Prevalence of high-grade dysplasia and cancer in the anal canal in human papillomavirus–infected individuals

Sobhani, Iradj; Vuagnat, Albert; Walker, Francine; Vissuzaine, C; Mirin, Babak; Hervatin, Florence; Marmuse, Jean–Pierre; Crémieux, Anne‐Claude; Carbon, C; Hénin, Dominique; Lehy, Thérèse; Mignon, M

doi:10.1053/gast.2001.22446

Cited by 102 publications

(76 citation statements)

References 46 publications

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“…Few studies show that the incidence of AIN among HIV-positive women is greater than the incidence among HIV-negative women. 17,18 In the current study, 6 of 19 female patients were HIV positive. All 6 (100%) had evidence of anal condyloma and/or AIN.…”

Section: Table 4 Summary Of Cytologic Features Of Anorectal Specimensmentioning

confidence: 64%

“…5,10 Similar to cervical carcinoma, HPV infection plays a significant role in the development of anal condyloma, AIN, and anal carcinoma. 2,3,9,[17][18][19][20] It is notewor- thy that koilocytes, a common finding in cervicovaginal cytology, were less frequent and were observed in only 16 (21%) specimens. Other studies have reported the absence of koilocytosis in anorectal smears despite the presence of AIN.…”

Section: Table 4 Summary Of Cytologic Features Of Anorectal Specimensmentioning

confidence: 99%

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Anorectal cytology as a screening tool for anal squamous lesions

Friedlander

Stier

Lin

2003

Cancer

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Section: Table 4 Summary Of Cytologic Features Of Anorectal Specimensmentioning

confidence: 64%

Section: Table 4 Summary Of Cytologic Features Of Anorectal Specimensmentioning

confidence: 99%

Anorectal cytology as a screening tool for anal squamous lesions

Friedlander

Stier

Lin

2003

Cancer

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“…Therefore, the increased incidence of AIN in immunodeficient individuals seems to be related to the greater persistence of the virus in these patients. Several studies have reported a two to six times greater prevalence of HPV infection in immunosuppressed patients [23][24][25][26][27][28] and twice the risk of progression from low-grade AIN to high-grade AIN. [27][28][29][30] AIN lesions are known to advance from low-grade to high-grade AIN within 2 years of diagnosis in 36-66% of individuals with progression occurring more rapidly and more frequently in immunodeficient individuals.…”

Section: Discussionmentioning

confidence: 99%

Human papillomavirus genotypes in anal intraepithelial neoplasia and anal carcinoma as detected in tissue biopsies

et al. 2010

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Human papillomavirus (HPV) infection strongly correlates with the development of anal intraepithelial neoplasias and carcinomas; however, few studies have characterized the distribution of the specific subtypes of the virus in the varying grades of dysplasia. This report characterizes the distribution of HPV 16/18 in surgical specimens with anal intraepithelial neoplasia (AIN) I-III and histological variants of anal carcinoma. A total of 111 anal surgical specimens with no dysplasia (10), AIN I-III (53), and anal carcinomas (48) were evaluated for the presence of high-risk HPV infection and subtyped by nested PCR or the Invader Assay. High-risk virus types were detected in progressively greater number of anal intraepithelial lesions from 56% in low grade to 88% in high grade. Type 16 was the prevalent subtype and was noted in 28% of low grade and 68% of high-grade lesions. Moderate dysplasias showed type 16 in 20%, a prevalence similar to that in low-grade lesions. The non-16/18 subtypes of the virus predominated and were present in 50% of the cases. Most (89%) squamous carcinomas were associated with high-risk viruses, 68% with type 16, a prevalence similar to that noted in highgrade dysplasia. Non-16/18 subtypes were encountered more frequently in squamous carcinomas from immunodeficient individuals (57% cases) as compared with immunocompetent individuals (18% cases). The similarity in the prevalence of type 16 in high-grade dysplasia and squamous carcinomas suggests that anal intraepithelial lesion III is the true precursor of squamous carcinoma and warrants aggressive management. Anal intraepithelial lesions II showed a virus distribution that was similar to low-grade dysplasia. In addition, a subset of these that were associated with type 16 or 18 showed progression, whereas those associated with non-16/18 subtypes regressed, thereby raising the possibility of conservative management for these lesions.

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“…Esses apresentam mais metástases linfonodais, maiores taxas de recidiva, menor expectativa de vida, 11,12 e pior resposta à radio e quimioterapia associadas. 13 O tratamento do CEC anal, descrito por Nigro em 1974, 14 combina radio e quimioterapia. Operações de resgate estão indicadas caso haja persistência ou recidiva da doença.…”

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“…[16][17][18] Há autores que não observaram diferenças com esse tratamento nessa população quando comparada à dos soronegativos para o HIV, 18,19 embora outros tenham referido aumento da toxicidade do esquema nos doentes soropositivos. 5,[11][12][13] Estudos comparando doentes imunodeprimidos e imunocompetentes vêm mostrado, respectivamente, envolvimento linfonodal em 60% e 17%, recidivas em 75% e 6%, boa resposta à radio e quimioterapia em 62% e 85%, toxicidade a esse tratamento em 80% e 30%, e sobrevivência global de 1,4 e 5,3 anos. [11][12][13] A sobrevivência global em cinco anos variou entre 62,5 e 75%, dependendo do estádio do tumor.…”

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Seguimento dos doentes soropositivos e soronegativos para o HIV com carcinoma espinocelular do canal anal

Nadal

Cruz²

2009

Rev bras. colo-proctol.

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RESUMO: A incidência do carcinoma espinocelular (CEC) anal e das neoplasias intra-epiteliais anais (NIA) é maior nos pacientes infectados pelo papilomavírus humano (HPV), e está relacionada à imunidade e à infecção pelo vírus da imunodeficiência humana (HIV). A associação com viroses de transmissão sexual indica que seja tumor sexualmente transmitido. A infecção pelo HIV mudou o perfil dos portadores do CEC anal. A doença que anteriormente acometia mulheres na 6 a década de vida, hoje atinge preferencialmente homens na 3ª e 4 a décadas. Nos Estados Unidos, a expectativa de diagnóstico desse tumor aumentou de 19/ 100.000, na época pré-HAART (1992-1995), para 48,3/100.000 no período pós-HAART imediato (1996-1999) e para 78,2/100.000 pessoas por ano, nos anos mais recentes (2000-2003). O tratamento do CEC anal, descrito por Nigro em 1974, combina radio e quimioterapia. Operações de resgate estão indicadas caso haja persistência ou recidiva da doença. Estudos comparando, respectivamente, doentes imunodeprimidos e imunocompetentes vêm mostrado envolvimento linfonodal em 60% e 17%, recidivas em 75% e 6%, boa resposta à radio e quimioterapia em 62% e 85%, toxicidade a esse tratamento em 80% e 30%, e sobrevivên-cia global de 1,4 e 5,3 anos. A contagem sérica baixa de linfócitos T CD4 prediz mau prognóstico. Quando acima de 200/mm 3 , os resultados são comparáveis aos observados entre os imunocompetentes.

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Prevalence of high-grade dysplasia and cancer in the anal canal in human papillomavirus–infected individuals

Cited by 102 publications

References 46 publications

Anorectal cytology as a screening tool for anal squamous lesions

Anorectal cytology as a screening tool for anal squamous lesions

Human papillomavirus genotypes in anal intraepithelial neoplasia and anal carcinoma as detected in tissue biopsies

Seguimento dos doentes soropositivos e soronegativos para o HIV com carcinoma espinocelular do canal anal

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