Clinical Investigation

The value of colposcopy, high risk HPV-DNA and histopathologic examination in the management of abnormal Pap smear results


  • Vugar Bayramov
  • Yavuz Emre Şükür
  • Sevgi Tezcan

Turk J Obstet Gynecol 2011;8(4):272-278


Pap smear test is a major screening test for early diagnosis and treatment of cervix cancer. The aim of our study was to assess the value of HPV-DNA, colposcopy and histopathologic examination in the management of patients with abnormal cervical cytology.

Materials and methods:

This prospective cohort study was conducted in Ankara University Cebeci Hospital gynecology outpatient clinic. The study compremised 86 patients with smear results of ASCUS, AGC, L-SIL and H-SIL. Age, gravity, parity, age at first coitus, smoking status, number of partners, high risk HPV-DNA status and pathologic colposcopy findings were investigated.


Mean age of the patients was 35 years and the most common abnormal smear result was ASCUS, with 55 patients (63%). There was no significant difference between the groups regarding demographic characteristics except age at first coitus and pathologic colposcopy findings. Among patients diagnosed as ASCUS 34.5% had been up-graded with histopathologic examination. Among patients diagnosed as L-SIL 73.6% had been down-graded with histopathologic examination. However, after the histopathologic exam of 9 H-SIL patients two (22.2%) were diagnosed as CIN II, two (22.2%) were diagnosed as CIN III and one (11.1%) was diagnosed as cervical cancer. In the groups of ASCUS, L-SIL and H-SIL the presence of high risk HPV-DNA were 11%, 5% and 33%, respectively.


If we are sure that the patient will attend the follow-up visits, then fort he ones with ASCUS and L-SIL a repeat smear test would be the appropriate. However, in the management of patients with H-SIL colposcopic biopsy would be the best approach.

Keywords: Pap smear, colposcopy, high risk HPV, cervix cancer\r\n