rijeka, Croatia
2 Department of Perinatology, University Department of Gynecology and Obstetrics, University
Hospital Center Rijeka, Croatia
3 Department of Pathology, School of Medicine, University of Rijeka, Croatia
Objective: To determine cytology-histology correlation after conisation or Large Loop
Excision of the Transformation Zone (LLETZ) for cervical intraepithelial neoplasia (CIN),
resection margin status, compliance to the follow-up protocol and evaluation of cervical
cytology and HPV testing in two years period after surgical treatment. Materials
and Methods: We made a retrospective analysis of the case records of 251 conisations
and LLETZ performed between January and December 2006. The conventional cervical
smears were analysed and digene Hybrid capture 2 test was used for detection of
13 high-risk HPV types. Results: Histology analysis demonstrated CIN1+ lesion in 234
cases (93,2%) with cytology-histology correlation in 97,9 % of cases. Preoperative HPV
test was made in 142 histology confirmed CIN1+ lesions and 137 (96,5%) tested positive.
The resection margins were involved in 48 (35,8%) cases and in 24 (10,2%) the margins
were difficult to determine. 217 (86,5%) patients attended the posttreatment visits and
abnormal cytology was found in 33 (15,2%) cases. The post-treatment HPV test was performed
in 159 women and was positive in 25 (15,7%) cases. The complete follow-up control
cytology, with at least three Pap smears in two years or with second treatment was
found in only 146 (58,2 %) patients. 14/217 (6,5 %) patients underwent second treatment
with histology confirmed treatment failure. In all patients where control smear was performed,
repeated cytology found HSIL. In six women control HPV test was performed, in
five cases it was positive and in one case with VAIN2 on biopsy of vagina it was negative.
Conclusion: Our study confirme important place of cervical cytology in the diagnisis of
cervical intraepitelial lesions and monitoring after treatment. In the future we have to
improve compliance to the follow-up protocols and use of HPV test in the selection of
women at risk of treatment failure.
dversa.ostojic@gmail.com
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4 th Croatian Congress of Clinical Cytology / 1 st Croatian Symposium of Analytical Cytology / 2 nd Croatian Symposium of Cytotechnology