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Anal-rectal cytology: correlation with human papillomavirus status and biopsy diagnoses in a population of HIV-positive patients.

Publication ,  Journal Article
Bean, SM; Chhieng, DC; Roberson, J; Raper, JL; Broker, TR; Hoesley, CJ; Eltoum, IA; Jin, G
Published in: J Low Genit Tract Dis
April 2010

OBJECTIVES: We describe the cytological distribution of disease, correlate cytological diagnoses with human papillomavirus (HPV) DNA status and surgical biopsy diagnoses, determine if CD4 counts correlate with lesion severity, and compare anal-rectal data of HIV-infected patients (primarily men) with cervical data. MATERIALS AND METHODS: A retrospective search of the computerized database identified 118 HIV-positive patients who had anal-rectal cytology. Cytology results were compared with available follow-up data including repeat anal-rectal cytology tests, surgical biopsy, CD4 counts, and HPV DNA polymerase chain reaction-based genotyping. RESULTS: Cytological diagnoses included 3% unsatisfactory for diagnosis, 41% negative for intraepithelial lesion or malignancy (NILM), 23% atypical squamous cells of undermined significance (ASC-US), 31% low-grade squamous intraepithelial lesion (LSIL), and 2% high-grade squamous intraepithelial lesion (HSIL) (ASC-US/squamous intraepithelial lesion, 0.7:1). Two anal intraepithelial neoplasia (AIN) II, 10 AIN III, and 1 invasive squamous cell carcinoma were histologically detected (11%). The majority of AIN II was preceded by LSIL, 54%; ASC-US, 15%; and HSIL, 8%. The false-negative fraction was 23%. Sensitivity, specificity, negative predictive value, and positive predictive value were 92%, 8%, 33%, and 67%, respectively. Of those HPV tested concurrent with the first cytology specimen, 48% NILM, 78% ASC-US, and 100% LSIL were HPV positive. Mean CD4 counts (per microliter) were lower in patients with HSIL (243 [SD, 65]) compared with LSIL (400 [SD, 261]) and NILM (428 [SD, 232]). CONCLUSIONS: Anal-rectal cytology is a useful screening test. A high percentage of AIN II lesions were detected in this at-risk population, and the majority was detected following cytological abnormality.

Duke Scholars

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Published In

J Low Genit Tract Dis

DOI

EISSN

1526-0976

Publication Date

April 2010

Volume

14

Issue

2

Start / End Page

90 / 96

Location

United States

Related Subject Headings

  • United States
  • Retrospective Studies
  • Rectum
  • Rectal Neoplasms
  • Papillomavirus Infections
  • Papillomaviridae
  • Obstetrics & Reproductive Medicine
  • Middle Aged
  • Male
  • Humans
 

Citation

APA
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ICMJE
MLA
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Bean, S. M., Chhieng, D. C., Roberson, J., Raper, J. L., Broker, T. R., Hoesley, C. J., … Jin, G. (2010). Anal-rectal cytology: correlation with human papillomavirus status and biopsy diagnoses in a population of HIV-positive patients. J Low Genit Tract Dis, 14(2), 90–96. https://doi.org/10.1097/LGT.0b013e3181ba9bcd
Bean, Sarah M., David C. Chhieng, Janie Roberson, James L. Raper, Thomas R. Broker, Craig J. Hoesley, Isam A. Eltoum, and Ge Jin. “Anal-rectal cytology: correlation with human papillomavirus status and biopsy diagnoses in a population of HIV-positive patients.J Low Genit Tract Dis 14, no. 2 (April 2010): 90–96. https://doi.org/10.1097/LGT.0b013e3181ba9bcd.
Bean SM, Chhieng DC, Roberson J, Raper JL, Broker TR, Hoesley CJ, et al. Anal-rectal cytology: correlation with human papillomavirus status and biopsy diagnoses in a population of HIV-positive patients. J Low Genit Tract Dis. 2010 Apr;14(2):90–6.
Bean, Sarah M., et al. “Anal-rectal cytology: correlation with human papillomavirus status and biopsy diagnoses in a population of HIV-positive patients.J Low Genit Tract Dis, vol. 14, no. 2, Apr. 2010, pp. 90–96. Pubmed, doi:10.1097/LGT.0b013e3181ba9bcd.
Bean SM, Chhieng DC, Roberson J, Raper JL, Broker TR, Hoesley CJ, Eltoum IA, Jin G. Anal-rectal cytology: correlation with human papillomavirus status and biopsy diagnoses in a population of HIV-positive patients. J Low Genit Tract Dis. 2010 Apr;14(2):90–96.

Published In

J Low Genit Tract Dis

DOI

EISSN

1526-0976

Publication Date

April 2010

Volume

14

Issue

2

Start / End Page

90 / 96

Location

United States

Related Subject Headings

  • United States
  • Retrospective Studies
  • Rectum
  • Rectal Neoplasms
  • Papillomavirus Infections
  • Papillomaviridae
  • Obstetrics & Reproductive Medicine
  • Middle Aged
  • Male
  • Humans