Kolposkopik Biyopsi ve Soğuk Konizasyon Sonuçlarının Gereksiz Tedavi ve Tanı Atlanması Durumları ile İlişkili Olarak Karşılaştırılması

Amaç: Çalışmanın amacı kolposkopik biyopsi ve soğuk konizasyon patolojik sonuçlarının gereksiz tedavi ve tanı atlanması durumlarıyla ile ilişkili olarak karşılaştırılmasıdır. Gereç ve Yöntemler: Jinekolojik onkoloji kliniğine anormal sitoloji ve/veya yüksek riskli insan papilloma virüsü varlığı nedeniyle sevk edilip, kolposkopik biyopsi ve soğuk konizasyon yapılan 72 hastanın verileri retrospektif olarak incelendi. Sonuçları uyumsuz olan olgular, özellikle fazladan tedavi ve gözden kaçan tanı açısından incelendi. Bulgular: Kolposkopik biyopsinin etkinliğinin değerlendirilmesinde duyarlılık, özgüllük, pozitif öngörü değeri ve negatif öngörü değeri sırasıyla %95,7, %48, %77,5 ve %85,7 idi. Bu çalışma grubundaki olguların 57’si (%79,2) kolposkopik biyopsi ile soğuk konizasyon arasında histopatolojik bulgular açısından tutarlı ve 15’i (%20,8) tutarsızdı. Sonuç: Kolposkopik biyopsi ve soğuk konizasyon sonuçları arasında tatminkar düzeyde uyum bulundu. Biyopsi ve eksizyon sonuçları arasındaki uyumsuzluğun nedenleri, klinik ve patolojik faktörlerin yanı sıra serviks kanseri tanısının atlanma endişesi nedeniyle klinisyenlerin daha fazla cerrahi seçeneği kullanmaya istekli olmalarıdır

Comparison of Colposcopic Biopsy and Conization Results in Association with Overtreatment or Missed Diagnosis

Objective: To compare pathological results of colposcopic biopsy and cold knife conization in association with overtreatment and missed diagnosis perspective. Materials and Methods: The data of 72 patients who were referred to the gynecologic oncology clinic because of the presence of atypical cytology and/ or high-risk human papillomavirus and underwent colposcopic biopsy and cold knife conization were retrospectively analyzed. Cases with discordant results were examined, particularly in terms of overtreatment and missed diagnosis. Results: Efficacy of colposcopic biopsy was evaluated; the sensitivity, specificity, positive predictive value, negative predictive value was 95.7%, 48%, 77.5%, 85.7%, respectively. Fifty seven cases (79.2%) were consistent and 15 cases (20.8%) were inconsistent in histopathological findings between colposcopic biopsy and cold knife conization. Conclusion: A satisfactory agreement was detected between colposcopic biopsy and cold knife conization pathologies. The reasons for the inconsistency between biopsy and excision results are; in addition to clinic and pathologic factors, clinicians are willing to use more surgical options because of the concern for missing a diagnosis of cervical cancer.

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