{"id":6388,"date":"2025-09-16T19:20:07","date_gmt":"2025-09-16T19:20:07","guid":{"rendered":"https:\/\/polikistikover.net\/yeni\/?page_id=6388"},"modified":"2025-12-09T23:39:23","modified_gmt":"2025-12-09T23:39:23","slug":"human-papilloma-virus-hpv-mantar-enfeksiyonu-ve-smear-testi","status":"publish","type":"page","link":"https:\/\/polikistikover.net\/yeni\/human-papilloma-virus-hpv-mantar-enfeksiyonu-ve-smear-testi\/","title":{"rendered":"Human Papilloma Vir\u00fcs (HPV), Mantar enfeksiyonu ve Smear Testi"},"content":{"rendered":"\n<p class=\"has-text-align-center\"><strong>Human Papilloma Vir\u00fcs\u00fc (HPV) rahim a\u011fz\u0131 kanserine (cervical cancer) neden olmaktad\u0131r(97,129).<\/strong><\/p>\n\n\n\n<p class=\"has-text-align-center\"><strong> Son y\u0131llarda HPV\u2019ye kar\u015f\u0131 korunmak amac\u0131yla baz\u0131 a\u015f\u0131lar \u00fcretilmi\u015ftir(92,95,124). <\/strong><\/p>\n\n\n\n<p class=\"has-text-align-center\"><strong><mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-dark-pink-color\">HPV a\u015f\u0131lar\u0131 baz\u0131 \u00fclkelerde yayg\u0131n olarak \u00f6nerilmekte olmas\u0131na ra\u011fmen rahim a\u011fz\u0131 kanserinin \u00f6nlenmesi amac\u0131yla kullan\u0131labilecek tek y\u00f6ntem a\u015f\u0131 de\u011fildir(45,104).<\/mark><\/strong> <\/p>\n\n\n\n<p class=\"has-text-align-center\"><strong><mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-dark-pink-color\">HPV a\u015f\u0131s\u0131 yap\u0131lan bir kad\u0131n\u0131n rahim a\u011fz\u0131 kanseri olma ihtimali, belirli aral\u0131klarla rahim a\u011fz\u0131ndan ak\u0131nt\u0131 \u00f6rne\u011fi al\u0131narak yap\u0131lan HPV DNA testi ve pap smear testi ile takip edilen bir kad\u0131ndan daha az de\u011fildir(21,31,32,45,83,92,93,95,100,101,104,108,115,121).<\/mark><\/strong><\/p>\n\n\n\n<p> Kongo gibi afrika \u00fclkelerinde (Sub-Saharan Africa) ve Fuji gibi pasifik okyanusundaki adalarda rahim a\u011fz\u0131 kanseri d\u00fcnya ortalamas\u0131ndan \u00e7ok daha fazla g\u00f6r\u00fclmektedir(28,29,109,129). Bu \u00fclkelerde ya\u015fayan kad\u0131nlara doktora ula\u015fma, HPV DNA testi ve pap smear testi yapt\u0131rma \u015fanslar\u0131 olduk\u00e7a d\u00fc\u015f\u00fck oldu\u011fu i\u00e7in toplu olarak (mass vaccination) HPV a\u015f\u0131s\u0131 yap\u0131lmas\u0131 do\u011fru olabilir(108,109,129). Fakat, kad\u0131nlar\u0131n doktora ula\u015fma, HPV DNA testi ve pap smear testi yapt\u0131rma \u015fanslar\u0131n\u0131n y\u00fcksek oldu\u011fu \u00fclkelerde HPV a\u015f\u0131s\u0131n\u0131n ki\u015finin tercihine ve iste\u011fine ba\u011fl\u0131 olarak (voluntary vaccination) yap\u0131lmas\u0131 daha do\u011fru bir y\u00f6ntemdir(104,109). <\/p>\n\n\n\n<p class=\"has-text-align-center\"><strong><mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-dark-pink-color\">Rahim a\u011fz\u0131 kanserini engelledi\u011fi kesinle\u015fmemi\u015f olmas\u0131na ra\u011fmen, a\u015f\u0131 olmayan ki\u015finin rahim a\u011fz\u0131 kanseri olaca\u011f\u0131 ve de a\u015f\u0131 olmak istemeyen bir ki\u015finin a\u015f\u0131dan ba\u015fka \u00e7aresi yokmu\u015f gibi g\u00f6sterilmesi do\u011fru de\u011fildir.<\/mark><\/strong><\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-rich is-provider-embed-handler wp-block-embed-embed-handler wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe loading=\"lazy\" title=\"#hpva\u015f\u0131s\u0131 #hpvenfeksiyonu @HPVEnfeksiyonuveRahimKanseri\" width=\"1320\" height=\"743\" src=\"https:\/\/www.youtube.com\/embed\/xcgcHi18x_M?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n\n\n<p>HPV a\u015f\u0131s\u0131 \u00fcreten ila\u00e7 firmalar\u0131n\u0131n maddi deste\u011fiyle yap\u0131lan baz\u0131 \u00e7al\u0131\u015fmalarda HPV DNA testi ve pap smear testinin ba\u015far\u0131s\u0131 d\u00fc\u015f\u00fck bulunmakta ve hatta bu testlerin yap\u0131lmas\u0131na gerek olmad\u0131\u011f\u0131 bile s\u00f6ylenmektedir(101,110). Halbuki, a\u015f\u0131 olmayan bir ki\u015finin, a\u015f\u0131n\u0131n tahmin edilen koruyuculu\u011fundan daha fazla etkili oldu\u011fu y\u0131llar \u00f6nce g\u00f6sterilmi\u015f y\u00f6ntemlerle (HPV DNA testi ve pap smear testi)&nbsp;korunmas\u0131 m\u00fcmk\u00fcnd\u00fcr.(21,31,32,55,77,80,81,83,85,87,88,90,93,94,95,97,100,101,104,110,115,120,121).<\/p>\n\n\n\n<p class=\"has-text-align-left\"><strong><mark style=\"background-color:#fb0808\" class=\"has-inline-color\">1-<\/mark><\/strong><mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-dark-blue-color\">HPV\u2019nin 200\u2032 den fazla \u00e7e\u015fidi (genotypes) vard\u0131r(105).<\/mark><\/p>\n\n\n\n<p><strong><mark style=\"background-color:#f60202\" class=\"has-inline-color\">2-<\/mark><\/strong>HPV nin genetik yap\u0131s\u0131nda olu\u015fan de\u011fi\u015fiklikler (mutasyonlar) her ge\u00e7en g\u00fcn yeni \u00e7e\u015fitlerin ortaya \u00e7\u0131kmas\u0131na neden olmaktad\u0131r(105,123,125).<\/p>\n\n\n\n<p><strong><mark style=\"background-color:#f60b0b\" class=\"has-inline-color\">3-<\/mark><\/strong> <mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-dark-pink-color\">200\u2032 den fazla \u00e7e\u015fidinden <\/mark>\u015fimdilik yakla\u015f\u0131k 20 tanesinin rahim a\u011fz\u0131 kanserine neden oldu\u011fu bilinmektedir(97,105). HPV a\u015f\u0131s\u0131 ise rahim a\u011fz\u0131 kanserine neden olan bu 20 HPV \u00e7e\u015fidinden sadece&nbsp;bir k\u0131sm\u0131na etki etmektedir(11,15,97).<\/p>\n\n\n\n<p><strong><mark style=\"background-color:#f60b0b\" class=\"has-inline-color\">4-<\/mark><\/strong> HPV\u2019 ye ba\u011fl\u0131 rahim a\u011fz\u0131 kanserinin ortaya \u00e7\u0131kmas\u0131 25 ile 40 y\u0131l kadar uzun bir s\u00fcreyi bulabilmektedir(131). HPV a\u015f\u0131s\u0131 kullan\u0131lmaya ba\u015fland\u0131\u011f\u0131ndan beri yeteri kadar bir s\u00fcre ge\u00e7memi\u015ftir. Bu nedenle a\u015f\u0131n\u0131n rahim a\u011fz\u0131 kanserine kar\u015f\u0131 uzun s\u00fcreli koruyuculu\u011fu da hen\u00fcz bilinmemektedir.<\/p>\n\n\n\n<p><strong><mark style=\"background-color:#f30909\" class=\"has-inline-color\">5-<\/mark><\/strong> HPV a\u015f\u0131s\u0131 HPV\u2019 nin rahim a\u011fz\u0131 h\u00fccrelerine yap\u0131\u015fma (capsid) yerinde bulunan protein (L1) i\u00e7in antikor olu\u015fturmaktad\u0131r(122). Rahim a\u011fz\u0131 kanseri yapan HPV \u00e7e\u015fitlerinde (genotypes)&nbsp; olu\u015fan genetik mutasyonlar (L1 protein variants) a\u015f\u0131n\u0131n etkinli\u011fini azaltmaktad\u0131r(123,125,126,127).<\/p>\n\n\n\n<p><strong><mark style=\"background-color:#fb2007\" class=\"has-inline-color\">6-<\/mark><\/strong> HPV a\u015f\u0131s\u0131 yap\u0131ld\u0131ktan sonra a\u015f\u0131n\u0131n koruyuculu\u011fu (seropositivity) takip eden y\u0131llarda giderek azalmaktad\u0131r(111,113,117,118,119).<\/p>\n\n\n\n<p><strong><mark style=\"background-color:#fd1007\" class=\"has-inline-color\">7-<\/mark><\/strong> HPV enfeksiyonu (positive) olan bir ki\u015fiye HPV a\u015f\u0131s\u0131 yap\u0131ld\u0131\u011f\u0131 zaman a\u015f\u0131n\u0131n rahim a\u011fz\u0131 kanserini \u00f6nleyici bir etkisi yoktur(106,107).<\/p>\n\n\n\n<p class=\"has-text-align-center\"><strong><mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-dark-pink-color\">Bu nedenlerle HPV a\u015f\u0131s\u0131 yapt\u0131ran ki\u015finin de yapt\u0131rmayanlar gibi a\u015f\u0131 yap\u0131ld\u0131ktan sonra HPV DNA testi ve pap smear testi ile ayn\u0131 \u015fekilde takip edilmesi gerekmektedir(100,112,114,116,118).<\/mark><\/strong><\/p>\n\n\n\n<p><strong><mark style=\"background-color:#f90a0a\" class=\"has-inline-color\">8-<\/mark><\/strong> Rahim a\u011fz\u0131 kanseri olan kad\u0131nlar\u0131n b\u00fcy\u00fck \u00e7o\u011funlu\u011funda HPV \u00e7e\u015fitlerinden biri veya bir ka\u00e7\u0131 saptanmas\u0131na ra\u011fmen, bir k\u0131sm\u0131nda ise HPV tespit edilememektedir(128,129,130). Demek ki a\u015f\u0131n\u0131n tahmin edilen koruyuculu\u011funun kapsamad\u0131\u011f\u0131 rahim a\u011fz\u0131 kanserleri de g\u00f6r\u00fclmektedir(128,129,130). Bu nedenle HPV a\u015f\u0131s\u0131 yapt\u0131rd\u0131ktan sonra a\u015f\u0131n\u0131n koruyuculu\u011funa g\u00fcvenerek takibi b\u0131rak\u0131p, pap smear testi ve HPV testi yapt\u0131rmay\u0131 ihmal eden ki\u015filerde tam tersine rahim a\u011fz\u0131 kanseri riski artabilir.<\/p>\n\n\n\n<p class=\"has-text-align-center\"><strong><mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-dark-pink-color\">Pap smear testi ve HPV DNA testi i\u00e7in&nbsp;muayene s\u0131ras\u0131nda rahim a\u011fz\u0131ndan, rahim a\u011fz\u0131 kanserinin en \u00e7ok g\u00f6r\u00fcld\u00fc\u011f\u00fc b\u00f6lgeden (transformation zone) \u00e7ubuk \u015feklinde, ince bir f\u0131r\u00e7a yard\u0131m\u0131yla ak\u0131nt\u0131 \u00f6rne\u011fi al\u0131n\u0131r(65,70,71). Bu ak\u0131nt\u0131 \u00f6rne\u011finde g\u00f6r\u00fclen h\u00fccrelerde HPV DNA\u2019 s\u0131n\u0131n varl\u0131\u011f\u0131n\u0131 tespit etmek i\u00e7in HPV DNA PCR testi yap\u0131l\u0131r, pap smear testinde de ak\u0131nt\u0131 \u00f6rne\u011findeki rahim a\u011fz\u0131 h\u00fccreleri mikroskop ile incelenerek HPV enfeksiyonunun neden oldu\u011fu de\u011fi\u015fiklikler g\u00f6r\u00fcl\u00fcr(41,51,54,57,58,59,65,70,71,75,77,86,91).<\/mark><\/strong><\/p>\n\n\n\n<p><strong><mark style=\"background-color:#fb0404\" class=\"has-inline-color\">9-<\/mark><\/strong> HPV a\u015f\u0131s\u0131n\u0131n kal\u0131c\u0131 hasar b\u0131rakan ve \u00f6l\u00fcmle sonu\u00e7lanan yan etkileri vard\u0131r(7,73,78,89). HPV a\u015f\u0131s\u0131nda bulunan baz\u0131 maddeler (antijen) beyinde bulunan sinir h\u00fccrelerini taklit etmektedir (cross-reactivity)(4,8,89). HPV a\u015f\u0131s\u0131n\u0131n ba\u011f\u0131\u015f\u0131kl\u0131k (imm\u00fcn) sistemini uyarmas\u0131 sonucunda HPV a\u015f\u0131s\u0131na kar\u015f\u0131 olu\u015fan antikorlar g\u00f6rme sinirine (neuromyelitis optica) ve beyin h\u00fccrelerine&nbsp;(acute disseminated encephalomyelitis) zarar verebilmektedir(3,4,5,6,7,8,9,10,62,73,89). HPV a\u015f\u0131s\u0131 ailesel (genetik) e\u011filimi olan kad\u0131nlarda multiple sclerosis (MS) gibi ba\u011f\u0131\u015f\u0131kl\u0131k sistemi (otoimm\u00fcn) hastal\u0131klar\u0131n\u0131n ortaya \u00e7\u0131kmas\u0131na neden olmaktad\u0131r(96). Japonya ve baz\u0131 Avrupa \u00fclkelerinde yan etkileri nedeniyle HPV a\u015f\u0131s\u0131 yasaklanm\u0131\u015ft\u0131r(1,2,44,46,48,66,74).<\/p>\n\n\n\n<p class=\"has-text-align-center\"><strong><mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-dark-pink-color\">HPV enfeksiyonu genellikle ak\u0131nt\u0131, kanama ve a\u011fr\u0131 gibi \u015fikayetler yapmamaktad\u0131r.<\/mark><\/strong><\/p>\n\n\n\n<p class=\"has-text-align-center\"> <strong><mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-dark-pink-color\">G\u00f6zle g\u00f6r\u00fclemeyen, ancak mikroskop ile g\u00f6r\u00fclebilen h\u00fccre i\u00e7inde baz\u0131 de\u011fi\u015fikliklere&nbsp;(Squamous Intraepithelial Lesion) (SIL) neden olmaktad\u0131r(35,36,41,43,49,51,54). <\/mark><\/strong><\/p>\n\n\n\n<p><strong><mark style=\"background-color:#ffe30a\" class=\"has-inline-color\">1-<\/mark><\/strong> Bu h\u00fccresel de\u011fi\u015fiklikler ancak pap smear testi ile g\u00f6r\u00fclebilmektedir. <\/p>\n\n\n\n<p><strong><mark style=\"background-color:#dcfb04\" class=\"has-inline-color\">2- <\/mark><\/strong>HPV DNA testinde HPV enfeksiyonu tespit edilenlerin (pozitif) bir k\u0131sm\u0131nda ise erken te\u015fhis nedeniyle pap smear testinde hen\u00fcz h\u00fccreye zarar verecek kadar s\u00fcre ge\u00e7medi\u011fi i\u00e7in h\u00fccresel de\u011fi\u015fiklik (SIL) g\u00f6r\u00fclmemektedir(12,13,14,15,16,17,18,19,20,22,24,34,40,82,102,132).<\/p>\n\n\n\n<p><strong><mark style=\"background-color:#fdd804\" class=\"has-inline-color\"> 3- <\/mark><\/strong>HPV DNA testi ve Pap smear testi birlikte yap\u0131ld\u0131\u011f\u0131nda bir ki\u015fide HPV enfeksiyonu oldu\u011fu halde bu testlerin yanl\u0131\u015fl\u0131kla yok deme ihtimali de, bir ki\u015fide HPV enfeksiyonu olmad\u0131\u011f\u0131 halde yanl\u0131\u015fl\u0131kla var deme ihtimali de olduk\u00e7a d\u00fc\u015f\u00fckt\u00fcr(53,55,57,59,63,80,81,86,90,93,99,101,103,104).<\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-full is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"225\" src=\"https:\/\/polikistikover.net\/yeni\/wp-content\/uploads\/2025\/09\/hpv.jpg\" alt=\"\" class=\"wp-image-6399\" style=\"width:387px;height:auto\"\/><\/figure>\n<\/div>\n\n\n<p class=\"has-text-align-center\"><em>Mikroskop incelemesinde Human Papilloma Vir\u00fcs\u00fc (HPV) nin rahim a\u011fz\u0131 h\u00fccrelerinde yapt\u0131\u011f\u0131 de\u011fi\u015fiklikler g\u00f6r\u00fclmektedir.<\/em><\/p>\n\n\n\n<p class=\"has-text-align-center\"><strong><mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-dark-pink-color\">Rahim a\u011fz\u0131nda g\u00f6r\u00fclen HPV enfeksiyonlar\u0131n\u0131n b\u00fcy\u00fck \u00e7o\u011funlu\u011fu (%90) normal ba\u011f\u0131\u015f\u0131kl\u0131\u011fa sahip olan ki\u015filerde yakla\u015f\u0131k 1 y\u0131l i\u00e7inde, daha k\u00fc\u00e7\u00fck bir k\u0131sm\u0131nda da 2 y\u0131l i\u00e7inde kendili\u011finden v\u00fccuttan temizlenmektedir (clearance)(23,24,25,26,27,30,33,37,39,42,43,47,56,60,64,69,76,79,84,98). <\/mark><\/strong><\/p>\n\n\n\n<p class=\"has-text-align-center\"><strong><mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-dark-pink-color\">Rahim a\u011fz\u0131nda yapt\u0131klar\u0131 h\u00fccresel de\u011fi\u015fikliklerin (SIL) b\u00fcy\u00fck bir k\u0131sm\u0131 da (%90) 2 y\u0131la kadar iyile\u015fmektedir(23,24,25,26,27,30,36,38,50,52,56,60,61,67,68,69). <\/mark><\/strong><\/p>\n\n\n\n<p class=\"has-text-align-center\"><strong><mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-dark-pink-color\">V\u00fccuttan temizlenmeyenlerin (persistence) b\u00fcy\u00fck \u00e7o\u011funlu\u011funu rahim a\u011fz\u0131 kanserine neden olan HPV \u00e7e\u015fitleri olu\u015fturmaktad\u0131r(25,27,37,38,84).<\/mark><\/strong> <\/p>\n\n\n\n<p class=\"has-text-align-center\"><strong>Rahim a\u011fz\u0131nda ortaya \u00e7\u0131kan ileri derecede h\u00fccresel de\u011fi\u015fikliklere (Cervical Intraepithelial Neoplasia) (CIN+2) genellikle 3 y\u0131l i\u00e7inde v\u00fccuttan temizlenmeyen HPV \u00e7e\u015fitleri neden olmaktadir(36,37,38,39,50,52,69,72,75,76,79,98). <\/strong><\/p>\n\n\n\n<p><strong><mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-dark-pink-color\">Rahim a\u011fz\u0131 kanserlerinin b\u00fcy\u00fck bir k\u0131sm\u0131na 2 y\u0131l i\u00e7inde v\u00fccuttan temizlenmeyen HPV-16 ve HPV-18 \u00e7e\u015fitleri neden olmaktad\u0131r(27,30,60,98). <\/mark><\/strong><\/p>\n\n\n\n<p>Demek ki burada do\u011fru olan 100 ki\u015fiden 90\u2019\u0131na&nbsp;kendili\u011finden iyile\u015fece\u011fini bile bile gereksiz yere ciddi yan etkileri olabilen bir a\u015f\u0131n\u0131n yap\u0131lmas\u0131 de\u011fil, rahim a\u011fz\u0131 kanseri riski ta\u015f\u0131yan ki\u015finin tespit edilerek onun HPV DNA testi ve pap smear testi ile takibinin ve tedavisinin yap\u0131lmas\u0131d\u0131r(75,80,81,83,93,97,99).&nbsp;Rahim a\u011fz\u0131 kanseri ve ona ba\u011fl\u0131 geli\u015fen \u00f6l\u00fcmler \u00e7o\u011funlukla Pap smear testi ve HPV DNA testi yapt\u0131rmayanlarda g\u00f6r\u00fclmektedir(77,83,87,94,121).<\/p>\n\n\n\n<p><strong><mark style=\"background-color:#f90707\" class=\"has-inline-color\">1-<\/mark>Cinsel olarak aktif hayata ba\u015flad\u0131ktan sonra belirli aral\u0131klarla yapt\u0131r\u0131lan HPV DNA testi ve Pap smear testi ile HPV\u2019nin neden oldu\u011fu ileride rahim a\u011fz\u0131 kanserine d\u00f6n\u00fc\u015febilecek h\u00fccresel de\u011fi\u015fiklikler erken d\u00f6nemde ki\u015fi rahim a\u011fz\u0131 kanseri olmadan te\u015fhi\u015f ve tedavi edilebilmektedir.<\/strong><\/p>\n\n\n\n<p><strong><mark style=\"background-color:#fa0505\" class=\"has-inline-color\">2-<\/mark>Belirli aral\u0131klarla HPV DNA testi ve Pap smear testi yapt\u0131ran bir ki\u015finin rahim a\u011fz\u0131 kanseri olma ihtimali, rahim a\u011fz\u0131 kanseri a\u015f\u0131s\u0131 yapt\u0131ran&nbsp;bir ki\u015fiden daha d\u00fc\u015f\u00fckt\u00fcr.<\/strong><\/p>\n\n\n\n<p><strong><mark style=\"background-color:#fa0505\" class=\"has-inline-color\">3-<\/mark>Herhangi bir yan etkisi olmayan HPV DNA testi ve Pap smear testi ile takibi yap\u0131lan bir ki\u015finin kal\u0131c\u0131 hasar ve \u00f6l\u00fcme neden olabilen yan etkilere sahip hpv a\u015f\u0131s\u0131n\u0131 yapt\u0131rmas\u0131 \u015fart de\u011fildir.<\/strong><\/p>\n\n\n\n<p class=\"has-text-align-center\">Polikistik over sendromu olan kad\u0131nlar\u0131n yakla\u015f\u0131k yar\u0131s\u0131nda \u00e7e\u015fitli derecelerde&nbsp;ins\u00fclin direnci&nbsp;g\u00f6r\u00fclmektedir. <strong><mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-dark-pink-color\">Polikistik Over Sendromu\u2019 nda&nbsp;ins\u00fclin direnci veya \u015feker hastal\u0131\u011f\u0131&nbsp;olan kad\u0131nlarda&nbsp;genital b\u00f6lgede (Vajina, Vulva) &nbsp;tekrarlayan&nbsp;mantar enfeksiyonlar\u0131&nbsp;daha s\u0131k g\u00f6r\u00fclmektedir.<\/mark><\/strong><\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-full is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"225\" src=\"https:\/\/polikistikover.net\/yeni\/wp-content\/uploads\/2025\/09\/mantar.jpg\" alt=\"\" class=\"wp-image-6402\" style=\"width:389px;height:auto\"\/><\/figure>\n<\/div>\n\n\n<p class=\"has-text-align-center\"><em>Mikroskop incelemesinde vajinal ak\u0131nt\u0131da candida (mantar) hif ve sporlar\u0131 g\u00f6r\u00fclmektedir.<\/em><\/p>\n\n\n\n<p><strong><mark style=\"background-color:#f85805\" class=\"has-inline-color\">1-<\/mark><\/strong>Mantar enfeksiyonu genellikle&nbsp;bozulmu\u015f s\u00fct k\u0131vam\u0131nda&nbsp;beyaz renkli ak\u0131nt\u0131, k\u0131zar\u0131kl\u0131k, \u015fi\u015flik,&nbsp;ka\u015f\u0131nt\u0131 ve yanma hissi \u015fikayetlerine&nbsp;neden olmaktad\u0131r. Bu&nbsp;\u015fikayetlerin hepsi&nbsp;bir ki\u015fide ortaya \u00e7\u0131kabilmekte ya da \u015fikayetlerden sadece bir tanesi &nbsp;g\u00f6r\u00fclmektedir.<\/p>\n\n\n\n<p><strong><mark style=\"background-color:#fb5308\" class=\"has-inline-color\">2-<\/mark><\/strong>Mantar enfeksiyonu da&nbsp;smear testi&nbsp;ile tespit edilir. Bu enfeksiyona en s\u0131k&nbsp;<strong>Kandida albicans (candida albicans)<\/strong>&nbsp;adl\u0131 mantar \u00e7e\u015fidi neden olmaktad\u0131r.&nbsp;Smear testi&nbsp;\u2018nde muayene s\u0131ras\u0131nda rahim a\u011fz\u0131ndan \u00e7ubuk \u015feklinde, ince bir f\u0131r\u00e7a yard\u0131m\u0131yla ak\u0131nt\u0131 al\u0131n\u0131r. Bu ak\u0131nt\u0131 cama s\u00fcr\u00fclerek mikroskop alt\u0131nda incelenir. Mikroskop incelemesinde (Patoloji) enfeksiyona neden olan mantar&nbsp;tespit edilir.<\/p>\n\n\n\n<p><strong><mark style=\"background-color:#f66f04\" class=\"has-inline-color\">3-<\/mark><\/strong>Hastalar\u0131n bir k\u0131sm\u0131nda&nbsp;ak\u0131nt\u0131, k\u0131zar\u0131kl\u0131k, \u015fi\u015flik,&nbsp;ka\u015f\u0131nt\u0131 ve yanma hissi \u015fikayetleri s\u0131k s\u0131k tekrarlamaktad\u0131r. Bu duruma genellikle diren\u00e7li bir mantar \u00e7e\u015fidi olan<strong>&nbsp;Kandida glabrata (Candida glabrata)&nbsp;<\/strong>neden olmaktad\u0131r. Mantar \u00e7e\u015fidinin te\u015fhisi&nbsp;vajen k\u00fclt\u00fcr\u00fc testi&nbsp;ile yap\u0131l\u0131r.&nbsp;Vajen ve rahim a\u011fz\u0131 (serviks) k\u00fclt\u00fcr\u00fc&nbsp;testinde rahim a\u011fz\u0131 ve vajina b\u00f6lgesinden&nbsp;\u00e7ubuk \u015feklinde, ince bir f\u0131r\u00e7a yard\u0131m\u0131yla ak\u0131nt\u0131 al\u0131narak bir besiyeri \u015fi\u015fesine konulur. Mikrobiyoloji laboratuvar\u0131nda besiyerinde \u00fcreyen mantar\u0131n \u00f6zelliklerine bak\u0131larak Kandida glabrata (Candida glabrata)&nbsp;olup olmad\u0131\u011f\u0131 tespit edilir.<\/p>\n\n\n\n<p><strong><mark style=\"background-color:#ff7405\" class=\"has-inline-color\">4-<\/mark><\/strong>Polikistik over sendromu olan kad\u0131nlarda diren\u00e7li, tekrarlayan mantar enfeksiyonu tedavisinin temel amac\u0131 \u00f6ncelikle altta yatan&nbsp;ins\u00fclin direncinin&nbsp;d\u00fczeltilmesidir.<\/p>\n\n\n\n<p class=\"has-text-align-center\"><strong><mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-dark-pink-color\">\u0130ns\u00fclin direncinin tedavi edilmesine ba\u011fl\u0131 olarak mantar enfeksiyonuna zemin haz\u0131rlayan ortam ortadan kalkmaktad\u0131r.&nbsp;K\u00f6t\u00fc hijyenik&nbsp;ortam&nbsp;ve \u0131slakl\u0131k (nem) mantar \u00fcremesini artt\u0131rmaktad\u0131r. K\u00f6t\u00fc hijyenik \u015fartlar d\u00fczeltildikten (g\u00fcnl\u00fck ped kullan\u0131m\u0131n\u0131n b\u0131rak\u0131lmas\u0131 gibi) ve kuru ortam sa\u011fland\u0131ktan sonra ins\u00fclin direnci tedavisi&nbsp;ve&nbsp;antibiyotik tedavisi birlikte uyguland\u0131\u011f\u0131nda mantar enfeksiyonu tedavi edilebilmektedir.<\/mark><\/strong><\/p>\n\n\n\n<p class=\"has-text-align-center\"><strong>Kaynaklar<\/strong><\/p>\n\n\n\n<p>1-Who Profits From Uncritical Acceptance of Biased Estimates of Vaccine Efficacy and Safety?&nbsp;Tomljenovic,&nbsp;Shaw CA. Am J Public Health. 2012 September; 102(9): e13\u2013e14.<\/p>\n\n\n\n<p>2-Lessons learnt in Japan from adverse reactions to the hpv vaccine: a medical ethics perspective. Beppu H, Minguchi M, Uchide K, Kumamoto K, Sekiguchi M, Yaju Y.&nbsp;Indian Journal of Medical Ethics. Vol II No 2 April-June 2017.<\/p>\n\n\n\n<p>3-Demyelinating disease and polyvalent human papilloma virus vaccination. Chang &nbsp;J, Campagnolo &nbsp;D, Vollmer &nbsp;TL, Bomprezzi &nbsp;R. J Neurol Neurosurg Psychiatry. 2011;82(11):1296-1298.<\/p>\n\n\n\n<p>4-Acute disseminated encephalomyelitis following vaccination against human papilloma virus.&nbsp;Wildemann &nbsp;B, Jarius S, Hartmann &nbsp;M, Regula &nbsp;JU, Hametner &nbsp;C. Neurology. 2009;72(24):2132-2133.<\/p>\n\n\n\n<p>5-Neuromyelitis optica following human papillomavirus vaccination. Menge T, Cree &nbsp;B, Saleh &nbsp;A, &nbsp;et al.Neurology. 2012;79(3):285-287.<\/p>\n\n\n\n<p>6-CNS demyelination and quadrivalent HPV vaccination. Sutton &nbsp;I, Lahoria &nbsp;R, Tan &nbsp;I, Clouston &nbsp;P, Barnett &nbsp;M.&nbsp;Mult Scler. 2009;15(1):116-119.<\/p>\n\n\n\n<p>7-The spectrum of postvaccination&nbsp;inflammatory&nbsp;CNS&nbsp;demyelinating&nbsp;syndromes. Karussis D, Petrou P. Autoimmun Rev. 2014 Mar;13(3):215-24.<\/p>\n\n\n\n<p>8-Vaccination and autoimmune diseases: is prevention of adverse health effects on the horizon? Maria Vadal\u00e0,&nbsp;Dimitri Poddighe,&nbsp;Carmen Laurino,&nbsp;Beniamino Palmieri. EPMA J.&nbsp;2017 Jul 20;8(3):295-311.<\/p>\n\n\n\n<p>9-Simultaneous Bilateral Optic Neuritis Following Human Papillomavirus Vaccination in a Young Child.&nbsp;Ngu Dau Bing Michael,&nbsp;Tengku Norina Tuan Jaffar,&nbsp;Adil Hussein,&nbsp;Wan-Hazabbah Wan Hitam. Cureus.&nbsp;2018 Sep 24;10(9):e3352.<\/p>\n\n\n\n<p>10-Quadrivalent human papillomavirus vaccine and autoimmune adverse events: a case-control assessment of the vaccine adverse event reporting system (VAERS) database.&nbsp;David A Geier,&nbsp;Mark R Geier. Immunol Res. 2017 Feb;65(1):46-54.<\/p>\n\n\n\n<p>11-HPV Genotype Prevalence and Success of Vaccination to Prevent Cervical Cancer. Katia Ramos Moreira Leite,&nbsp;Ruan Pimenta,&nbsp;Juliana Canavez,&nbsp;Flavio Canavez,&nbsp;Fernando R de Souza,&nbsp;Ligia Vara,&nbsp;Carmen Estivallet, Luiz Heraldo Camara-Lopes.&nbsp;Acta Cytol.&nbsp;2020;64(5):420-424.<\/p>\n\n\n\n<p>12-Human papillomavirus prevalence in women attending routine cervical screening in South Wales, UK: a cross-sectional study.&nbsp;S Hibbitts,&nbsp;J Jones,&nbsp;N Powell,&nbsp;N Dallimore,&nbsp;J McRea,&nbsp;H Beer,&nbsp;A Tristram,&nbsp;H Fielder,&nbsp;A N Fiander. Br J Cancer.&nbsp;2008 Dec 2;99(11):1929-33.&nbsp;<\/p>\n\n\n\n<p>13-Prevalence of high-risk human papillomavirus (HR-HPV) types 16 and 18 in healthy women with cytologically negative Pap smear. Raksha Arora,&nbsp;Arunaz Kumar,&nbsp;Bhupesh K Prusty,&nbsp;Uma Kailash,&nbsp;Swaraj Batra,&nbsp;Bhudev C Das. Eur J Obstet Gynecol Reprod Biol.&nbsp;2005 Jul 1;121(1):104.<\/p>\n\n\n\n<p>14-HPV prevalence among Mexican women with neoplastic and normal cervixes.M Torroella-Kouri,&nbsp;S Morsberger,&nbsp;A Carrillo,&nbsp;A Mohar,&nbsp;A Meneses,&nbsp;M Ibarra,&nbsp;R W Daniel,&nbsp;A M Ghaffari,&nbsp;G Solorza,&nbsp;K V Shah. Gynecol Oncol.&nbsp;1998 Jul;70(1):115-20.<\/p>\n\n\n\n<p>15-Genotype distribution and prevalence of human papillomavirus among women with cervical cytological abnormalities in Xinjiang, China. Wang J,&nbsp;Tang D, Wang J, Zhang Z, Chen Y, Wang K, Zhang X, Ma C. Hum Vaccin Immunother. 2019;15(7-8):1889-1896<\/p>\n\n\n\n<p>16-Prevalence of HPV genotypes determined by PCR and DNA sequencing in cervical specimens from French women with or without abnormalities. C Pannier-Stockman,&nbsp;C Segard,&nbsp;S Bennamar,&nbsp;J Gondry,&nbsp;J-C Boulanger,&nbsp;H Sevestre,&nbsp;S Castelain,&nbsp;G Duverlie. J Clin Virol. 2008 Aug;42(4):353-60.<\/p>\n\n\n\n<p>17-Prevalence of Human Papillomavirus Genotypes and Abnormal Pap Smears Among Women in the Military Health System.&nbsp;Christopher M Daly,&nbsp;Shana L Hansen,&nbsp;Paul O Kwon,&nbsp;Timothy A Roberts.&nbsp;J Community Health.&nbsp;2018 Jun;43(3):441-447.<\/p>\n\n\n\n<p>18-Human papillomavirus genotypes distribution by cervical cytologic status among women attending the General Hospital of Loandjili, Pointe-Noire, Southwest Congo (Brazzaville).&nbsp;Luc Magloire Anicet Boumba,&nbsp;Zineb Qmichou,&nbsp;Mustapha Mouallif,&nbsp;Mohammed Attaleb,&nbsp;Mohammed El Mzibri,&nbsp;Lahoucine Hilali,&nbsp;Moukassa Donatien,&nbsp;Moulay Mustapha Ennaji&nbsp;Affiliati. J Med Virol.&nbsp;2015 Oct;87(10):1769-76.<\/p>\n\n\n\n<p>19-The relationship of human papillomavirus (HPV) detection to pap smear classification of cervical-scraped cells in asymptomatic women in northeast Thailand.&nbsp;Ekalaksananan T, Pientong C, Kotimanusvanij D, Kongyingyoes B, Sriamporn S, Jintakanon D.J Obstet Gynaecol Res. 2001 Jun;27(3):117-24.<\/p>\n\n\n\n<p>20-Frequency of human papillomavirus infection and genotype distribution among women with known cytological diagnosis in a Southern Italian region.&nbsp;Chironna M, Neve A, Sallustio A, De Robertis A, Quarto M, Germinario C, Lepera A, Cicinelli E, Carriero C, Pinto V, Miniello G, Borraccino V, Blasi N, Romano F, Noya E; HPV Study Group.&nbsp;J Prev Med Hyg. 2010 Dec;51(4):139-45.<\/p>\n\n\n\n<p>21-Primary HPV testing versus cytology-based cervical screening in women in Australia vaccinated for HPV and unvaccinated: effectiveness and economic assessment for the National Cervical Screening Program.&nbsp;Lew JB,&nbsp;Simms KT,&nbsp;Smith MA, Hall M, Kang YJ, Xu XM, Caruana M, Velentzis LS, Bessell T, Saville M, Hammond I, Canfell K.&nbsp;Lancet Public Health. 2017 Feb;2(2):e96-e107.<\/p>\n\n\n\n<p>22-The prevalence and genotype distribution of human papillomaviruses among women in Taizhou, China.&nbsp;Rongrong Jin,&nbsp;Hua Qian,&nbsp;Yongsheng Zhang,&nbsp;Donglan Yuan,&nbsp;Jingjing Bao,&nbsp;Huilin Zhou,&nbsp;Min Chen,&nbsp;Junxing Huang,&nbsp;Hong Yu. Medicine.&nbsp;2019 Sep;98(39):e17293.<\/p>\n\n\n\n<p>23-Management of adolescents who have abnormal cytology and histology.&nbsp;Moscicki AB.&nbsp;Obstet Gynecol Clin North Am. 2008 Dec;35(4):633-43; x.&nbsp;<\/p>\n\n\n\n<p>24-Persistence of type-specific human papillomavirus infection among Daqing City women in China with normal cytology: a pilot prospective study.&nbsp;Ni Li,&nbsp;Dong Hang,&nbsp;Lin Yang&nbsp;,&nbsp;Xiaoshuang Feng, et al. Oncotarget.&nbsp;2017 Aug 11;8(46):81455-81461.<\/p>\n\n\n\n<p>25-Minor Cytological Abnormalities and up to 7-Year Risk for Subsequent High-Grade Lesions by HPV Type.&nbsp;Maria Persson,&nbsp;K Miriam Elfstr\u00f6m,&nbsp;Sven-Erik Olsson,&nbsp;Joakim Dillner,&nbsp;Sonia Andersson. PloS One.&nbsp;2015 Jun 17;10(6):e0127444.<\/p>\n\n\n\n<p>26-Adolescent&nbsp;cervical&nbsp;dysplasia: histologic evaluation, treatment, and outcomes.&nbsp;Moore K, Cofer A, Elliot L, Lanneau G, Walker J, Gold MA.&nbsp;Am J Obstet Gynecol. 2007 Aug;197(2):141.e1-6.&nbsp;<\/p>\n\n\n\n<p>27-Type-specific prevalence and persistence of human papillomavirus in women in the United States who are referred for typing as a component of cervical cancer screening.&nbsp;Ralston Howe E,&nbsp;Li Z, McGlennen RC, Hellerstedt WL, Downs LS Jr.&nbsp;Am J Obstet Gynecol. 2009 Mar;200(3):245.e1-7.<\/p>\n\n\n\n<p>28-Human papillomavirus genotypes distribution by cervical cytologic status among women attending the General Hospital of Loandjili, Pointe-Noire, Southwest Congo (Brazzaville).&nbsp;Boumba LM, Qmichou Z, Mouallif M, Attaleb M, El Mzibri M, Hilali L, Donatien M, Ennaji MM.&nbsp;J Med Virol. 2015 Oct;87(10):1769-76.&nbsp;<\/p>\n\n\n\n<p>29-Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries.&nbsp;Freddie Bray,&nbsp;Jacques Ferlay,&nbsp;Isabelle Soerjomataram,&nbsp;Rebecca L Siegel,&nbsp;Lindsey A Torre&nbsp;,&nbsp;Ahmedin Jemal. CA Cancer J Clin.&nbsp;2018 Nov;68(6):394-424.<\/p>\n\n\n\n<p>30-Determinants of clearance of human papillomavirus infections in Colombian women with normal cytology: a population-based, 5-year follow-up study.&nbsp;Molano M, Van den Brule A, Plummer M, Weiderpass E, Posso H, Arslan A, Meijer CJ, Mu\u00f1oz N, Franceschi S; HPV Study Group.&nbsp;Am J Epidemiol. 2003 Sep 1;158(5):486-94.<\/p>\n\n\n\n<p>31-HPV testing as a screen for cervical cancer.&nbsp;Goodman A.&nbsp;BMJ. 2015 Jun 30;350:h2372.<\/p>\n\n\n\n<p>32-American Cancer Society guideline for the early detection of cervical neoplasia and cancer.&nbsp;Saslow D, Runowicz CD, Solomon D, Moscicki AB, Smith RA, Eyre HJ, Cohen C; American Cancer Society.&nbsp;CA Cancer J Clin. 2002 Nov-Dec;52(6):342-62.<\/p>\n\n\n\n<p>33-Factors associated with type-specific persistence of high-risk human papillomavirus infection: A population-based study.&nbsp;Stensen S, Kjaer SK, Jensen SM, Frederiksen K, Junge J, Iftner T, Munk C.&nbsp;Int J Cancer. 2016 Jan 15;138(2):361-8.<\/p>\n\n\n\n<p>34-Incidence, duration, and determinants of cervical human papillomavirus infection in a cohort of Colombian women with normal cytological results.&nbsp;Mu\u00f1oz N, M\u00e9ndez F,&nbsp;Posso H, Molano M, van den Brule AJ, Ronderos M, Meijer C, Mu\u00f1oz A; Instituto Nacional de Cancerologia HPV Study Group.&nbsp;J Infect Dis. 2004 Dec 15;190(12):2077-87.&nbsp;<\/p>\n\n\n\n<p>35-A longitudinal study of genital human papillomavirus infection in a cohort of closely followed adolescent women.&nbsp;Brown DR, Shew ML, Qadadri B, Neptune N, Vargas M, Tu W, Juliar BE, Breen TE, Fortenberry JD.&nbsp;J Infect Dis. 2005 Jan 15;191(2):182-92.&nbsp;<\/p>\n\n\n\n<p>36-Development and duration of human papillomavirus lesions, after initial infection.&nbsp;Winer RL, Kiviat NB, Hughes JP, Adam DE, Lee SK, Kuypers JM, Koutsky LA.&nbsp;J Infect Dis. 2005 Mar 1;191(5):731-8.&nbsp;<\/p>\n\n\n\n<p>37-Type-specific duration of human papillomavirus infection: implications for human papillomavirus screening and vaccination.&nbsp;Trottier H, Mahmud S, Prado JC, Sobrinho JS, Costa MC, Rohan TE, Villa LL, Franco EL.&nbsp;J Infect Dis. 2008 May 15;197(10):1436-47.<\/p>\n\n\n\n<p>38-Rapid clearance of human papillomavirus and implications for clinical focus on persistent infections.&nbsp;Rodr\u00edguez AC,&nbsp;Schiffman M, Herrero R, Wacholder S, Hildesheim A, Castle PE, Solomon D, Burk R; Proyecto Epidemiol\u00f3gico Guanacaste Group.&nbsp;J Natl Cancer Inst. 2008 Apr 2;100(7):513-7.&nbsp;<\/p>\n\n\n\n<p>39-The natural history of human papillomavirus infection as measured by repeated DNA testing in adolescent and young women.&nbsp;Moscicki AB, Shiboski S, Broering J, Powell K, Clayton L, Jay N, Darragh TM, Brescia R, Kanowitz S, Miller SB, Stone J, Hanson E, Palefsky J.&nbsp;J Pediatr. 1998 Feb;132(2):277-84.<\/p>\n\n\n\n<p>40-Risks for incident human papillomavirus infection and low-grade squamous intraepithelial lesion development in young females.&nbsp;Moscicki AB, Hills N, Shiboski S, Powell K, Jay N, Hanson E, Miller S, Clayton L, Farhat S, Broering J, Darragh T, Palefsky J.&nbsp;JAMA. 2001 Jun 20;285(23):2995-3002.<\/p>\n\n\n\n<p>41-The&nbsp;2001&nbsp;Bethesda System: terminology for reporting results of cervical cytology.&nbsp;Solomon D, Davey D, Kurman R, Moriarty A, O\u2019Connor D, Prey M, Raab S, Sherman M, Wilbur D, Wright T Jr, Young N; Forum Group Members; 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DB.&nbsp;Ann Intern Med. 2000 May 16;132(10):810-9.<\/p>\n\n\n\n<p>78-Quadrivalent HPV vaccination reactions\u2013more hype than harm.&nbsp;Douglas RJ.&nbsp;Aust Fam Physician. 2009 Mar;38(3):139-42.<\/p>\n\n\n\n<p>79-The natural history of human papillomavirus infection.&nbsp;de Sanjos\u00e9 S,&nbsp;Brotons M, Pav\u00f3n MA.&nbsp;Best Pract Res Clin Obstet Gynaecol. 2018 Feb;47:2-13.<\/p>\n\n\n\n<p>80-Long term predictive values of cytology and human papillomavirus testing in cervical cancer screening: joint European cohort study.&nbsp;Dillner J, Rebolj M, Birembaut P, Petry KU, Szarewski A, Munk C, de Sanjose S, Naucler P, Lloveras B, Kjaer S, Cuzick J, van Ballegooijen M, Clavel C, Iftner T; Joint European Cohort Study.&nbsp;BMJ. 2008 Oct 13;337:a1754.<\/p>\n\n\n\n<p>81-Long term duration of protective effect for HPV negative women: follow-up of primary HPV screening randomised controlled trial.&nbsp;Elfstr\u00f6m KM,Smelov V<strong>,<\/strong>&nbsp;Johansson AL, Eklund C, 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Colposcopy and&nbsp;Cervical&nbsp;Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of&nbsp;cervical&nbsp;cancer.&nbsp;Saslow D,&nbsp;Solomon D, Lawson HW, Killackey M, Kulasingam SL, Cain J, Garcia FA, Moriarty AT, Waxman AG, Wilbur DC, Wentzensen N, Downs LS Jr, Spitzer M, Moscicki AB, Franco EL, Stoler MH, Schiffman M, Castle PE, Myers ER; ACS-ASCCP-ASCP Cervical Cancer Guideline Committee.&nbsp;CA Cancer J Clin. 2012 May-Jun;62(3):147-72.<\/p>\n\n\n\n<p>111-Ten-year immune persistence and safety of the HPV-16\/18 AS04-adjuvanted vaccine in females vaccinated at 15-55&nbsp;years of age.&nbsp;Schwarz TF,&nbsp;Galaj A, Spaczynski M, Wysocki J, Kaufmann AM, Poncelet S, Suryakiran PV, Folschweiller N, Thomas F, Lin L, Struyf F.&nbsp;Cancer Med. 2017 Nov;6(11):2723-2731.&nbsp;<\/p>\n\n\n\n<p>112-Adapting cervical cancer screening for women vaccinated against human papillomavirus infections: The value of stratifying 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H, Toyoshima H, Wakai K, Ito Y, Hashimoto S, Kikuchi S, Koizumi A, Kawamura T, Watanabe Y, Miki T, Date C, Sakata K, Nose T, Hayakawa N, Yoshimura T, Shibata A, Okamoto N, Shino H, Ohno Y, Kitagawa T, Kuroki T, Tajima K.&nbsp;Jpn J Clin Oncol. 2006 Aug;36(8):511-8.<\/p>\n\n\n\n<p>116-Cervical Cancer Screening Programs in Europe: The Transition Towards HPV Vaccination and Population-Based HPV Testing.&nbsp;Chrysostomou AC, Stylianou DC, Constantinidou A, Kostrikis LG.&nbsp;Viruses. 2018 Dec 19;10(12):729.<\/p>\n\n\n\n<p>117-Evaluation on the persistence of anti-HPV&nbsp;immune responses to the quadrivalent&nbsp;HPV&nbsp;vaccine in Chinese females and males: Up to 3.5 years of follow-up.&nbsp;Huang T, Liu Y, Li Y, Liao Y, Shou Q, Zheng M, Liao X, Li R.&nbsp;Vaccine. 2018 Mar 7;36(11):1368-1374.&nbsp;<\/p>\n\n\n\n<p>118-Detection of High-Risk Human Papillomavirus in Cervix Sample in an 11.3-year Follow-Up after Vaccination against HPV 16\/18.&nbsp;Teixeira CSC, Teixeira JC, Oliveira ERZM, Machado HC,&nbsp;Zeferino LC.&nbsp;Rev Bras Ginecol Obstet. 2017 Aug;39(8):408-414.&nbsp;<\/p>\n\n\n\n<p>119-Long-term immunogenicity, effectiveness, and safety of nine-valent human papillomavirus vaccine in girls and boys 9 to 15 years of age: Interim analysis after 8 years of follow-up.&nbsp;Olsson SE, Restrepo JA, Reina JC, Pitisuttithum P, Ulied A, Varman M, Van Damme P, Moreira ED Jr, Ferris D, Block S, Bautista O, Gallagher N, McCauley J, Luxembourg A.&nbsp;Papillomavirus Res. 2020 Jul 11;10:100203.<\/p>\n\n\n\n<p>120-Impact of scaled up human papillomavirus vaccination and cervical screening and the potential for global elimination of cervical cancer in 181 countries,&nbsp;<strong>2020<\/strong>-99: a modelling study.&nbsp;Simms KT, Steinberg J, Caruana M, Smith MA, Lew JB, Soerjomataram I, Castle PE, Bray F, Canfell K.&nbsp;Lancet Oncol. 2019 Mar;20(3):394-407.<\/p>\n\n\n\n<p>121-Estimates of incidence and mortality of cervical cancer in 2018: a worldwide analysis.&nbsp;Arbyn 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International biological study on cervical cancer (IBSCC) Study Group.&nbsp;Bosch FX, Manos MM, Mu\u00f1oz N, Sherman M, Jansen AM, Peto J, Schiffman MH, Moreno V, Kurman R, Shah KV.&nbsp;J Natl Cancer Inst. 1995 Jun 7;87(11):796-802.<\/p>\n\n\n\n<p>129-Human papillomavirus is a necessary cause of invasive cervical cancer worldwide.&nbsp;Walboomers JM,&nbsp;Jacobs MV, Manos MM, Bosch FX, Kummer JA, Shah KV, Snijders PJ, Peto J, Meijer CJ, Mu\u00f1oz N.&nbsp;J Pathol. 1999 Sep;189(1):12-9.&nbsp;<\/p>\n\n\n\n<p>130-HPV-negative carcinoma of the uterine cervix: a distinct type of cervical cancer with poor prognosis.&nbsp;Rodr\u00edguez-Carunchio L,&nbsp;Soveral I, Steenbergen RD, Torn\u00e9 A, Martinez S, Fust\u00e9 P, Pahisa J, Marimon L, Ordi J, del Pino M.BJOG. 2015 Jan;122(1):119-27.<\/p>\n\n\n\n<p>131-Reframing cervical cancer prevention. Expanding the field towards prevention of human papillomavirus infections and related diseases.&nbsp;Bosch FX,&nbsp;Tsu V, Vorsters A, Van Damme P, Kane MA.&nbsp;Vaccine. 2012 Nov 20;30 Suppl 5:F1-11.&nbsp;<\/p>\n\n\n\n<p>132-Variations in the age-specific curves of human papillomavirus prevalence in women worldwide.&nbsp;Franceschi S,&nbsp;Herrero R, Clifford GM, Snijders PJ, Arslan A, Anh PT, Bosch FX, Ferreccio C, Hieu NT, Lazcano-Ponce E, Matos E, Molano M, Qiao YL, Rajkumar R, Ronco G, de Sanjos\u00e9 S, Shin HR, Sukvirach S, Thomas JO, Meijer CJ, Mu\u00f1oz N.&nbsp;Int J Cancer. 2006 Dec 1;119(11):2677-84.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Human Papilloma Vir\u00fcs\u00fc (HPV) rahim a\u011fz\u0131 kanserine (cervical cancer) neden olmaktad\u0131r(97,129). Son y\u0131llarda HPV\u2019ye kar\u015f\u0131 korunmak amac\u0131yla baz\u0131 a\u015f\u0131lar \u00fcretilmi\u015ftir(92,95,124). HPV a\u015f\u0131lar\u0131 baz\u0131 \u00fclkelerde yayg\u0131n olarak \u00f6nerilmekte olmas\u0131na ra\u011fmen rahim a\u011fz\u0131 kanserinin \u00f6nlenmesi amac\u0131yla kullan\u0131labilecek tek y\u00f6ntem a\u015f\u0131 de\u011fildir(45,104). HPV a\u015f\u0131s\u0131 yap\u0131lan bir kad\u0131n\u0131n rahim a\u011fz\u0131 kanseri olma ihtimali, belirli aral\u0131klarla rahim a\u011fz\u0131ndan ak\u0131nt\u0131 \u00f6rne\u011fi [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-6388","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/polikistikover.net\/yeni\/wp-json\/wp\/v2\/pages\/6388","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/polikistikover.net\/yeni\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/polikistikover.net\/yeni\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/polikistikover.net\/yeni\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/polikistikover.net\/yeni\/wp-json\/wp\/v2\/comments?post=6388"}],"version-history":[{"count":28,"href":"https:\/\/polikistikover.net\/yeni\/wp-json\/wp\/v2\/pages\/6388\/revisions"}],"predecessor-version":[{"id":13241,"href":"https:\/\/polikistikover.net\/yeni\/wp-json\/wp\/v2\/pages\/6388\/revisions\/13241"}],"wp:attachment":[{"href":"https:\/\/polikistikover.net\/yeni\/wp-json\/wp\/v2\/media?parent=6388"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}