Anal High-Grade Squamous Intraepithelial Lesions in Human Immunodeficiency Virus–Infected Men: A Study of 100 Cases With Emphasis on Cytohistologic Correlation. Issue 3 (26th February 2017)

• Record Type: Journal Article
• Authors: Liu, Yuxin; Wang, Xiaofei; Kalir, Tamara; Chhieng, David; Sigel, Keith; Gaisa, Michael M.
• Is Part Of: American journal of clinical pathology. Volume 147:Issue 3(2017)
• Page Start: 315
• Page End: 321
• Publication Date: 2017-02-26
• Subjects: Anorectal cytology -- HIV-infected MSM -- Anal high-grade squamous intraepithelial lesions; Diagnosis, Laboratory -- Periodicals; Pathology -- Periodicals; 616.07
• DOI: 10.1093/ajcp/aqw229
• Languages: English
• ISSNs: 0002-9173

Abstract

Abstract: Objectives: Anorectal cytology (ARC) is a widely used screening tool for anal cancer in human immunodeficiency virus (HIV)–infected men who have sex with men (MSM). Its diagnostic accuracy needs to be improved, especially for high-grade squamous intraepithelial lesions (HSILs). Methods: Using 100 HIV+ MSM with biopsy-proven anal HSILs, we correlated histologic/cytologic findings. Results: Upon review, HSIL cells were present in 58 cytology samples and absent in 42. Positive samples were higher in cellularity and contained transformation zones ( P < .05). Cytology was able to predict HSILs in 36%, 48%, 68%, and 78% of patients with one, two, three, and four or more high-grade lesions. HSIL cells were identified in all cytology samples initially reported as HSILs or atypical squamous cells, cannot exclude HSIL and in 34 samples reported as low-grade squamous intraepithelial lesions or less. Notably, among this last category, 15 (44%) were keratinized-type HSILs. Conclusions: Our findings should improve the ARC detection rate for anal HSILs, helping to implement ARC as the primary screening tool for anal cancer.