Histological outcomes of anal high‐grade cytopredictions

Roberts, J. M.; Jin, Fengyi; Poynten, I. Mary; Law, Carmella; Templeton, David J; Thurloe, Julia K.; Garland, Suzanne M.; Grulich, Andrew E.; Farnsworth, Annabelle; Hillman, Richard J.

doi:10.1002/cncy.21936

Cited by 14 publications

(8 citation statements)

References 39 publications

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“…The authors further suggested that HRA should be the standard for detecting HGAIN, as most HGAIN is not palpable by digital rectal examination or simple anoscopy except in the case of advanced lesions. An Australian study by Roberts et al on the histological outcomes of highgrade cytopredictions with HRA in MSM also complemented this finding (19). Data showed that high-grade cytopredictions are meaningful with a histological HSIL confirmed in more than 90% of cases after 3 HRAs over a 12-month period.…”

Section: Discussionmentioning

confidence: 77%

An Update on the Current Role of High Resolution Anoscopy in Patients With Anal Dysplasia

et al. 2018

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The incidence of anal squamous cell carcinoma (ASCC) in the U.S. is increasing, particularly in immunocompromised patients. Preventative screening is used to monitor precancerous dysplasia known as anal intraepithelial neoplasia (AIN), which can progress to ASCC. High Resolution Anoscopy (HRA) is one screening procedure that uses a colposcope with acetic acid and Lugol's iodine solution to visualize the anal epithelium for AIN. HRA has offered potential in managing AIN, but as more evidence emerges it is unclear whether HRA provides definitive benefit. This narrative review updates readers on the efficacy of HRA in screening AIN, compares HRA to other techniques, compares the use of HRA in various high-risk populations, and offers practical information on the use of HRA. Keyword searches were conducted using MEDLINE, Web of Science, and Cochrane Library. Current literature is mixed regarding the utility of HRA. Further randomized controlled trials are needed to definitively assess the role of HRA.

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Section: Discussionmentioning

confidence: 77%

An Update on the Current Role of High Resolution Anoscopy in Patients With Anal Dysplasia

et al. 2018

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“…Four retrospective studies have suggested that the administration of the HPV vaccine to women who have undergone treatment for HSIL/CIN2-3 can reduce the risk of developing persistent/recurrent disease [ 8 , 9 , 10 , 11 , 12 ]. A recent study (SPERANZA) was the first to prospectively evaluate the effectiveness of HPV vaccination after conization in women treated for HSIL/CIN2-3.…”

Section: Discussionmentioning

confidence: 99%

“…Different mechanisms may contribute to this increased risk of cervical cancer. Persistent human papilloma virus (HPV) infection after treatment, with or without residual HSIL/CIN2-3, is clearly the most important established risk factor [ 11 ]. Another possible mechanism is the acquisition of a new HPV infection, since women who have already developed HSIL/CIN2-3 have shown an increased risk of developing new HPV-associated lesions [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

HPV Vaccination as Adjuvant to Conization in Women with Cervical Intraepithelial Neoplasia: A Study under Real-Life Conditions

et al. 2020

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Background: Recent studies have shown preliminary evidence that vaccination against human papillomavirus (HPV) could decrease the risk of persistent/recurrent HSIL in women treated for high-grade cervical intraepithelial lesion (HSIL). We aimed to determine the benefits of HPV vaccination in patients undergoing conization for HSIL in real-life conditions and evaluate vaccination compliance associated with different funding policies. Methods: From January 2013 to July 2018, 265 women underwent conization in our center. From January 2013 to July 2017, treated patients (n = 131) had to pay for the vaccine, whereas after July 2017 the vaccine was publicly funded and free for treated women (n = 134). Post-conization follow-up controls were scheduled every six months with a Pap smear, HPV testing, and a colposcopy. Results: 153 (57.7%) women accepted vaccination (vaccinated group), and 112 (42.3%) refused the vaccine (non-vaccinated group). Persistent/recurrent HSIL was less frequent in vaccinated than in non-vaccinated women (3.3% vs. 10.7%, p = 0.015). HPV vaccination was associated with a reduced risk of persistent/recurrent HSIL (OR 0.2, 95%CI: 0.1–0.7, p = 0.010). Vaccination compliance increased when the vaccine was publicly funded (from 35.9% [47/131] to 79.1% [106/134], p < 0.001). Conclusions: HPV vaccination in women undergoing conization is associated with a 4.5-fold reduction in the risk of persistent/recurrent HSIL. Vaccination policies have an important impact on vaccination compliance.

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“…However, cytology is subjective and has low reproducibility. Moreover, the cytological categories showed different predictive values in the identification of histological HSILs [ 16 ]. In order to improve the detection of these lesions and to use more objective methods, several HPV-related biomarkers have been evaluated, mainly in HIV-infected MSM [ 17 , 18 , 19 , 20 , 21 , 22 ].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of HPV-Related Biomarkers in Anal Cytological Samples from HIV-Uninfected and HIV-Infected MSM

et al. 2021

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Men who have sex with men (MSM) harbor the highest risk for anal carcinoma, mainly caused by Human Papillomavirus (HPV). The use of HPV-related biomarkers in the screening for this neoplasia is still debated. We assessed the association between high-risk (hr)HPV DNA, HPV16/18 DNA, hrHPV E6/E7 mRNA, and p16/Ki-67 with cytological abnormalities (any grade) and high-grade intraepithelial lesions (HSIL) in HIV-uninfected and HIV-infected MSM. Overall, 150 cytological samples in PreservCyt (Hologic), with a negative to HSIL report, were analyzed for hrHPV DNA, hrHPV E6/E7 mRNA, and p16/Ki-67 using the Linear Array (Roche), Aptima (Hologic), and CINtec® PLUS (Roche) assays. In HIV-infected MSM, positivity for all the biomarkers significantly increased with the cytological grade. In both populations, the association of hrHPV E6/E7 mRNA and p16/Ki-67 positivity with HPV16 did not differ significantly compared to hrHPVs other than HPV16. In HIV-uninfected MSM, the odds of having an HSIL increased approximately six times for the p16/Ki-67 positive cases. In HIV-infected individuals, all the biomarkers showed a significant association with HSIL, except for hrHPV DNA, with the strongest association observed for p16/Ki-67. The odds of HSIL increased almost 21 times in those positive for this biomarker. Our results encourage further investigation on the use of p16/Ki-67 dual staining in anal cancer screening for HIV-uninfected and HIV-infected MSM.

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Histological outcomes of anal high‐grade cytopredictions

Cited by 14 publications

References 39 publications

An Update on the Current Role of High Resolution Anoscopy in Patients With Anal Dysplasia

An Update on the Current Role of High Resolution Anoscopy in Patients With Anal Dysplasia

HPV Vaccination as Adjuvant to Conization in Women with Cervical Intraepithelial Neoplasia: A Study under Real-Life Conditions

Evaluation of HPV-Related Biomarkers in Anal Cytological Samples from HIV-Uninfected and HIV-Infected MSM

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