Agreement between Methods for Diagnosing HPV-Induced Anal Lesions in Women with Cervical Neoplasia

• Published in: Acta cytologica Vol. 55; no. 2; pp. 218 - 224
• Main Authors: Heráclio, Sandra de Andrade, Souza, Alex Sandro Rolland de, Pinto, Fátima Regina Gomes, Amorim, Melania Maria Ramos, Oliveira, Micheline de Lucena, Souza, Paulo Roberto Eleutério de
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland Karger 01-01-2011
• Subjects: Anus Neoplasms - complications; Anus Neoplasms - diagnosis; Anus Neoplasms - pathology; Anus Neoplasms - virology; Biological and medical sciences; Cytodiagnosis - methods; Female; Female genital diseases; Gynecology. Andrology. Obstetrics; Humans; Investigative techniques, diagnostic techniques (general aspects); Medical sciences; Papillomaviridae - genetics; Papillomaviridae - physiology; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Polymerase Chain Reaction; Techniques; Tumors; Uterine Cervical Neoplasms - complications; Uterine Cervical Neoplasms - pathology; Uterine Cervical Neoplasms - virology; Anoscopy; Human papillomavirus; Anal cancer; Cervical intraepithelial neoplasia; Anal intraepithelial neoplasia; Cytology; Human; Premalignant lesion; Digestive system; Papovaviridae; Uterine cervix; Method; Female genital diseases; Papillomavirus; Virus; Agreement; Anatomic pathology; Anus; Adult; Female; Diagnosis; Woman; Uterine cervix diseases
• ISSN: 0001-5547; 1938-2650
• DOI: 10.1159/000320922

Objective: To evaluate agreement between 3 methods for screening anal intraepithelial lesions: anal cytology, anoscopy and human papillomavirus (HPV) detection by PCR. Study Design: This prospective, cross-sectional study screened 324 women with cervical neoplasia for anal neoplasia. Agreement between methods was calculated using the ĸ coefficient. Results: Of 324 anal cytologies performed, 31.5% (n = 102) were found to be abnormal: low-grade anal lesions were detected in 19.1% (n = 62) of cases, high-grade lesions in 3.1% (n = 10) and atypical squamous cells of undetermined significance in 9.3% (n = 30). With respect to the biopsies, 25.7% (n = 20) were positive, consisting of 7 cases of HPV infection, 5 anal intraepithelial neoplasia (AIN) grade 1, 6 AIN grade 2, and 2 AIN grade 3. Twenty-one samples (6.5%) were inadequate for HPV analysis. Of the 303 adequate samples, 84.2% (n = 255) tested positive for HPV. Agreement between cytology and anoscopy was fair (ĸ = 0.31). Agreement between PCR for HPV and cytology was slight (ĸ = 0.08) and no agreement was found between PCR for HPV and anoscopy (ĸ = 0.00). Conclusion: Agreement between the different methods of diagnosing HPV-induced anal lesions is slight to fair; however, anal cytology permits identification of cases in which lesions are present, allowing them to be referred for anoscopy and biopsy.