Anal intraepithelial neoplasia in a sexually transmitted diseases outpatient clinic: correlation with cytological screening

Jiménez, J.B. Repiso; Frieyro-Elicegui, M.; Padilla-España, L.; Palma-Carazo, F.; Torre, Javier de la; Rivas-Ruiz, Francisco

doi:10.1111/jdv.12109

Cited by 9 publications

(5 citation statements)

References 14 publications

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“…30 Instead, anal cytology has a high degree of correlation with histology only for the high-grade dysplasia (H-SIL), while there is a poor cytohistological agreement for the low-grade lesions (ASC-US / L-SIL). 29 In our study in all three patients with H-SIL on Pap test who underwent anoscopy, we found a high-grade lesion (two cases of histologically confirmed AIN II-III/carcinoma in situ and one case of invasive carcinoma), but we also identified three cases of AIN II-III in patients with a cytological report of ASC-US, L-SIL and ASC-H, respectively.…”

Section: Discussionsupporting

confidence: 49%

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Liquid-based Anal Cytology as a Screening Tool for Prevention of Anal Cancer in at-risk Populations: A Single-Center Retrospective Analysis on 111 Patients

Pisano

Tiradritti

Lorenzoni

et al. 2021

Journal of Coloproctology

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Objective Squamous cell carcinoma of the anus (SCCA) is associated with human papillomavirus (HPV) infection in almost 90% of the cases. Its incidence is alarmingly high among men who have sex with men (MSM) and continues to increase at an average rate of 2% per year. The objective of the present study is to evaluate the usefulness and performance of liquid-based anal cytology as a screening tool for prevention and early detection of SCCA in a cohort of at-risk men. Method We conducted a retrospective study including 111 MSM, aged between 22 and 62 years old, who underwent anal cytological screening with a liquid-based Pap test at our sexually transmitted diseases (STDs) clinic from January 2015 to March 2017. Results Out of 111 anal smears, 57 (51,4%) resulted negative, 42 (37,8%) abnormal, and 12 (10,8%) unsatisfactory for the cytological evaluation. Only patients with an abnormal cytology underwent anoscopy and subsequent biopsy. The histological results were as follows: negative for squamous intraepithelial lesion (SIL) in 5 cases, low-grade SIL (L-SIL) in 21, high-grade SIL (H-SIL) in 5, SCCA in 1. Five patients had a normal anoscopy and biopsy was not taken. Conclusion Liquid-based cytology, reducing the “darkening factors” typical for the conventional smears, has a higher positive predictive value than the traditional technique. Moreover, a cytological diagnosis of atypical squamous cells of undetermined significance (ASC-US) or L-SIL may hide a severe dysplasia or even a carcinoma. Thus, all patients with an abnormal anal cytology at any grade should be considered for anoscopy.

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Section: Discussionsupporting

confidence: 49%

“…This suggests that all patients with an abnormal screening anal cytological result at any grade should be considered for anoscopy, preferably high-resolution anoscopy (HRA). [26][27][28][29]…”

Section: Discussionmentioning

confidence: 99%

Liquid-based Anal Cytology as a Screening Tool for Prevention of Anal Cancer in at-risk Populations: A Single-Center Retrospective Analysis on 111 Patients

Pisano

Tiradritti

Lorenzoni

et al. 2021

Journal of Coloproctology

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“…The predictive value of a negative cytology on the probability of AIN has been critically examined before . In a community‐based sample of MSM, the probability of AIN with negative cytology was 23% for HIV‐negative and 45% for HIV‐positive men .…”

Section: Discussionmentioning

confidence: 99%

Human papillomavirus status, anal cytology and histopathological outcome in HIV‐positive patients

Dietrich

Hermans

Heppt

et al. 2015

Acad Dermatol Venereol

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“…In a recent clinic-based study, 71% of the patients with AIN had an association with anogenital warts. 25…”

Section: Discussionmentioning

confidence: 99%

Anal cytology and p16 immunostaining for screening anal intraepithelial neoplasia in HIV-positive and HIV-negative men who have sex with men: a cross-sectional study

et al. 2014

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Summary Akin to cervical cancer in sexually-active women, men who have sex with men (MSM) are predisposed to anal cancers, especially those with HIV co-infection. This cross-sectional study endeavored to assess the prevalence of anal dysplasia using Pap smears and p16 immunostaining amongst Indian MSM. A total of 31 consecutive HIV-positive and 34 HIV-negative MSM, from a cohort of sexually transmitted infection clinic attendees, underwent anal cytological evaluation with Pap smear and p16 staining. Chi square test and coefficient of correlation were used for comparison. Eighteen (27.7%) had abnormal anal cytology; increased in HIV-positive as compared to HIV-negative men (35% versus 20%, p = 0.180). Similarly, both low-grade (25.8% versus 17.6%) and high-grade lesions (8.3% versus 4.8%) were comparable in HIV-positive and HIV-negative group. Thirteen (20%) smears were p16-positive with a sensitivity and specificity for anal dysplasia of 72.3% and 100%, respectively. Anal cytology may be used to screen for anal dysplasia in MSM irrespective of HIV status. Furthermore, the addition of p16, with greater specificity for high-grade lesions, may improve diagnostic accuracy especially for high-grade lesions. A larger study to further corroborate these observations is warranted.

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Anal intraepithelial neoplasia in a sexually transmitted diseases outpatient clinic: correlation with cytological screening

Abstract: Anal cytology in at-risk populations has a high degree of agreement with the biopsy when performed surgically, though less in low-grade dysplasias, which must always be studied. More studies evaluating the degree of progression of AIN to anal cancer are necessary.

Cited by 9 publications

References 14 publications

Liquid-based Anal Cytology as a Screening Tool for Prevention of Anal Cancer in at-risk Populations: A Single-Center Retrospective Analysis on 111 Patients

Liquid-based Anal Cytology as a Screening Tool for Prevention of Anal Cancer in at-risk Populations: A Single-Center Retrospective Analysis on 111 Patients

Human papillomavirus status, anal cytology and histopathological outcome in HIV‐positive patients

Anal cytology and p16 immunostaining for screening anal intraepithelial neoplasia in HIV-positive and HIV-negative men who have sex with men: a cross-sectional study

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