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Keratosis reduces sensitivity of anal cytology in detecting anal intraepithelial neoplasia.

Publication ,  Journal Article
ElNaggar, AC; Santoso, JT; Xie, HB
Published in: Gynecol Oncol
February 2012

OBJECTIVE: To identify factors that may contribute to poor sensitivity of anal cytology in contrast to the sensitivity of anoscopy in heterosexual women. METHODS: We analyzed 324 patients with biopsy confirmed diagnosis of genital intraepithelial neoplasia (either vulva, vaginal, or cervical) from 2006 to 2011 who underwent both anal cytology and anoscopy. Cytology, anoscopy, and biopsy results were recorded. Biopsy specimens underwent independent analysis for quality of specimen. Also, biopsy specimens were analyzed for characteristics that may contribute to correlation, or lack thereof, between anal cytology and anoscopic directed biopsy. RESULTS: 133 (41%) patients had abnormal anoscopy and underwent directed biopsy. 120 patients with normal anal cytology had anoscopy directed biopsies, resulting in 58 cases of AIN (sensitivity 9.4%; 0.039-0.199). This cohort was noted to have extensive keratosis covering the entire dysplastic anal lesion. 18 patients yielded abnormal anal cytology. Of these patients, 13 had anoscopic directed biopsies revealing 6 with AIN and absent keratosis (specificity 88.6%; 0.78-0.95). The κ statistic for anal cytology and anoscopy was -0.0213 (95% CI=-0.128-0.086). CONCLUSION: Keratosis reduces the sensitivity of anal cytology. Furthermore, anal cytology poorly correlates with anoscopy in the detection of AIN (κ statistic=-0.0213).

Duke Scholars

Published In

Gynecol Oncol

DOI

EISSN

1095-6859

Publication Date

February 2012

Volume

124

Issue

2

Start / End Page

292 / 295

Location

United States

Related Subject Headings

  • Young Adult
  • Sensitivity and Specificity
  • Oncology & Carcinogenesis
  • Middle Aged
  • Keratosis
  • Humans
  • Genital Neoplasms, Female
  • Female
  • Carcinoma in Situ
  • Biopsy
 

Citation

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ElNaggar, A. C., Santoso, J. T., & Xie, H. B. (2012). Keratosis reduces sensitivity of anal cytology in detecting anal intraepithelial neoplasia. Gynecol Oncol, 124(2), 292–295. https://doi.org/10.1016/j.ygyno.2011.10.016
ElNaggar, Adam C., Joseph T. Santoso, and Huiwen Bill Xie. “Keratosis reduces sensitivity of anal cytology in detecting anal intraepithelial neoplasia.Gynecol Oncol 124, no. 2 (February 2012): 292–95. https://doi.org/10.1016/j.ygyno.2011.10.016.
ElNaggar AC, Santoso JT, Xie HB. Keratosis reduces sensitivity of anal cytology in detecting anal intraepithelial neoplasia. Gynecol Oncol. 2012 Feb;124(2):292–5.
ElNaggar, Adam C., et al. “Keratosis reduces sensitivity of anal cytology in detecting anal intraepithelial neoplasia.Gynecol Oncol, vol. 124, no. 2, Feb. 2012, pp. 292–95. Pubmed, doi:10.1016/j.ygyno.2011.10.016.
ElNaggar AC, Santoso JT, Xie HB. Keratosis reduces sensitivity of anal cytology in detecting anal intraepithelial neoplasia. Gynecol Oncol. 2012 Feb;124(2):292–295.
Journal cover image

Published In

Gynecol Oncol

DOI

EISSN

1095-6859

Publication Date

February 2012

Volume

124

Issue

2

Start / End Page

292 / 295

Location

United States

Related Subject Headings

  • Young Adult
  • Sensitivity and Specificity
  • Oncology & Carcinogenesis
  • Middle Aged
  • Keratosis
  • Humans
  • Genital Neoplasms, Female
  • Female
  • Carcinoma in Situ
  • Biopsy