Value of conventional cytology in the presence of macroscopic lesions of the anal canal

Abstract

Objectives To verify the value of conventional cytology for the diagnosis of macroscopic lesions of the anal canal and to describe the limitations of the samples. Method We evaluated 395 conventional cytology samples obtained by brushing the anal canal of patients (predominantly male, HIV-positive) and compared them to the presence of macroscopic lesions of the anal canal observed under anorectal examination. Results Of the total, 91.6% of samples were classified as adequate. Cellular elements representative of the anal transformation zone were observed in 63.5% of samples. Sensitivity in the presence or absence of cellularity was 80% and 31%, respectively. Conclusion The study demonstrates the feasibility of using conventional anal cytology in outpatients.

Conventional cytologic diagnosis of human papillomavirus‐induced anal intraepithelial neoplasia: The experience of a referral center in Rio de Janeiro, Brazil

“…Most of the samples (60%) contained metaplastic or glandular cells or both, indicating that the procedure had reached the ATZ. We observed some impact on sensitivity when we compared samples with and without this cellularity (86% and 75%, respectively), although the impact was greater when we assessed the samples' sensitivity with, and without ATZ compared to the presence of macroscopic lesion in the anal canal in a previous publication 27 . Various studies state that finding such cellularity is indicative of high‐quality samples, but without significant repercussions on diagnostic performance 5,17 .…”

“…We observed some impact on sensitivity when we compared samples with and without this cellularity (86% and 75%, respectively), although the impact was greater when we assessed the samples' sensitivity with, and without ATZ compared to the presence of macroscopic lesion in the anal canal in a previous publication. 27 Various studies state that finding such cellularity is indicative of high-quality samples, but without significant repercussions on diagnostic performance. 5,17 Still, a recent article using LBC concluded that normal cytological results without representation of the transformation zone have higher odds of being false negatives than those that contain representation of the ATZ, 28 while further studies are necessary.…”