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Published on: July 6, 2014
A comparative study between conventional and liquid-based cytology in screening for anal intraepithelial lesions in
Livia Bravo Maia1, Larissa Cardoso Marinho, Tania Wanderley Paes Barbosa
1Department of Pathology, Hospital Universitário de Brasília (HUB), Brasília, DF, Brazil.
Insights
Conventional cytology (CC) and liquid-based cytology (LBC) are equally effective for screening anal preneoplastic lesions. Both methods showed significant concordance in detecting anal intraepithelial neoplasia (AIN) in high-risk patients.
Area of Science:
- Anorectal diseases
- Oncology
- Cytopathology
Background:
- Anal intraepithelial neoplasia (AIN) is linked to HPV infection and requires effective screening.
- High-risk populations, such as HIV-positive individuals, need validated screening methods.
- Conventional cytology (CC) and liquid-based cytology (LBC) are cytological screening methods for AIN.
Purpose of the Study:
- To assess the concordance between CC and LBC in diagnosing anal preneoplastic lesions.
- To compare cytological results with anoscopy, histopathology, and molecular findings.
- To evaluate screening efficacy in a high-risk HIV-positive cohort.
Main Methods:
- Comparative study of 33 HIV-positive patients.
- Co-testing with CC and LBC for anal cytology.
- Anoscopy and biopsy of suspicious lesions.
- Histopathological and molecular biology analysis (HPV typing).
Main Results:
- Statistically significant concordance (P < 0.05) between CC and LBC for AIN detection.
- CC identified 75% of biopsy-positive cases; LBC identified 85.71%.
- LSIL cases showed the highest number of HPV subtypes; no significant association between biopsy results and specific HPV types or multiple infections.
Conclusions:
- CC and LBC demonstrate comparable effectiveness in screening for anal preneoplastic lesions.
- Both methods are valuable tools for AIN detection in high-risk populations.
- Further research may refine screening protocols based on cytological and molecular data.
Abstract:
Anal intraepithelial neoplasia (AIN) is associated with HPV infection and can be detected by cytological screening. While conventional exfoliative cytology (CC) is a low-cost and nonaggressive method, liquid-based cytology (LBC) tends to give clearer readings. Although studies of the efficacy of anal cancer screening methods would be of great importance for groups at high risk for AIN, few such studies have been conducted. The aim of the present study was to assess the concordance of CC and LBC in diagnosing anal pre-neoplastic lesions, and to compare cytological results with anoscopy, histopathological, and molecular biology findings. Comparative study involving 33 HIV-positive patients, who underwent anoscopy and biopsy of suspected lesions. Concordance between the two cytology methods was calculated, as were the associations between cytology results and findings from other screening methods. A total of 54.5% of cases were considered AIN-negative by CC and LBC, and concordance between the two methods was statistically significant (P < 0.05). Anoscopy was negative in 15 of the 18 CC- and LBC-negative cases. CC identified 75% of patients with positive biopsy, while LBC identified 85.71% of these patients. Molecular biology results showed that patients with LSIL tested positive for the highest number of HPV subtypes. The associations between positive biopsy and high grade HPV, HPV 16, and multiple HPV infections were not statistically significant. Conventional and liquid-based cytology are equally effective in screening for anal preneoplastic lesions.
