Cervical Cytology Findings in Renal Transplant Patients and Comparison of These Findings with Normal Population

Alev OK ATILGAN, Merih TEPEOĞLU, Asuman Nihan HABERAL REYHAN, Esra KUŞCU, Handan ÖZDEMİR, Mehmet HABERAL
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Abstract

Long-term immunosuppressive therapy increases the likelihood of renal transplant patients developing cervical cancer. We aimed to analyze the results of cervical cytology in renal transplant patients, compare these findings to those of the normal population, and determine the risk factors linked to the development of squamous intraepithelial lesions. Our analysis involved a retrospective study of hospital records from January 2000 to April 2018, encompassing 140 female renal transplant patients. A control group of 280 women with normal health status was selected and matched based on age and the cervical cytology procedure. The cervical cytology findings of the patients were re-evaluated using the Bethesda 2014 criteria. Of the total of 420 patients, 37 patients had epithelial cell abnormalities; including 32 (86.5%) patients in the renal transplant group and 5 (13.5%) control group (p ≤ 0.001). Sixty-two patients had infections; including 44 (71%) patients in the renal transplant group and 18 (29%) control group (p ≤ 0.001). We revealed that the development of squamous intraepithelial lesions was associated with factors such as having an immunologic disease as the primary renal disease, undergoing re-transplantation, and the presence of acute rejection (p ≤ 0.05). Cervical cytology screening plays a crucial role in detecting preinvasive lesions. The incidence of epithelial cell abnormalities is significantly higher in renal transplant patients compared to the normal population. Regular cervical cytology follow-up is vital for the early detection and prevention of cervical cancer progression in transplant recipients.
肾移植患者宫颈细胞学检查结果及其与正常人群的比较
长期免疫抑制治疗增加肾移植患者发生子宫颈癌的可能性。我们的目的是分析肾移植患者的宫颈细胞学结果,将这些结果与正常人群的结果进行比较,并确定与鳞状上皮内病变发展相关的危险因素。我们的分析涉及对2000年1月至2018年4月的医院记录进行回顾性研究,其中包括140名女性肾移植患者。选择280名健康状况正常的妇女作为对照组,并根据年龄和宫颈细胞学检查程序进行匹配。使用Bethesda 2014标准重新评估患者宫颈细胞学检查结果。在420例患者中,37例患者有上皮细胞异常;其中肾移植组32例(86.5%),对照组5例(13.5%)(p≤0.001)。62例患者感染;其中肾移植组44例(71%),对照组18例(29%)(p≤0.001)。我们发现鳞状上皮内病变的发生与免疫性疾病作为原发性肾脏疾病、再次移植和急性排斥反应的存在等因素相关(p≤0.05)。宫颈细胞学筛查在发现浸润前病变方面起着至关重要的作用。与正常人群相比,肾移植患者上皮细胞异常的发生率明显更高。定期宫颈细胞学随访对于早期发现和预防移植受者宫颈癌进展至关重要。
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