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1264 Quadrant based topography of high grade cervical intraepithelial neoplasia in terms of different HrHPV types
  1. Elcin Telli,
  2. Vehbi Yavuz Tokgöz,
  3. Tufan Oge and
  4. Omer Tarik Yalcin
  1. Eskisehir Osmangazi University School of Medicine, Department of Obstetrics and Gynecology, Eskisehir, Türkiye


Introduction/Background To investigate the precancerous effect of different types of high risk human papilloma viruses on four quadrant model of uterine cervix

Methodology A total of 139 patients with a diagnosis of HSIL and underwent loop electrosurgical excision procedure (LEEP) for treatment was investigated. Excised cervical tissue specimens were sutured on 12 oclock positions and the cone was sampled 12 equal pieces according to clock positions. Quadrant 1 was defined as the area between 1–3 oclock position, quadrant 2 as between 4–6 oclock position, quadrant 3 as between 7–9 oclock position and quadrant 4 as between 10–12 oclock position.

Results Median age of the patients was 40 (20–65) years. Fifteen point eight percent of the patients was nulligravid. Most of the patients (82%) was premenapousal and coital active. Coitus interruptus (85.6%) was the main method to achieve pregnancy control. Fourtyfour percent of the patients was HPV 16/18 positive, 15.8% was HPV 16+other hrHPV positive, 2.2% was 18+ other hrHPV positive, 27.3% other hr HPV positive and 10.8% was unknown genotype hrHPV positive. Q2(n=89) and Q4 (n=132) were the most HSIL positive quadrants. HPV 16/18 was the most causative agent for HSIL among quadrants.

HPV 16/18 induced HSIL was present at 51.4%, 47.2%, 48.7%, 44.7% of Q1, Q2, Q3and Q4, respectively. When compared HSIL positive quadrants according to hr HPV genotypes, there were not statistically significance between the groups (Q1; p=0.1, Q2; p=0.98, Q3; p= 0.805, Q4; p= 0.749).

Conclusion Although all four quadrants were keen to be affected by hrHPV agents, Q2 and Q4 are most common quadrants to be HSIL positive. Random biopsies can be achieved in these two quadrants in the absence of colposcopy equipment or when the lesion is too small to determine during colposcopy

Disclosures None

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