Patolojik servikal sitolojili kadınlardaki anal sitoloji pozitifliğinin analizi

Year 2022, Volume: 13 Issue: 47, 425 - 430, 15.12.2022

Mehmet Esat Duymuş , Zeynep Bayramoğlu , Hulya Ayik , Yusuf Murat Bag

https://doi.org/10.17944/mkutfd.1142816

Abstract

Amaç: Servikal sitoloji (SS) serviks kanserini azaltmak için kullanılan rutin bir tarama yöntemidir. Anal kanser ve serviks kanseri benzer etiyolojik faktörlere sahip olsa da anal kanser tarama programı hakkındaki görüş net değildir. Bizim bu çalışma ile amacımız; SS ile servikal neoplazi taraması yapılan kadınlardan anormal anal sitoloji (AS)’ye sahip olanlarının özelliklerini belirlemektir.

Yöntem: Toplam 205 kadın hastanın SS sonuçları incelendi. Normal SS’li hastalar dışlandı ve sonuçta 87 katılımcı çalışmaya dahil edildi. Demografik özellikleri, tıbbi, cinsel verileri ile reproduktif özellikleri analiz edildi.

Bulgular: Çalışma grubunun yaş ortalaması 40.77 ± 9.50 idi. AS 6 hasta (%6.9)’da patolojikti ve bunlardan 4 (%66.7)’ü yüksek dereceli skuamöz intraepitelyal lezyon (HSIL), 2 (%33.3)’si düşük dereceli skuamöz intraepitelyal lezyon (LSIL) idi. Bu hastaların SS sonuçları HSIL’di ve hepsinde human papillomavirus (HPV) pozitifti. En sık görülen tipi HPV 16 idi.

Sonuç: SS sonucu HSIL çıkan kadınlarda (özellikle eşlik eden HPV varlığında) AS pozitifliği daha riskli olabilir. Diğerlerinin ise AS sonuçlarının negatif çıkması muhtemeldir. AS kullanımı bu hasta grubu için anal intraepitelyal lezyonların erken teşhisinde (bir tarama aracı gibi) kullanılabilir.

Keywords

Servikal sitoloji, anal sitoloji, human papillomavirus

The analysis of anal cytology positivity in women with pathological cervical cytology

Abstract

Objective: Cervical cytology (CC) is a routine screening method used to reduce cervical cancer. Although anal cancer and cervical cancer have similar etiological factors the opinion about the anal cancer screening program is unclear. We aimed to determine the features of women with abnormal anal cytology (AC) who had screened via CC for cervical neoplasia.

Method: Two hundred and five females’ CC results were investigated. The patients with normal CC were excluded, finally 87 participants were included. The demographics, medical, sexual, and reproductive features, CC and AC results were analyzed.

Results: The study group had a mean age of 40.77 ± 9.50 years. AC was pathological in six patients (6.9%). Four of these (66.7%) were high-grade squamous intraepithelial lesions (HSIL) and two (33.3%) were low-grade squamous intraepithelial lesions (LSIL). The CC results of these patients were all HSIL, all of them were human papillomavirus (HPV) positive, with the most common type being 16 (83.3%).

Conclusion: Women with HSIL in CC (especially with concomitant HPV) may be riskier for AC positivity. The others are most likely to have negative AC results. The use of AC for early diagnosis of risky anal intraepithelial lesions (such as a screening tool) may be considered for this group of patients.

Keywords

Cervical cytology, anal cytology, human papillomavirus

References

• Shiels MS, Kreimer AR, Coghill AE, Darragh TM, Devesa SS. Anal Cancer Incidence in the United States, 1977-2011: Distinct Patterns by Histology and Behavior. Cancer Epidemiol Biomarkers Prev 2015;24(10):1548–56. https://doi. org/10.1158/1055-9965.EPI-15-0044.
• Palefsky JM. Anal human papillomavirus infection and anal cancer in HIV-positive individuals: an emerging problem. AIDS 1994;8(3):283-95. https://doi.org/10.1097/00002030-199403000-00001.
• Tseng HF, Morgenstern H, Mack TM, Peters RK. Risk factors for anal cancer: results of a population-based case–control study. Cancer Causes Control 2003;14(9):837-46. https://doi.org/10.1023/b:caco.0000003837.10664.7f.
• Moscicki AB, Schiffman M, Kjaer S, Villa LL. Updating the natural history of HPV and anogenital cancer. Vaccine 2006;24:S3/42–5 https://doi.org/10.1016/j.vaccine.2006.06.018.
• Valari O, Koliopoulos G, Karakitsos P, Valasoulis G, Founta C, Godevenos G, et al. Human papillomavirus DNA and mRNA positivity of the anal canal in women with lower genital tract HPV lesions, Predictors and Clinical Implications. Gynecol Oncol 2011;122(3):505-8. https://doi.org/10.1016/j. ygyno.2011.05.033.
• Joseph DA, Miller JW, Wu X, Chen VW, Morris CR, Goodman MT, et al. Understanding the burden of human papillomavirus associated anal cancers in the US. Cancer 2008;113(S10):2892-900. https://doi.org/10.1002/cncr.23744.
• Daling JR, Madeleine MM, Johnson LG, Schwartz SM, Shera KA, Wurscher MA, et al. Human papillomavirus, smoking, and sexual practices in the etiology of anal cancer. Cancer 2004;101(2):270-80. https://doi.org/10.1002/cncr.20365.
• Frisch M, Glimelius B, Van den Brule AJ, Wohlfahrt J, Meijer CJ, Walboomers JM, et al. Sexually transmitted infection as a cause of anal cancer. N Engl J Med 1997;337(19):1350-8. https://doi.org/10.1056/NEJM199711063371904.
• Holly EA, Ralston ML, Darragh TM, Greenblatt RM, Jay N, Palefsky JM. Prevalence and risk factors for anal squamous intraepithelial lesions in women. J Natl Cancer Inst 2001;93(11):843-9. https://doi.org/10.1093/jnci/93.11.843.
• Do Socorro NM, Jacyntho CM, Eleutério JJr, Giraldo PC, Gonçalves AK. Abnormal anal cytology risk in women with known genital squamous intraepithelial lesion. Braz J Infect Dis 2016;20(3):294-7. https://doi.org/10.1016/j.bjid.2016.01.008.
• Williams AB, Darragh TM, Vranizan K, Ochia C, Moss AR, Palefsky JM. Anal and cervical human papillomavirus infection and risk of anal and cervical epithelial abnormalities in human immunodeficiency virus-infected women. Obstet Gynecol 1994;83(2):205-11.
• Lammé J, Pattaratornkosohn T, Mercado-Abadie J, Alkhas A, Robinson A, Lanneau G. Concurrent anal human papillomavirus and abnormal anal cytology in women with known cervical dysplasia. Obstet Gynecol 2014;124(2pt1):242-8. https://doi.org/10.1097/AOG.0000000000000370.
• Slama J, Sehnal B, Dusek L, Zima T, Cibula D. Impact of risk factors on prevalence of anal HPV infection in women with simultaneous cervical lesion. Neoplasma 2015; 62(2):308-14. https://doi.org/10.4149/neo_2015_037.
• Luff R, Kurman R, Solomon D. The Bethesda system for reporting cervical/vaginal cytologic diagnoses. J Fam PracT 1992;35(1):98-101. PMID:1613480.
• Calore EE, Giaccio CM, Nadal SR. Prevalence of anal cytological abnormalities in women with positive cervical cytology. Diagn Cytopathol 2011;39(5):323-7. https://doi.org/10.1002/dc. 21386.
• Brum VDOR, Tricoti ADSO, Pannain GD, Drumond DG, Leite ICG. Cytology-based Screening for Anal Intraepithelial Neoplasia in Immunocompetent Brazilian Women with a History of High-Grade Cervical Intraepithelial Neoplasia or Cancer. Rev Bras de Ginecol Obstet 2022;44(7):678-85. https://doi.org/10.1055/s-0042-1743163.
• Hosseini MS, Khosravi D, Farzaneh F, Ebrahimi A, Arab M, Ganjoie TA, et al. Evaluation of Anal Cytology in Women with History of Abnormal Pap Smear, Cervical Intraepithelial Neoplasia, Cervical Cancer and High Risk HPV for Anogenital Dysplasia. Asian Pac J Cancer Prev 2018;19(11):3071-5. https://doi.org/10.31557/APJCP.2018.19.11.3071.
• Melbye M, Smith E, Wohlfahrt J, Osterlind A, Orholm M, Bergmann OJ, et al. Anal and cervical abnormality in women-prediction by human papillomavirus tests. Int J Cancer 1996;68(5):559-64. https://doi.org/10.1002/(SICI)1097-0215(19961127)68:5<559::AID-IJC1>3.0.CO;2-Y.
• Edgren G, Sparén P. Risk of anogenital cancer after diagnosis of cervical intraepithelial neoplasia: a prospective population-based study. Lancet Oncol 2007;8(4):311-16. https://doi. org/10.1016/S1470- 045(07)70043-8.
• Bräutigam K, Meier S, Meneder S, Proppe L, Stroschein K, Polack S, et al. Distribution of HPV Subtypes in Diverse Anogenital and Oral Samples from Women and Correlation of Infections with Neoplasia of the Cervix. Cancers 2022;14(13):3136. https://doi.org/: 10.3390/cancers14133136.