Citologia anal como método de rastreamento para a detecção precoce do câncer anal: esfregaços com algodão hidrófilo são mesmo insatisfatórios?

Silva, Ivan Tramujas da Costa e; Gimenez, Felicidad Santos; Guimarães, Ricardo Alexandre Gonçalves; Camelo, Romildo Torres; Melo, Manoel Nilzomar Damasceno; Barros, Flávio Silveira de; Daumas, Adriana; Cabral, Celso Rômulo Barbosa; Guimarães, Erica Liberato

doi:10.1590/s0102-86502005000100015

Cited by 3 publications

(1 citation statement)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Consequently, a cytology test equivalent to the Pap smear to diagnose cervical cancer is also used to diagnose anal lesions. However, even though this test is efficient, inexpensive (44) and highly sensitive (98%) to detect cellular alterations, it has low specificity (50%) (37) . So in cases of anal cell changes with signs of dysplasia of any magnitude, tend to indicate the use of anuscopy with magnified a procedure similar to cervical (8,23) .…”

Section: Introductionmentioning

confidence: 99%

The value of high-resolution anoscopy in the diagnosis of anal cancer precursor lesions in hiv-positive patients

Gimenez

Costa-e-Silva

Daumas

et al. 2011

Arq. Gastroenterol.

Self Cite

View full text Add to dashboard Cite

-Context -Anal cancer, although a still rare disease, is being observed in ascending rates among some population segments known to be at risk for the development of the disease. Human papillomavirus (HPV) infection, immunodepression and anal intercourse are some factors associated with the development of the malignancy. Its similarities to cervical cancer have led to many studies aiming to establish guidelines for detecting and treating precursor lesions of anal cancer, with the goal of prevention. Highresolution anoscopy is routinely used for the diagnosis of anal cancer precursor lesions in many centers but the medical literature is still deficient concerning the role of this diagnostic modality. Objectives -To evaluate diagnostic validation and precision measures of high-resolution anoscopy in comparison to histopathological results of anal biopsies performed in HIV-positive patients treated at the Tropical Medicine Foundation of Amazonas, AM, Brazil. To observe any possible association between some risk factors for the development of anal cancer and the presence of anal squamous intraepithelial lesions. Methods -A hundred and twenty-eight HIV-positive patients were submitted to anal canal cytological sampling for the detection of HPV infection by a PCR based method. High-resolution anoscopy was then performed after topical application of acetic acid 3% in the anal canal for 2 minutes. Eventual acetowhite lesions that were detected were recorded in respect to location, and classified by their tinctorial pattern, distribution aspect, relief, surface and vascular pattern. Biopsies of acetowhite lesions were performed under local anesthesia and the specimens sent to histopathological analysis. The patients were interviewed for the presence of anal cancer risk factors. Results -The prevalences of anal HPV infection and of anal squamous intraepithelial lesions in the studied population were, respectively, 79% and 39.1%. High-resolution anoscopy showed sensibility of 90%, specificity of 19.23%, positive predictive value of 41.67%, negative predictive value of 75%, and a kappa coefficient of 0.076. From the analyzed lesions, high-grade squamous intraepithelial lesions was more frequently observed in association to dense (68%), flat (61%), smooth (61%), non-papillary (83%) and normal vascular pattern (70%) acetowhite lesions, while low-grade squamous intraepithelial lesions tended to be associated to dense (66%), flat-raised or raised (68%), granular (59%), non-papillary (62%) and normal vascular pattern (53%) acetowhite lesions. No statistical significance was observed as to the association of epidemiological characteristics and of most of the investigated anal cancer risk factors and presence of acetowhite lesions or anal squamous intraepithelial lesions. However, anal receptive sex and anal HPV infection were significantly associated to anal squamous intraepithelial lesions (P = 0.0493 and P = 0.006, respectively). Conclusion -High-resolution anoscopy demonstrated to be a sensitive, but not specific test ...

show abstract

Section: Introductionmentioning

confidence: 99%

The value of high-resolution anoscopy in the diagnosis of anal cancer precursor lesions in hiv-positive patients

Gimenez

Costa-e-Silva

Daumas

et al. 2011

Arq. Gastroenterol.

Self Cite

View full text Add to dashboard Cite

show abstract

HPV-Genotype Distribution and Oncogene Expression in HIV-Positive Adults and the Underlying Risk Factors for Anal, Oral and Genital Malignancy: An Atlantic Canada Prospective Cohort Study

Mugford

Aslanov

2013

Annals of Epidemiology

View full text Add to dashboard Cite

BACKGROUND:Human Papillomavirus (HPV) is the most common sexually transmitted agent. These small DNA viruses target the basal cells of the epithelium. While the HPV family is comprised of more than 100 genotypes, only about 40 or so types are associated with human anogenital infections. Infection s with oncogenic HPV 53,66,6 8,73,18,31,33,35,39,45 ,51,52,56,58,59) OBJECTIVES:Primary: To determine the prevalence and distribution of high risk (HR) oncogenic HPV-types in HIV-positive adult s in Atlantic Canada.Secondary: To correlate the prevalence of HR HPV genotyp es with underl ying pre-malign ant lesions and maligna ncy through a cross-sectiona l study.To corre late pre-ma lignant lesions and malignancy with patient s' demographics and underlying risk factor s.This thesis is part of a larger prospective cohort study designed to follow consenting persons with Hl'V infection in Atlantic Canada over a 3-year period subsequent to baseline screening in year one. The data in this thesis are limited to that obtained at baseline in all four Atlantic Provinces during the first year of the study. All Hlv-positive adults treated through the participating infectious disease clinics were approached by the clinic physicians or nurses to request participation in the study. Atlantic Canada has approximately 800 routinely followed HlV-positive adults and we expected to enroll approximately 400 of them. This study was approved by ethic committees of all participating institutions as well as the Public Health Agency of Canada, the funding agency for the study.Recruitment commenced in June, 2009. All procedures were performed after obtaining informed consent. Consenting participants were required to comp lete a confidential questionnaire to obtain demographic and risk factor data. Participants' identifiers were retained to permit questionnaire data to be correlated with HPV related disease outcomes. SurePath (Becton Dickinson) liquid cytology medium was used in the collection of oropharyngeal and anal swab specimens from all males and females, and an additional cervical specimen was obtained from females. All specimens were tested for cytologic abnormalities , HPV DNA and genotyping . The study cohort will be followed up with the above protocol for a period of 3 years. These results will be subsequently used to assess any HPV related disease outcome and genotypic specific information. Consent also gives access to patients' medical files for information on viral load, CD4+T cell count and treatment regimens in order to correlate these factors with disease outcome.The study analysis is based on a total of 300 patients; of these 91.7% were males. The population and gender distribution among the provinces were: Nova Scotia, Halifax (NSH) -total 150 patients, of these 142 (94.7%) were males; New Brunswick, Moncton (NBM) -total 90 patients, of these 85 (94.4%) were males; Newfoundland and Labrador, St. John's (NLSJ) -total 44 patients, of these 34 (77.3%) were males; and New Brunswick, Saint John (NBSJ) -total 16 patients, of ...

show abstract

Sensibilidade e especificidade da citologia anal com escova no diagnóstico das lesões clínicas provocadas pelo papilomavírus humano, comparando uma com duas coletas

Nadal

Calore

Manzione

et al. 2009

Rev bras. colo-proctol.

View full text Add to dashboard Cite

OBJETIVO: comparar os resultados da coleta única com duas amostras para avaliar se haverá melhora da sensibilidade e especificidade do exame. MÉTODO: Foram 112 doentes masculinos HIV-positivo com doença anal pregressa ou atual pelo Papilomavírus humano (HPV). As lesões HPV induzidas foram observadas em 58 deles. Colhemos material do canal anal utilizando duas escovas (cytobrush) Comparamos estatisticamente os resultados da primeira amostra com a soma das duas coletas. RESULTADOS: dos 58 doentes com lesões clínicas, a primeira amostra confirmou a doença em 40 (69%) e a soma das duas coletas revelou lesões em 51 (88%). Os resultados mostraram sensibilidade de 69% com a primeira coleta e 88% quando somadas as duas amostras. Essa diferença foi confirmada estatisticamente. A especificidade foi menor para as duas amostras, porém sem diferença estatística. CONCLUSÃO: Concluímos que a sensibilidade foi maior e a especificidade foi semelhante quando os resultados foram obtidos com a somação das duas amostras da citologia anal.

show abstract

Citologia anal como método de rastreamento para a detecção precoce do câncer anal: esfregaços com algodão hidrófilo são mesmo insatisfatórios?

Abstract: Our results showed that cotton swabs were as efficient as dacron swabs or cytologic brushes in the ability to produce satisfactory analpap readings.

Cited by 3 publications

References 17 publications

The value of high-resolution anoscopy in the diagnosis of anal cancer precursor lesions in hiv-positive patients

The value of high-resolution anoscopy in the diagnosis of anal cancer precursor lesions in hiv-positive patients

HPV-Genotype Distribution and Oncogene Expression in HIV-Positive Adults and the Underlying Risk Factors for Anal, Oral and Genital Malignancy: An Atlantic Canada Prospective Cohort Study

Sensibilidade e especificidade da citologia anal com escova no diagnóstico das lesões clínicas provocadas pelo papilomavírus humano, comparando uma com duas coletas

Contact Info

Product

Resources

About