1. Anal papanicolaou smear in women with abnormal cytology: a thai hospital experience.
- Author
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Sananpanichkul P, Pittyanont S, Yuthavisuthi P, Thawonwong N, Techapornroong M, Bhamarapravatana K, and Suwannarurk K
- Subjects
- Adult, Aged, Anal Canal virology, Anus Neoplasms epidemiology, Anus Neoplasms etiology, Carcinoma, Squamous Cell epidemiology, Carcinoma, Squamous Cell etiology, Female, Follow-Up Studies, HIV physiology, HIV Infections virology, Humans, Middle Aged, Neoplasm Staging, Prognosis, Prospective Studies, Risk Factors, Specimen Handling, Thailand epidemiology, Young Adult, Anal Canal pathology, Anus Neoplasms diagnosis, Carcinoma, Squamous Cell diagnosis, Cytodiagnosis, HIV Infections complications, Papanicolaou Test
- Abstract
Background: Anal intraepithelial lesions (AIL) are likely to represent a precursor for anal cancer. Women infected with human immunodeficiency virus (HIV) may be at higher risk of anal cancer but a screening program for AIL still is not routinely recommended. We here studied the relationship of dysplastic cells from cervical and anal cytology in HIV-infected women., Materials and Methods: This prospective study was conducted in Prapokklao Hospital, Thailand during 2013-2014. Five hundred and ninety nine HIV-infected women were recruited. Participants who had cytological reports of equally or over "abnormal squamous/glandular cells of undetermined significance" (ASC-US) were classified as abnormal cervical or anal cytology. Descriptive statistics and logistic regression analysis were used to evaluate correlations between groups., Results: HIV-infected women with abnormal cervical cytology had 3.8 times more risk (adjusted odd ratio 3.846, 95% confidence interval 1.247-11.862, p-value. 019) for abnormal anal cytology. The major problem of the anal Pap test in this study was the inadequacy of the collected specimens for evaluation (34.4%, 206/599). Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of cervical and anal Pap tests were 93.9/12.0, 87.3/96.9, 39.7/21.4, 99.4/94.1 and 88.1/91.4 percent, respectively., Conclusions: Abnormal cervical cytology in HIV-infected women indicates elevated risk for abnormal anal cytology. The sensitivity of the anal Pap test for detection of AIL 2/3 in HIV-infected women was quite low while specificity was excellent. Inadequacy of specimen collection for evaluation was a major limitation. Improvement of sample collection is recommended for future investigations.
- Published
- 2015
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