PURPOSE:To investigate the differences in Langerhans cells (LCs) populations between HIV-positive and negative anal squamous cell carcinomas patients. METHODS:Twenty five patients (14 HIV-positive and 11 HIV-negative) were evaluated. Paraffin-block transversal thin sections from biopsies of anal squamous cell carcinomas (ASCC) were stained using the anti-CD1A antibody that identifies activated LCs. LCs counts were performed using histometry at 20 different sites, at baseline in the ASCC cases. These were then compared with LCs counts in anal canal specimens from HIV-negative and positive patients without ASCC (controls groups). RESULTS:In patients with ASCC, the LC count was greater among HIV-negative individuals than among HIV-positive individuals (p<0.05). The LC count was greater in the control HIV-negative group than in HIV-positive patients with ASCC (p<0.05). CONCLUSION:There was a lower amount of activated LCs in HIV-positive patients with anal squamous cell carcinomas than in HIVnegative patients, thereby suggesting worsening of the immune response. MÉTODOS:Avaliamos 25 pacientes, sendo 11 HIV-negativo e 14 HIV-positivo portadores do CEC do canal anal. Realizamos estudo com a coloração imunoistoquímica anti-CD1A para avaliar as CL ativadas. Utilizamos as lâminas coradas e pelo método da histometria contamos em 20 campos diferentes as células coradas na camada basal da lâmina própria, onde era evidente a disseminação tumoral.Realizamos dois grupos controles compostos por pacientes submetidos à biopsia anal sem neoplasia (sete pacientes HIV-negativo e quatro HIV-positivo). Comparamos as contagens de CL. RESULTADOS:A quantidade de CL foi superior nos pacientes portadores do CEC do canal anal soronegativo para o HIV, em relação aos soropositivos (p<0,05). A quantidade de CL foi superior no grupo controle HIV-negativo em relação ao grupo composto por pacientes soropositivos portadores do CEC do canal anal (p<0,05). CONCLUSÃO:Houve aumento das células de Langerhans ativadas na área peritumoral dos pacientes soropositivos para o HIV, o que sugere diminuição da resposta imune local.

The aim of this study was to compare the frequency of dysplasia and human papillomavirus (HPV) infection in the anal canal of patients with Crohn's disease (CD) with a control group and assess whether there is a correlation between use of immunosuppressants and anal manifestation of CD. Patients with CD and control individuals were submitted to anal cytology and material collection for polymerase chain reaction (PCR). The cytology was classified as normal, atypical squamous cells of undetermined significance (ASCUS), low-grade squamous intraepithelial lesion (LSIL), or high-grade (HSIL). PCR was considered positive or negative according to virus presence or absence. A total of 117 patients were included (54 in the control group and 63 in the CD group, being 32 without and 31 with immunosuppressants). ASCUS and LSIL were found in 25.9 and 22.2% of control patients and 28.6 and 39.7% of CD patients. HPV was identified in 14.8% of the control group and 27% of the CD group. In CD patients, HPV was found in 37.5 and 16.1% of those without and with immunosuppressants, respectively. Patients with perianal involvement had 15.6% of PCR positivity. There was no statistical difference in dysplasia and infection by HPV between the groups. Use of immunosuppressants did not influence the result, but anal manifestation was inversely proportional to viral detection.

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Background Compare the frequency of subclinical papillomavirus (HPV) in the anal canal os Crohn′s disease (DC) patients to a control group by smear cytology and polymerase chain reaction (PCR) and hybridisation and to assess whether there is correlation with the presence of immunosuppression and anal manifestations of the disease, besides establishing the agreement between the two diagnostic methods used. Methods Two groups were selected, one with DC and others to be the control population. All the individuals were submitted to smear cytology (two brushes inserted in sequence in the anal canal) and a third one preserved for molecular analysis (PCR and hybridisation). The cytology was classified according to Bethesda criteria as normal, atypical squamous cells of undetermined significance (ASCUS), low-grade squamous intraepithelial lesion (LSIL), high-grade squamous intraepithelial lesion (HSIL). The molecular analysis was considered with HPV present or absent and types 16 and high-risk HPV group identified. Results During sixteen months, 104 patients underwent anal cytology collection for smear preparation and HPV molecular method detection. The control group consisted of 41 individuals and the DC of 63 patients (32 immunocompetent and 31 immunosuppressed). ASCUS and LSIL represented respectively 26.8% and 22.0% of the control patients and 28.6% and 39.7% of the Crohn′s patients, with no statistically significant difference between the groups. HPV was identified in 17.1% of patients in the control group and 27% of patients with CD by the molecular method, being predominantly high risk in both groups. In a subanalysis considering Crohn’s disease patients with and without immunosuppression and the control group, there was no statistical difference between the frequencies detected by PCR and hybridisation (p = 0.084) as well as the anal manifestation of Crohn’s disease. The Kappa coefficient for agreement between smear anal cytology and HPV identification by PCR and hybridisation was -0.127 in the total sample. Conclusion In this study, is possible to conclude that in the sample studied there was no difference between subclinical HPV anal infection between control patients and Crohn’s disease group evaluated by both cytology and hybridisation and immunosuppression and anal impairment did not influence these results either. Anal cytology and hybridisation did not show agreement represented by the Kappa coefficient in this population.

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