Oncogenic human papillomavirus is not helpful for cytology screening of the precursor lesions of anal cancers in Taiwanese men who are infected with human immunodeficiency virus

Shu Hsing Cheng, Chi Chao Wang, Shih Lung Chang, Fang Yeh Chu, Yu Mei Hsueh

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background: Homosexual men infected with human immunodeficiency virus (HIV) are at increased risk of developing anal cancer. The aim of this study was to assess the clinical sensitivity of anal cytology analysis and oncogenic human papillomavirus (HPV) detection for predicting histological anal intraepithelial neoplasia. Methods: Between March 2011 and December 2013, we enrolled 196 HIV-positive men in Taoyuan General Hospital, Taiwan. We analyzed the results of thin-preparation anal Pap smears, HPV genotyping, and histology of anoscopic biopsy samples. Results: The mean age (±standard deviation) was 31.43 (±8.74) years. The proportion (95 % confidence interval) with abnormal thin-preparation anal cytology was 36.2 % (29.8–43.2 %): 16.8 % (12.2–22.7 %) atypical squamous cells of undetermined significance, 14.8 % (10.5–20.4 %) low-grade squamous intraepithelial lesions, and 4.6 % (2.4–8.5 %) high-grade squamous intraepithelial lesions. At least one HPV genotype was detected in 90.8 % of subjects, and the mean number of HPV infection types was 4.41 (±3.24).The frequency of histological high-grade anal intraepithelial lesions was 7.14 % (95 % confidence interval 4.3–11.6 %). Anal cytology yielding atypical squamous cells of undetermined significance or higher grades resulted in a sensitivity of 64.3 %, specificity of 65.9 %, positive predictive value of 12.7 %, and negative predictive value of 96 %. Using both oncogenic HPV and cytology did not provide better performance. Conclusions: Anal cytology yielding atypical squamous cells of undetermined significance or higher grades could detect two-thirds of high-grade anal intraepithelial neoplasias in HIV-infected men and should be promoted for anal cancer prevention.

Original languageEnglish
Pages (from-to)943-951
Number of pages9
JournalInternational Journal of Clinical Oncology
Volume20
Issue number5
DOIs
Publication statusPublished - Feb 25 2015

Fingerprint

Anus Neoplasms
Cell Biology
HIV
Confidence Intervals
Papanicolaou Test
Papillomavirus Infections
Taiwan
General Hospitals
Neoplasms
Histology
Genotype
Biopsy
Sensitivity and Specificity
Atypical Squamous Cells of the Cervix

Keywords

  • Anal intraepithelial neoplasia
  • Human immunodeficiency virus (HIV)
  • Human papillomavirus (HPV)
  • Men who have sex with men
  • Squamous intraepithelial lesion

ASJC Scopus subject areas

  • Oncology
  • Surgery
  • Hematology

Cite this

Oncogenic human papillomavirus is not helpful for cytology screening of the precursor lesions of anal cancers in Taiwanese men who are infected with human immunodeficiency virus. / Cheng, Shu Hsing; Wang, Chi Chao; Chang, Shih Lung; Chu, Fang Yeh; Hsueh, Yu Mei.

In: International Journal of Clinical Oncology, Vol. 20, No. 5, 25.02.2015, p. 943-951.

Research output: Contribution to journalArticle

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abstract = "Background: Homosexual men infected with human immunodeficiency virus (HIV) are at increased risk of developing anal cancer. The aim of this study was to assess the clinical sensitivity of anal cytology analysis and oncogenic human papillomavirus (HPV) detection for predicting histological anal intraepithelial neoplasia. Methods: Between March 2011 and December 2013, we enrolled 196 HIV-positive men in Taoyuan General Hospital, Taiwan. We analyzed the results of thin-preparation anal Pap smears, HPV genotyping, and histology of anoscopic biopsy samples. Results: The mean age (±standard deviation) was 31.43 (±8.74) years. The proportion (95 {\%} confidence interval) with abnormal thin-preparation anal cytology was 36.2 {\%} (29.8–43.2 {\%}): 16.8 {\%} (12.2–22.7 {\%}) atypical squamous cells of undetermined significance, 14.8 {\%} (10.5–20.4 {\%}) low-grade squamous intraepithelial lesions, and 4.6 {\%} (2.4–8.5 {\%}) high-grade squamous intraepithelial lesions. At least one HPV genotype was detected in 90.8 {\%} of subjects, and the mean number of HPV infection types was 4.41 (±3.24).The frequency of histological high-grade anal intraepithelial lesions was 7.14 {\%} (95 {\%} confidence interval 4.3–11.6 {\%}). Anal cytology yielding atypical squamous cells of undetermined significance or higher grades resulted in a sensitivity of 64.3 {\%}, specificity of 65.9 {\%}, positive predictive value of 12.7 {\%}, and negative predictive value of 96 {\%}. Using both oncogenic HPV and cytology did not provide better performance. Conclusions: Anal cytology yielding atypical squamous cells of undetermined significance or higher grades could detect two-thirds of high-grade anal intraepithelial neoplasias in HIV-infected men and should be promoted for anal cancer prevention.",
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AU - Cheng, Shu Hsing

AU - Wang, Chi Chao

AU - Chang, Shih Lung

AU - Chu, Fang Yeh

AU - Hsueh, Yu Mei

PY - 2015/2/25

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N2 - Background: Homosexual men infected with human immunodeficiency virus (HIV) are at increased risk of developing anal cancer. The aim of this study was to assess the clinical sensitivity of anal cytology analysis and oncogenic human papillomavirus (HPV) detection for predicting histological anal intraepithelial neoplasia. Methods: Between March 2011 and December 2013, we enrolled 196 HIV-positive men in Taoyuan General Hospital, Taiwan. We analyzed the results of thin-preparation anal Pap smears, HPV genotyping, and histology of anoscopic biopsy samples. Results: The mean age (±standard deviation) was 31.43 (±8.74) years. The proportion (95 % confidence interval) with abnormal thin-preparation anal cytology was 36.2 % (29.8–43.2 %): 16.8 % (12.2–22.7 %) atypical squamous cells of undetermined significance, 14.8 % (10.5–20.4 %) low-grade squamous intraepithelial lesions, and 4.6 % (2.4–8.5 %) high-grade squamous intraepithelial lesions. At least one HPV genotype was detected in 90.8 % of subjects, and the mean number of HPV infection types was 4.41 (±3.24).The frequency of histological high-grade anal intraepithelial lesions was 7.14 % (95 % confidence interval 4.3–11.6 %). Anal cytology yielding atypical squamous cells of undetermined significance or higher grades resulted in a sensitivity of 64.3 %, specificity of 65.9 %, positive predictive value of 12.7 %, and negative predictive value of 96 %. Using both oncogenic HPV and cytology did not provide better performance. Conclusions: Anal cytology yielding atypical squamous cells of undetermined significance or higher grades could detect two-thirds of high-grade anal intraepithelial neoplasias in HIV-infected men and should be promoted for anal cancer prevention.

AB - Background: Homosexual men infected with human immunodeficiency virus (HIV) are at increased risk of developing anal cancer. The aim of this study was to assess the clinical sensitivity of anal cytology analysis and oncogenic human papillomavirus (HPV) detection for predicting histological anal intraepithelial neoplasia. Methods: Between March 2011 and December 2013, we enrolled 196 HIV-positive men in Taoyuan General Hospital, Taiwan. We analyzed the results of thin-preparation anal Pap smears, HPV genotyping, and histology of anoscopic biopsy samples. Results: The mean age (±standard deviation) was 31.43 (±8.74) years. The proportion (95 % confidence interval) with abnormal thin-preparation anal cytology was 36.2 % (29.8–43.2 %): 16.8 % (12.2–22.7 %) atypical squamous cells of undetermined significance, 14.8 % (10.5–20.4 %) low-grade squamous intraepithelial lesions, and 4.6 % (2.4–8.5 %) high-grade squamous intraepithelial lesions. At least one HPV genotype was detected in 90.8 % of subjects, and the mean number of HPV infection types was 4.41 (±3.24).The frequency of histological high-grade anal intraepithelial lesions was 7.14 % (95 % confidence interval 4.3–11.6 %). Anal cytology yielding atypical squamous cells of undetermined significance or higher grades resulted in a sensitivity of 64.3 %, specificity of 65.9 %, positive predictive value of 12.7 %, and negative predictive value of 96 %. Using both oncogenic HPV and cytology did not provide better performance. Conclusions: Anal cytology yielding atypical squamous cells of undetermined significance or higher grades could detect two-thirds of high-grade anal intraepithelial neoplasias in HIV-infected men and should be promoted for anal cancer prevention.

KW - Anal intraepithelial neoplasia

KW - Human immunodeficiency virus (HIV)

KW - Human papillomavirus (HPV)

KW - Men who have sex with men

KW - Squamous intraepithelial lesion

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