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The correlation Between anal pap cytology and histologic outcomes in HIV-Positive males
Tonna McCutcheon1, Alexander T Hawkins1, Molly M Ford1
1The Vanderbilt University Medical Center, 1161 21st Ave South, D-5203 MCN, Nashville, TN, 37232, USA.
Background:
Anal intraepithelial neoplasia is a precursor to anal carcinoma. The use of anal pap cytology has been accepted as a screening method for anal carcinoma, however sensitivity and specificity vary.
Materials And Methods:
Retrospective cohort study involving 155 HIV-positive males with abnormal anal cytology and surgical resection.
Results:
155 patients met inclusion criteria. 31.6% were diagnosed with atypical cytology, 61.9% with low-grade cytology, and 6.4% with high-grade cytology. At surgery, 19.4% were diagnosed with condylomata, 34.8% with anal intraepithelial neoplasia 1, 17.4% with anal intraepithelial neoplasia 2, 27.1% with anal intraepithelial neoplasia 3 and 1.3% with anal carcinoma. There was a positive correlation between high-grade anal cytology and high-grade histology (r = 0.27; p = 0.0008). Comparison of risk factors showed no significant association.
Conclusion:
Anal cytology has a significant correlation with surgical histology. There were still instances of high-grade lesions being found after low-grade cytology. This highlights the necessity of patients with low-grade cytology undergoing anoscopic evaluation.
