Öz
Giriş: Human papilloma virüs (HPV), servikal kanser gelişimi açısından iyi bilinen bir etken patojendir. Human papilloma virüs prevalansı ve genotiplerinin dağılımı bölgeler arası değişkenlik göstermektedir. Bu çalışmanın amacı, servikal sitolojisi olan hastalarda yüksek riskli HPV (YR-HPV) prevelansını ve genotip dağılımını tespit etmektir.
Gereç ve Yöntem: 1 Ocak 2017-30 Temmuz 2019 tarihleri arasında hastanemizin Kadın Hastalıkları ve Doğum Polikliniği’ne başvuran 17-91 yaşları arasında toplam 1.571 kadın dahil edildi. Servikal sitoloji için numuneler toplandı ve HPV deoksiribonükleik asit (DNA) testi için Tıbbi Mikrobiyoloji Laboratuvarı’na gönderildi. Servikal numuneler YR-HPV varlığı ve genotiplendirilmesi için gerçek zamanlı polimeraz zincir reaksiyonu ile ticari bir kit (Nuclear Laser Medicine S.r.l., Milano, İtalya) kullanılarak araştırıldı. Eş zamanlı olarak sitolojik inceleme, geleneksel (Papanicolaou) yöntem kullanılarak yapıldı ve Bethesda sistemine göre yorumlandı. Veriler Statistical Package for the Social Sciences (SPSS) sürüm 22.0 (SPSS Inc, Chicago, IL, ABD) kullanılarak analiz edildi.
Bulgular: Çalışmaya ortalama yaşı 39,98 (±10,17) olan 1.571 kadın hasta dahil edildi. Hastaların 972’sinde (%61,9) HPV DNA negatif iken; 599 (%38,1) hastada YR-HPV pozitif olarak bulundu. Yaş grupları arasında HPV pozitifliği açısından anlamlı fark bulunmadı (p=0,18). Tespit edilen en yaygın YR-HPV tipleri azalan sıra ile HPV16 (%28,5), HPV68 (%18,7), HPV51 (%15,5), HPV39 (%15,4) ve HPV31 (%13,4) idi. Tüm pozitif sonuçların %61,4’ünde (368/599) tek tip HPV genotipi ile enfeksiyon tespit edilirken; %38,6’sında (231/599) multipl enfeksiyon saptandı.
Sonuç: Bu çalışmada Türkiye’nin merkezi kısmında yer alan bir bölgedeki kadınlarda HPV prevalansı beklenenden daha yüksek olarak saptandı. Ek olarak, bu çalışmada aşı dışı genotiplerin yüksek prevalansı bölgesel bir farklılık olarak düşünülmelidir. Bu bilgilerin profilatik aşıların seçiminde ve geliştirilmesinde rehberlik amacıyla kullanılması daha geniş bir koruma sağlayabilir.
Anahtar Kelimeler: HPV, tarama, aşı, kanser
Kaynakça
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