Descriptive-analytical study of cyto-histological and anoscopy findings in high-risk patients with anal lesions in 3 years
Anal cytology is a simple and inexpensive tool for the early detection of precursor lesions of anal carcinoma. Risk individuals include HIV (+), immunocompromised, women with a history of intraepithelial lesion in the lower genital tract, and men who have sex with men (MSM). L...
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| Autores principales: | , , , , , |
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| Formato: | Artículo revista |
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Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
2022
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| Acceso en línea: | https://revistas.unc.edu.ar/index.php/med/article/view/39040 |
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| Sumario: | Anal cytology is a simple and inexpensive tool for the early detection of precursor lesions of anal carcinoma. Risk individuals include HIV (+), immunocompromised, women with a history of intraepithelial lesion in the lower genital tract, and men who have sex with men (MSM). Low-grade squamous intraepithelial lesions (L-SIL) are not precursors to malignancy, but have the potential to progress to high-grade (H-SIL), which could eventually develop into anal carcinoma. High-resolution anoscopy , which uses a video colposcope with magnifying lenses, is the choice for cases that do not present a visible lesion with common anoscopy, but with altered cytological smears. The objective of the work was to describe the cyto-histological and anoscopic findings of anal lesions in patients at risk of a private institution in Córdoba, in a period of 3 years.
An observational, descriptive-analytical, retrospective and cross-sectional study was carried out. The inclusion criteria were: patients with anal injury who had some risk factor for anal intraepithelial neoplasia, and the following variables: sex, age, PCR for HPV, serology for HIV, MSM, cytohistological classification according to Bethesda and anoscopy.
Of 34 patients, with an age range of 20 to 59 years, 15 were women (12 had a history of genital HPV) and 19 men (100% MSM; 13 anal lesions at the time of consultation and 3 had a history of anal warts). Of the total, 6 patients were HIV (+) (100% male) and 19 had high-risk HPV. Of 19 anoscopies, the majority presented acetowhite lesions , positive on histology. 48 smears were performed (some patients had multiple samples over the years): 24 were NILM (negative for malignant intraepithelial lesion), 18 LSIL, 5 HSIL and 1 ASC-H (atypical squamous cells, HSIL cannot be ruled out) . Contrasted with histology, 95% reported some degree of dysplasia, demonstrating high sensitivity. 34.7% of the cytologies were categorized as higher grade in biopsy and 9% as lower grade.
Although cytology has its limitations compared to histology, it is an excellent cost-effective screening tool to detect atypia.
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