Anal High-Grade Squamous Intraepithelial Lesions in Human Immunodeficiency Virus–Infected Men

Abstract

Our findings should improve the ARC detection rate for anal HSILs, helping to implement ARC as the primary screening tool for anal cancer.

Anal cytological lesions and HPV infection in individuals at increased risk for anal cancer

“…For instance, genotype‐restricted tests that identify HPV‐16 and/or HPV‐18 DNA (or RNA) might be useful for selecting individuals with an ASCUS or LSIL report at higher risk for an underlying HGAIN. Indeed, a recent study has provided further confirmation that grade 2 or higher anal intraepithelial neoplasia/HGAIN may be diagnosed in patients with a report of an LSIL or less.…”

“…The Linear Array HPV genotyping test (Roche Diagnostics) was used to assess the presence of HPV DNA, as previously described. 21,22 This assay allows the detection of 37 HPV genotypes (ie, 6,11,16,18,26,31,33,35,39,40,42,45,51,52,53,54,55,56,58,59,61,62,64,66,67,68,69,70,71,72,73,81,82,83,84, IS39 [HPV-82 subtype], and CP6108 [HPV-89]).…”

Prevalence of high‐risk human papillomavirus DNA and mRNA and its association with abnormal anal cytology in the Czech male anal cancer screening cohort

“…However, overestimation of the quality of anal cytology smears might confound assessment of the screening result and such false negative smears could contribute to the overall lower sensitivity of cytology for detection of HGAIN might occur from such false-negative smears as revealed by Liu et al 21 These authors mainly emphasized the importance of high cellularity and representation of the transformation zone in in the anal smears to score true positive HSIL cytology samples and correlate with histology. 21 This phenomenon might also explain the relatively low sensitivity of anal cytology for AIN2+ observed by Schofield et al; in their study one-third of histological AIN2+ findings were associated with negative cytology while only 1% of samples were considered unsatisfactory. 17 Khattab et al pointed out that more than 5% of patients with unsatisfactory results are diagnosed with HSIL within 2 years and they recommended repeat cytology and/or HR-HPV testing for those patients.…”

Unsatisfactory exfoliative anal cytology samples, 15‐year experience with histologic, cytologic, and molecular follow‐up

“…18 In light of this, exfoliative anal cytology testing and molecular testing for HPV DNA have become standard in many healthcare delivery systems. [19][20][21][22][23] Laboratory rates of unsatisfactory anal cytology interpretations are higher (historically 6 fold higher at Cleveland Clinic) than for unsatisfactory cervical cytology interpretations. Higher unsatisfactory anal cytology interpretation percentages may be attributed to less than ideal collection methods resulting in insufficient cellularity, predominance of anucleated squamous epithelial cells, and fecal contamination.…”