Liquid‐based cytology and HPV DNA testing using intra‐anal specimens from HIV‐negative women with and without genital HPV‐induced lesions

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Background: There is a high frequency of human papillomavirus (HPV)-induced lesions in cervix and anus of immunosuppressed patients. However, few studies have evaluated these lesions in kidney-transplanted women.Methods: This cross-sectional study examined 31 kidney-transplanted women receiving immunosuppressive therapy at the General Hospital of Fortaleza in Brazil. Cervical and anal samples were collected and preserved in order to perform liquid-based cytology and a real-time polymerase chain reaction assay detecting high-risk HPV. Results: The patients' ages ranged from 31 to 70 years (mean: 42.6 ± 10.4). The age of sexual debut varied from 14 to 30 years (mean: 19.7 ± 3.8). Cervical cytology was diagnosed as atypical in 25.8% of cases (atypical squamous cells of undetermined significance [ASC-US] in 2 [6.2%], atypical squamous cells, but unable to exclude a high-grade squamous intraepithelial lesion in 1 [3.1%], low-grade squamous intraepithelial lesion [LSIL] in 4 [12.4%], and squamous cell carcinoma in 1 [3.1%]). Anal cytology was atypical in 35.4% of cases (ASC-US in 1 [3.2%]and LSIL in 7 [21.7%]). The presence of cervical HPV was confirmed in 22.5% of patients, and anal HPV was found in 48.8% of the cases. The relative risk of atypical anal cytology in cases of atypical cervical cytology was 4.37 (1. 35-14.20). High-risk cervical HPV did not significantly increase the risk of having atypical anal cytology. However, for HPV in the anus, this was associated with a relative risk of 10.18 (1.45-71.54).Conclusion: High-risk HPV and atypical cytology are very common in the cervix and anus of kidney-transplanted women. Furthermore, the presence of HPV in an anal sample correlates with an increased risk of atypical anal cytology. HPV tests could be useful tools for identifying patients who require anal cytology.

“…In immunocompetent women, 15 the risk for atypical anal cytology in patients testing positive for HPV in the cervix was not significant.…”

Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Prevalence of high‐risk HPV and atypia in liquid‐based cytology of cervical and intra‐anal specimens from kidney‐transplanted women

Eleutério

Cavalcante

Gonçalves

et al. 2019

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

Khattab

McMeekin

Taege

et al. 2017

High risk patients with unsatisfactory anal cytology are not "negative". At least one-third proved to be concomitantly HR-HPV DNA positive with one-fifth showing subsequent cytologic squamous abnormalities and with more than 5% being diagnosed with a high grade intraepithelial lesion within two years. Prompt repeat cytology and/or HR-HPV DNA is recommended for high risk patients with non-diagnostic cytology.

Liquid‐based cytology and HPV DNA test in anal specimens from women with cervical cancer

Eleutério

Surimã

Lima

et al. 2021

Introduction Cervical and anus cancers have similarities: association with HPV infection, epithelial transformation zone, and precursor lesions. However, it is still unclear whether women with cervical cancer should be screened to identify high‐grade squamous intraepithelial lesions and anal cancer. We aimed to identify high‐risk HPV and cytological atypia in anal samples from women diagnosed with invasive squamous cell carcinoma of the cervix. Study design We conducted a cross‐sectional study between July 2016 and August 2017 in reference services in oncology in the State of Ceará, Brazil. We studied 59 patients diagnosed with frankly invasive squamous cell carcinoma of the cervix (at least stages IB) and 60 women in a control group. We performed liquid‐based cytology (Surepath™) and HPV test (Cobas® 4800 System Test) of anal samples. To determine statistical significance with a confidence interval of 95%, we used Fisher's exact test and Student's t‐test using the GraphPad Prism 7.0 software. Results The mean age in the control group was 56.7 ± 8.5 years, while in the group of women with cervical squamous cancer, it was 54.3 ± 14.8. The liquid‐based cytology results of the satisfactory cases were: negative for intraepithelial lesion or malignancy (NLM): 51 cases (85%) in the control group and 38 (64.4%) in the study group (p = .0116). The HPV test was negative more frequently in the control group (n = 56, 93.3%) than in the study group (n = 17, 31.5%) (p < .0001). HPV 16 was the most frequent type (67.6%). Conclusions There is a higher frequency of high‐risk HPV and atypical cytology in women with cervical cancer than without lesions. Thus, this group should be considered as a target population for screening.