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: Anglada, MG, Martinello, M, Romano, SM, Tornini, A, Cremonezzi, DC, Szlabi, S
Formato: Artículo revista
Publicado: 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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record_format ojs
institution Universidad Nacional de Córdoba
institution_str I-10
repository_str R-327
container_title_str Revista de la Facultad de Ciencias Médicas de Córdoba
format Artículo revista
topic LSIL
HSIL
precursor
carcinoma
anal
LSIL
HSIL
precursor
cáncer
anal
spellingShingle LSIL
HSIL
precursor
carcinoma
anal
LSIL
HSIL
precursor
cáncer
anal
Anglada, MG
Martinello, M
Romano, SM
Tornini, A
Cremonezzi, DC
Szlabi, S
Descriptive-analytical study of cyto-histological and anoscopy findings in high-risk patients with anal lesions in 3 years
topic_facet LSIL
HSIL
precursor
carcinoma
anal
LSIL
HSIL
precursor
cáncer
anal
author Anglada, MG
Martinello, M
Romano, SM
Tornini, A
Cremonezzi, DC
Szlabi, S
author_facet Anglada, MG
Martinello, M
Romano, SM
Tornini, A
Cremonezzi, DC
Szlabi, S
author_sort Anglada, MG
title Descriptive-analytical study of cyto-histological and anoscopy findings in high-risk patients with anal lesions in 3 years
title_short Descriptive-analytical study of cyto-histological and anoscopy findings in high-risk patients with anal lesions in 3 years
title_full Descriptive-analytical study of cyto-histological and anoscopy findings in high-risk patients with anal lesions in 3 years
title_fullStr Descriptive-analytical study of cyto-histological and anoscopy findings in high-risk patients with anal lesions in 3 years
title_full_unstemmed Descriptive-analytical study of cyto-histological and anoscopy findings in high-risk patients with anal lesions in 3 years
title_sort descriptive-analytical study of cyto-histological and anoscopy findings in high-risk patients with anal lesions in 3 years
description 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.
publisher Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
publishDate 2022
url https://revistas.unc.edu.ar/index.php/med/article/view/39040
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spelling I10-R327-article-390402024-04-15T16:14:45Z Descriptive-analytical study of cyto-histological and anoscopy findings in high-risk patients with anal lesions in 3 years Estudio descriptivo-analítico de los hallazgos cito-histológicos y anoscopia en pacientes de alto riesgo con lesiones anales en 3 años Anglada, MG Martinello, M Romano, SM Tornini, A Cremonezzi, DC Szlabi, S LSIL HSIL precursor carcinoma anal LSIL HSIL precursor cáncer anal 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. La citología anal es una herramienta sencilla y de bajo costo para la detección temprana de las lesiones precursoras del carcinoma anal. Los individuos de riesgo incluyen HIV (+), inmunodeprimidos, mujeres con antecedente de lesión intraepitelial en tracto genital inferior y hombres que practican sexo con hombres (HSH). Las lesiones escamosas intraepiteliales de bajo grado (L-SIL) no son precursoras de malignidad, pero tienen potencial de progresar a alto grado (H-SIL), que con el tiempo podrían desarrollar carcinoma anal. La anoscopia de alta resolución, que utiliza un videocolposcopio con lentes de aumento, es de elección para casos que no presentan lesión visible con la anoscopia común, pero con extendidos citológicos alterados. El objetivo del trabajo es describir los hallazgos cito-histológicos y anoscópicos de lesiones anales en pacientes de riesgo de una institución privada de Córdoba, en un período de 3 años. Se realizó un estudio observacional, descriptivo-analítico, retrospectivo y transversal. Los criterios de inclusión fueron: pacientes con lesión anal que tuvieran algún factor de riesgo para neoplasia intraepitelial anal, y las siguientes variables: sexo, edad, PCR para HPV, serología para VIH, HSH, clasificación cito-histológica según Bethesda y anoscopia. De 34 pacientes, con rango etario de 20 a 59 años, 15 fueron mujeres (12 tenían historia de HPV genital) y 19 varones (100% HSH; 13 lesiones anales al momento de la consulta y 3, antecedentes de verrugas anales). Del total, 6 pacientes eran VIH (+) (100% varones) y 19 tenían VPH de alto riesgo. De 19 anoscopias, la mayoría presentaba lesiones acetoblancas, positivas en la histología. Se realizaron 48 citologías (algunos pacientes tuvieron varias tomas a lo largo de los años):24 fueron NILM (negativo para lesión intraepitelial maligna), 18 LSIL, 5 HSIL y 1 ASC-H (células escamosas atípicas, no se puede descartar HSIL). Contrastadas con histología, el 95% informó algún grado de displasia, demostrando una alta sensibilidad. El 34,7% de las citologías fueron categorizadas de mayor grado en biopsia y un 9% de menor grado. Si bien la citología tiene sus limitaciones en comparación con la histología, es una excelente herramienta de cribado para detectar atipia, con una buena relación costo-efectiva. Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2022-10-26 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion texto https://revistas.unc.edu.ar/index.php/med/article/view/39040 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 79 No. Suplemento JIC XXIII (2022): Suplemento JIC XXIII Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 79 Núm. Suplemento JIC XXIII (2022): Suplemento JIC XXIII Revista da Faculdade de Ciências Médicas de Córdoba; v. 79 n. Suplemento JIC XXIII (2022): Suplemento JIC XXIII 1853-0605 0014-6722 http://creativecommons.org/licenses/by-nc/4.0