High‐resolution anoscopy in women with cervical neoplasia

Heráclio, Sandra de Andrade; Schettini, Juliana; Oliveira, Micheline L.; Souza, Alex Sandro Rolland; Souza, Paulo Roberto Eleutério de; Amorim, Melânia Maria Ramos

doi:10.1016/j.ijgo.2014.09.014

Cited by 8 publications

(9 citation statements)

References 22 publications

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“…68 Anal Pap smear and HRA have a wide-ranging sensitivity and specificity. 69,70 In one study of 300 HIV-positive men with positive anal Pap smears, only 54% demonstrated highgrade precursor lesions. 71 There is much debate regarding where this technique should be used and where it should fall in the colorectal surgeon's armamentarium.…”

Section: High-resolution Anoscopymentioning

confidence: 99%

Basic Science, Epidemiology, and Screening for Anal Intraepithelial Neoplasia and Its Relationship to Anal Squamous Cell Cancer

Davis

Orangio

2018

Clinics in Colon and Rectal Surgery

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Despite the progress made in the reduction of squamous cell carcinoma of the cervix, the incidence of anal squamous cell carcinoma (ASCC) has been increasing since 1992. While it remains an uncommon disease, the prevalence is climbing steadily. Among human immunodeficiency virus (HIV)-infected adults, especially men who have sex with men, ASCC is one of the more common non-AIDS-defining malignancies. The precursor lesion, anal intraepithelial neoplasia (AIN), is prevalent in the HIV-infected population. More than 90% of ASCCs are related to human papilloma virus (HPV), oncogenic types (HPV 16, 18). While the biology of HPV-related intraepithelial neoplasia is consistent in the anogenital area, the natural history of AIN is poorly understood and is not identical to cervical intraepithelial neoplasia (CIN). CIN is also considered an AIDS-defining malignancy, and the methods for screening and prevention of AIN are derived from the CIN literature. This article will discuss the epidemiology of ASCC and its association with HPV and the life cycle of the HPV, and the molecular changes that lead to clearance, productive infection, latency, and persistence. The immunology of HPV infection will discuss natural immunity, humoral and cellular immunity, and how the HPV virus evades and interferes with these mechanisms. We will also discuss high-risk factors for developing AIN in high-risk patient populations with relation to infections (HIV, HPV, and chlamydia infections), prolonged immunocompromised people, and sexual behavior and tobacco abuse. We will also discuss the pre- and post-HAART era and its effect on AINs and ASCC. Finally, we will discuss the importance of anal cytology and high-resolution anoscopy with and without biopsy in this high-risk population.

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Section: High-resolution Anoscopymentioning

confidence: 99%

Basic Science, Epidemiology, and Screening for Anal Intraepithelial Neoplasia and Its Relationship to Anal Squamous Cell Cancer

Davis

Orangio

2018

Clinics in Colon and Rectal Surgery

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“…Autores sugerem que a AAR pode ser um método superior à citologia para o rastreio do câncer anal 30 . Contudo, esse posicionamento ainda é controverso quando consideramos que a biópsia do canal anal, etapa constituinte do procedimento da anuscopia, apresenta algumas dificuldades, com relação tanto à execução quanto à interpretação dos achados histopatológicos 19 . Quando os exames da tríade clássica concordam entre si, há maior segurança diagnóstica.…”

Section: Discussionunclassified

“…As imagens colposcópicas foram analisadas após aplicação de ácido acético a 5% e solução de lugol a 2%. Na presença de áreas anormais sugestivas de NIA, foi efetuada biópsia, mesmo sem o resultado do exame citopatológico 19 .…”

Section: Métodosunclassified

“…As mulheres com achados na anuscopia de alta resolução (AAR) sugestivos de metaplasia com citologia anormal foram biopsiadas no retorno da consulta inicial. As biópsias foram realizadas no ambulatório com aplicação de anestésico local, utilizando-se pinça de Gaylor Medina 19 . As lesões que se sobrepunham aos plexos hemorroidários e situavam-se abaixo da linha pectínea foram retiradas no bloco cirúrgico para estudo histopatológico.…”

Section: Métodosunclassified

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Prevalência da lesão HPV induzida em canal anal de mulheres com neoplasia intraepitelial cervical 2 e 3: um estudo de corte transversal

Heráclio

araujo

Souza

et al. 2015

Rev. Bras. Ginecol. Obstet.

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“…9,10 Consequently, screening for precursor lesions has been encouraged in these groups. [11][12][13] Nevertheless, there is a need for further investigation into the profile of the women affected by this disease, since few studies have been conducted in this population.…”

Section: Introductionmentioning

confidence: 99%

Profile of women with anal neoplasia associated with cervical neoplasia receiving care at a tertiary healthcare facility in northeastern Brazil

Heráclio

Souza

Amorim

2019

Journal of Coloproctology

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Objective To describe the epidemiological, clinical and laboratory profiles of women with anal neoplasia associated with cervical neoplasia attending a tertiary healthcare facility in northeastern Brazil. Methods This epidemiological, descriptive study was conducted using a database from a cross-sectional study carried out between December 2008 and January 2016. Women with a diagnosis of cervical neoplasia associated with anal neoplasia were included in the present study. Results Of the women with cervical neoplasia, 14% were found to have an anal intraepithelial lesion or anal cancer. Median age was 33 years, 68% were non-white, and 70% were from urban regions, had little schooling and low income. Most reported having had anoreceptive (73%) and unprotected intercourse (84%). Regarding symptoms, 7% reported bleeding and 11% pruritus. Overall, 10% of the sample tested positive for the human immunodeficiency virus. Anal cytology was abnormal in 92%. High-resolution anoscopy was abnormal in all cases. Histopathology revealed three cases of invasive carcinoma and high-grade lesions in 32% of the cases. Conclusion Women with a diagnosis of anal and cervical neoplasia are often young, non-white women, who initiated their sexual life at an early age, were exposed to unprotected anoreceptive intercourse, live in urban centers, have little schooling and a low-income level.

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High‐resolution anoscopy in women with cervical neoplasia

Abstract: HRA findings can be systematized, reducing the subjectivity of interpretation.

Cited by 8 publications

References 22 publications

Basic Science, Epidemiology, and Screening for Anal Intraepithelial Neoplasia and Its Relationship to Anal Squamous Cell Cancer

Basic Science, Epidemiology, and Screening for Anal Intraepithelial Neoplasia and Its Relationship to Anal Squamous Cell Cancer

Prevalência da lesão HPV induzida em canal anal de mulheres com neoplasia intraepitelial cervical 2 e 3: um estudo de corte transversal

Profile of women with anal neoplasia associated with cervical neoplasia receiving care at a tertiary healthcare facility in northeastern Brazil

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