HPV Rectal lesions, diagnosis with anal PAP and high resolution anoscopy with biopsies
First series in Uruguay
Abstract
Introduction: the incidence of anal cáncer has doubled in the last decades. The HPV is the cause for the most frequent sexually transmitted disease in the world, and causes 90% of anal cancers.
This is the first time a protocol for screening rectoanal neoplasias is followed in Uruguay, using PAPs and high resolution anoscopies with biopsies.
Objetives: to describe rectoanal lesions associated with HPV in a population of patients belonging to risk groups with anal PAP (citology) and biopsies with high resolution anoscopy with aceto-whitening. To compare the diagnostic yield of anal PAP with histology in high resolution anoscopy with aceto-whitening guided biopsy samples (golden standard).
Method: we conducted a statistical description of the population studied. We conducted the agreement test (Kappa coefficient). Internal validity coefficients were calculated (sensitivity and specificity). The Epi-Info version 3.5.1 statistics package was used to process the information.
Results: 60 patients were considered for the study, average age was 33 years old, 78% were female. The Kappa coefficient for agreement between histology and the cell classification with PAP was 0.403, IC 95% (0.17-0.63). PAPA sensitivity was 92%, specificity was 46%.
Conclusion: the sensitivity of anal PAP we have found suggests it could be considered as a screening technique for the diagnosis of these lesions. Its scarce specificity suggests the need for confirmation with high resolution anoscopy with aceto-whitening guided biopsy in the future in the cases when PAP cytology is positive.
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