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11. Goldstone S: A stand against expectant management of anal dysplasia. Dis Colon Rectum; 2006 Oct;49(10):1648-9; author reply 1649-50
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] A stand against expectant management of anal dysplasia.
  • [MeSH-major] Anus Neoplasms / surgery. HIV Seropositivity / complications
  • [MeSH-minor] Anal Canal / pathology. Disease Progression. Humans. Treatment Outcome

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  • [CommentOn] Dis Colon Rectum. 2002 Apr;45(4):453-8 [12006924.001]
  • [CommentOn] Dis Colon Rectum. 2006 Jan;49(1):36-40 [16283561.001]
  • [CommentOn] Dis Colon Rectum. 2005 May;48(5):1042-54 [15868241.001]
  • (PMID = 16972138.001).
  • [ISSN] 0012-3706
  • [Journal-full-title] Diseases of the colon and rectum
  • [ISO-abbreviation] Dis. Colon Rectum
  • [Language] eng
  • [Publication-type] Comment; Letter
  • [Publication-country] United States
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12. Goldstone SE: High-resolution anoscopy is a crucial component of anal dysplasia screening. Dis Colon Rectum; 2010 Mar;53(3):364-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] High-resolution anoscopy is a crucial component of anal dysplasia screening.
  • [MeSH-major] Anus Diseases / epidemiology. HIV Infections / complications. Proctoscopy

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  • [CommentOn] Dis Colon Rectum. 2009 Jun;52(6):1130-6 [19581857.001]
  • (PMID = 20173491.001).
  • [ISSN] 1530-0358
  • [Journal-full-title] Diseases of the colon and rectum
  • [ISO-abbreviation] Dis. Colon Rectum
  • [Language] eng
  • [Publication-type] Comment; Letter
  • [Publication-country] United States
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13. Eckert L: Screening for anal dysplasia in women with cervical, vaginal, or vulvar dysplasia: yes, no, maybe? Obstet Gynecol; 2010 Sep;116(3):566-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Screening for anal dysplasia in women with cervical, vaginal, or vulvar dysplasia: yes, no, maybe?
  • [MeSH-major] Anus Neoplasms / diagnosis. Carcinoma in Situ / diagnosis. Genital Neoplasms, Female / complications

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  • [CommentOn] Obstet Gynecol. 2010 Sep;116(3):578-82 [20733438.001]
  • (PMID = 20733435.001).
  • [ISSN] 1873-233X
  • [Journal-full-title] Obstetrics and gynecology
  • [ISO-abbreviation] Obstet Gynecol
  • [Language] eng
  • [Publication-type] Comment; Editorial
  • [Publication-country] United States
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4. Gingelmaier A, Weissenbacher T, Kost B, Kaestner R, Sovric M, Mylonas I, Friese K, Bergauer F: Anal cytology as a screening tool for early detection of anal dysplasia in HIV-infected women. Anticancer Res; 2010 May;30(5):1719-23
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  • [Title] Anal cytology as a screening tool for early detection of anal dysplasia in HIV-infected women.
  • BACKGROUND AND AIM: HIV-infected patients show a high rate of anal dysplasia and anal carcinoma but there is no gold standard for early detection.
  • Therefore, the objectives of this prospective study were: a) evaluation of an anal screening using anal/perianal cytology;.
  • PATIENTS AND METHODS: In every HIV-infected woman visiting our gynaecological outpatient clinic, an anal and perianal swab for anal cytology was taken.
  • The results of 13 (13.5%) anal cytologies were classified as suspicious for low-grade or high-grade anal dysplasia and 6 of these were confirmed in an anal biopsy.
  • A total of 9 out of 13 also had a cervical dysplasia and 12 were positive for high-risk HPV at the cervix.
  • CONCLUSION: In this pilot study, anal screening using anal cytology showed 13.5% suspected anal dysplasia in HIV-infected women.
  • All performed biopsies revealed the presence of a high-grade anal lesion.
  • In summary, we found anal cytology to be a useful tool to early detect anal dysplasia of high-risk patients such as HIV-infected women.
  • How far this screening method contributes to the prevention of anal cancer has to be evaluated in further investigations.
  • [MeSH-major] Anal Canal / pathology. Anus Diseases / diagnosis. Anus Diseases / virology. Anus Neoplasms / diagnosis. Cytological Techniques / methods. HIV Infections / complications. HIV Infections / virology
  • [MeSH-minor] Adult. Biopsy. Cohort Studies. Female. Humans. Immune System. Middle Aged. Papillomavirus Infections / complications. Papillomavirus Infections / diagnosis. Papillomavirus Infections / virology. Prospective Studies. Uterine Cervical Neoplasms / complications. Uterine Cervical Neoplasms / diagnosis. Uterine Cervical Neoplasms / virology


15. Alvarez-Salas LM: Amolimogene bepiplasmid, a DNA-based therapeutic encoding the E6 and E7 epitopes from HPV, for cervical and anal dysplasia. Curr Opin Mol Ther; 2008 Dec;10(6):622-8
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  • [Title] Amolimogene bepiplasmid, a DNA-based therapeutic encoding the E6 and E7 epitopes from HPV, for cervical and anal dysplasia.
  • MGI Pharma Biologics is developing amolimogene bepiplasmid as a potential therapy for HPV-associated diseases, including cervical dysplasia.
  • In phase I and I/II clinical trials of ZYC-101 (the precursor of amolimogene bepiplasmid containing a single epitope from HPV-16 E7) in patients with cervical dysplasia and patients with anal dysplasia, ZYC-101 produced significant histological regression and was safe and well tolerated.
  • Results from this trial led to a phase II clinical trial of amolimogene bepiplasmid in patients with cervical dysplasia.
  • [MeSH-major] Anus Neoplasms / therapy. Cancer Vaccines / therapeutic use. Oncogene Proteins, Viral / immunology. Repressor Proteins / immunology. Uterine Cervical Dysplasia / therapy. Vaccines, DNA / therapeutic use

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  • (PMID = 19051140.001).
  • [ISSN] 1464-8431
  • [Journal-full-title] Current opinion in molecular therapeutics
  • [ISO-abbreviation] Curr. Opin. Mol. Ther.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Cancer Vaccines; 0 / E6 protein, Human papillomavirus type 16; 0 / Epitopes; 0 / Oncogene Proteins, Viral; 0 / Papillomavirus E7 Proteins; 0 / Repressor Proteins; 0 / Vaccines, DNA; 0 / amolimogene bepiplasmid; 0 / oncogene protein E7, Human papillomavirus type 16
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16. Sassone J, Schaefer W, Schwartz T, Valenti WM: Trends in HIV care, Part 1: new antiretrovirals, anal dysplasia, and reimbursement for diagnostic testing--a roundtable discussion. AIDS Read; 2008 Dec;18(12):615-21
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Trends in HIV care, Part 1: new antiretrovirals, anal dysplasia, and reimbursement for diagnostic testing--a roundtable discussion.
  • [MeSH-major] AIDS-Related Opportunistic Infections. Anti-Retroviral Agents / therapeutic use. Anus Diseases. Diagnostic Techniques and Procedures / economics. HIV Infections / diagnosis. Insurance, Health, Reimbursement. Papillomavirus Infections


17. Moran MG, Barkley TW Jr, Hughes CB: Screening and management of anal dysplasia and anal cancer in HIV-infected patients: a guide for practice. J Assoc Nurses AIDS Care; 2010 Sep-Oct;21(5):408-16
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  • [Title] Screening and management of anal dysplasia and anal cancer in HIV-infected patients: a guide for practice.
  • People living with HIV infection have a significantly higher rate of anal cancer as compared with that of uninfected people.
  • It is believed that high-grade anal dysplasia secondary to human papillomavirus infection is a precursor to anal cancer.
  • Considering this, screening and treatment of high-grade anal dysplasia is a possible means of preventing the development of anal cancer.
  • No national or international guidelines exist to guide practice for screening and management of anal dysplasia.
  • On the basis of a review of research and expert recommendations, a guide to practice for screening and management of anal dysplasia and anal cancer is made for clinicians.
  • [MeSH-major] Anus Neoplasms / complications. HIV Infections / complications

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  • [Copyright] (c) 2010 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.
  • (PMID = 20409734.001).
  • [ISSN] 1552-6917
  • [Journal-full-title] The Journal of the Association of Nurses in AIDS Care : JANAC
  • [ISO-abbreviation] J Assoc Nurses AIDS Care
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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18. Cranston RD, Hart SD, Gornbein JA, Hirschowitz SL, Cortina G, Moe AA: The prevalence, and predictive value, of abnormal anal cytology to diagnose anal dysplasia in a population of HIV-positive men who have sex with men. Int J STD AIDS; 2007 Feb;18(2):77-80
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  • [Title] The prevalence, and predictive value, of abnormal anal cytology to diagnose anal dysplasia in a population of HIV-positive men who have sex with men.
  • Due to the increasing incidence of anal cancer in HIV-positive men who have sex with men, and the potential to detect and treat high-grade anal dysplasia--the putative anal cancer precursor--we have introduced an anal cytology screening service.
  • Patients with abnormal anal cytology have follow-up high-resolution anoscopy (HRA) with biopsy of lesions clinically suspicious for high-grade dysplasia.
  • One hundred and sixty-four (67%) men had abnormal anal cytology, and 93 of them had follow-up HRA and anal biopsy.
  • The positive predictive value for any anal cytological abnormality to predict any degree of anal dysplasia was 95.7+/-2.1%, and for any anal cytological abnormality to predict high-grade anal dysplasia was 55.9+/-5.1%.
  • Abnormal anal cytology was highly predicative of anal dysplasia on biopsy.
  • [MeSH-major] Anal Canal / pathology. Anus Neoplasms. Carcinoma, Squamous Cell. HIV Infections / complications. Homosexuality, Male
  • [MeSH-minor] AIDS-Related Opportunistic Infections / diagnosis. AIDS-Related Opportunistic Infections / epidemiology. Adult. Aged. Biopsy. Cytological Techniques. Humans. Male. Middle Aged. Predictive Value of Tests. Prevalence

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  • (PMID = 17331275.001).
  • [ISSN] 0956-4624
  • [Journal-full-title] International journal of STD & AIDS
  • [ISO-abbreviation] Int J STD AIDS
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
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19. Nahas CS, da Silva Filho EV, Segurado AA, Genevcius RF, Gerhard R, Gutierrez EB, Marques CF, Cecconello I, Nahas SC: Screening anal dysplasia in HIV-infected patients: is there an agreement between anal pap smear and high-resolution anoscopy-guided biopsy? Dis Colon Rectum; 2009 Nov;52(11):1854-60
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  • [Title] Screening anal dysplasia in HIV-infected patients: is there an agreement between anal pap smear and high-resolution anoscopy-guided biopsy?
  • PURPOSE: The purpose of this study was to analyze the agreement between anal Pap smear and high-resolution anoscopy-guided biopsy in diagnosing anal dysplasia in HIV-infected patients.
  • METHODS: We conducted cross-sectional analysis of HIV-infected patients receiving anal dysplasia screening as part of routine care.
  • Agreement between measures was estimated by weighted kappa statistics, using a three-tiered cytologic and histologic grading system (normal, low-grade dysplasia, and high-grade dysplasia).
  • Estimates of sensitivity, specificity, and predictive values were calculated using a two-tiered cytologic and histologic grading system ("without dysplasia" and "with dysplasia of any grade").
  • Estimates were also calculated for the detection of high-grade dysplasia.
  • RESULTS: During a one-year period, 222 patients underwent 330 anal Pap smears followed by high-resolution anoscopy-guided biopsies.
  • Considering histology the standard, the frequency of anal dysplasia was 46%.
  • Kappa agreement between anal Pap smear and biopsy was 0.20.
  • For detection of anal dysplasia of any grade, anal Pap smear showed sensitivity of 61%, specificity of 60%, positive predictive value of 56%, and negative predictive value of 64%.
  • For high-grade dysplasia, anal Pap smear showed sensitivity of 16% and specificity of 97%.
  • CONCLUSION: Anal Pap smears alone were not sensitive enough to rule out anal dysplasia.
  • We recommend that high-resolution anoscopy-guided biopsy be incorporated as a complementary screening test for anal dysplasia in high-risk patients.
  • Following baseline high-resolution anoscopy, these individuals could be followed with serial anal cytology to dictate the need for future high-resolution anoscopy-guided biopsies.
  • [MeSH-major] Anal Canal / pathology. Anus Diseases / diagnosis. Cytodiagnosis / methods. HIV Seropositivity / pathology

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  • [CommentIn] Dis Colon Rectum. 2009 Nov;52(11):1860-3 [19966633.001]
  • (PMID = 19966632.001).
  • [ISSN] 1530-0358
  • [Journal-full-title] Diseases of the colon and rectum
  • [ISO-abbreviation] Dis. Colon Rectum
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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20. Gohy L, Gorska I, Rouleau D, Ghattas G, Pokomandy Ad, Vézina S, Coté P, Macleod J, Allaire G, Hadjeres R, Kornegay JR, Franco E, HIPVIRG Study Group, Coutlée F: Genotyping of human papillomavirus DNA in anal biopsies and anal swabs collected from HIV-seropositive men with anal dysplasia. J Acquir Immune Defic Syndr; 2008 Sep 1;49(1):32-9
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  • [Title] Genotyping of human papillomavirus DNA in anal biopsies and anal swabs collected from HIV-seropositive men with anal dysplasia.
  • BACKGROUND: Human papillomavirus (HPV) causes anal intraepithelial neoplasia (AIN) in HIV-seropositive men.
  • The detection of HPV genotypes in anal biopsies and swabs was compared.
  • METHODS: HPV DNA was detected in anal swabs and biopsies obtained concurrently from 154 HIV-seropositive men [31 without AIN, 60 low-grade AIN (AIN-1), 62 high-grade AIN (AIN-2,3), and 1 indeterminate AIN] under or eligible to highly active antiretroviral therapy.
  • RESULTS: HPV DNA was detected in 24.2% of normal biopsies compared with 93.5% with AIN-2,3 (P < 0.001) and 88.3% with AIN-1 (P < 0.001).
  • The proportion of biopsies containing multiple genotypes was greater in AIN-1 (n = 21, 35.0%; P = 0.002) and AIN-2,3 (n = 38, 58%; P < 0.001) than in normal biopsies (n = 2, 6.5%).
  • The most frequent genotypes in order of frequency were in AIN-2,3 biopsies HPV-16, 18, 58, and 45 and were in AIN-1 biopsies HPV-6, 11, 16, and 39.
  • Controlling for age, CD4 count, and smoking, the presence of high-risk HPV DNA in biopsies [odds ratio (OR) = 50.8, 95% confidence interval (CI): 13.0 to 199.5] but not in swabs (OR = 2.0, 95% CI: 0.6 to 7.0) was associated with AIN-2,3.
  • CONCLUSIONS: AIN-2,3 was associated with high-risk HPV infection detected in biopsies but not in swabs in men under or starting highly active antiretroviral therapy, possibly due to the presence of HPV foci outside of the neoplastic lesion.
  • [MeSH-major] Alphapapillomavirus / genetics. Anus Diseases / virology. Carcinoma in Situ / complications. Carcinoma in Situ / virology. DNA, Viral. HIV Seropositivity / virology

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  • (PMID = 18667921.001).
  • [ISSN] 1525-4135
  • [Journal-full-title] Journal of acquired immune deficiency syndromes (1999)
  • [ISO-abbreviation] J. Acquir. Immune Defic. Syndr.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / DNA, Viral
  • [Investigator] OAllaire G; Baril JG; Boissonnault M; Charest L; Charron MA; Cote S; Cote P; Coutlee F; de Pokomandy A; Dion H; Dufresne S; Falutz J; Fortin C; Franco E; Ghattas G; Gilmore N; Gorska I; Hadjeres R; Junod P; Klein M; Lalonde R; Laplante F; Leblanc R; Legault D; Lessard B; Longpre D; Mcleod J; Maziade JP; Murphy D; Nguyen VK; O'Brien R; Phaneuf D; Rouleau D; Routy JP; Szabo J; Tessier D; Thomas R; Toma E; Tremblay C; Trepanier JM; Trottier B; Tsoukas C; Turner H; Vezina S
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21. Cranston RD, Hirschowitz SL, Cortina G, Moe AA: A retrospective clinical study of the treatment of high-grade anal dysplasia by infrared coagulation in a population of HIV-positive men who have sex with men. Int J STD AIDS; 2008 Feb;19(2):118-20
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  • [Title] A retrospective clinical study of the treatment of high-grade anal dysplasia by infrared coagulation in a population of HIV-positive men who have sex with men.
  • HIV-positive men who have sex with men (MSM) are at high risk of developing human papillomavirus-associated anal squamous cell cancer.
  • Similar to the management of cervical dysplasia, clinicians are treating high-grade anal dysplasia to prevent progression to cancer.
  • Infrared coagulation (IRC) is an outpatient treatment for high-grade anal dysplasia.
  • This retrospective clinical study reports on 68 HIV-positive MSM with 78 biopsy proven high-grade anal lesions.
  • Of the 74 evaluable lesions; 39 had anal intraepithelial neoplasia (AIN) 1, 20 had AIN 2, seven had AIN 3, and eight had normal epithelium.
  • The IRC showed 64% efficacy per treated lesion and shows promise as a treatment modality for high-grade anal dysplasia in this population.
  • [MeSH-major] Anus Diseases / pathology. Anus Diseases / radiotherapy. Anus Neoplasms / prevention & control. HIV Infections / complications. HIV Seropositivity / complications. Homosexuality, Male. Infrared Rays / therapeutic use

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  • (PMID = 18334066.001).
  • [ISSN] 0956-4624
  • [Journal-full-title] International journal of STD & AIDS
  • [ISO-abbreviation] Int J STD AIDS
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article
  • [Publication-country] England
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22. Ogilvie JW Jr, Park IU, Downs LS, Anderson KE, Hansberger J, Madoff RD: Anal dysplasia in kidney transplant recipients. J Am Coll Surg; 2008 Dec;207(6):914-21
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  • [Title] Anal dysplasia in kidney transplant recipients.
  • BACKGROUND: Although the risk of anal cancer in immunosuppressed individuals is significantly higher than in the general population, methods for detecting precancerous anal dysplasia have not been well studied in solid-organ transplant recipients.
  • We sought to identify the incidence of anal dysplasia in kidney transplant recipients and associated factors that increase the likelihood of dysplasia.
  • We interviewed willing participants and performed anal cytology sampling and high-resolution anoscopy; if we found microscopic abnormalities, we performed biopsies.
  • We used univariate analysis to measure the association between variables and anal dysplasia.
  • Their median duration of immunosuppression was 5.6 years; 23 (59%) had fewer than 5 lifetime sexual partners, and 2 (5%) reported ever practicing anal intercourse.
  • Of all cytology specimens, 35 (88%) had sufficient cells for interpretation and 2 (6%) demonstrated dysplasia.
  • We performed biopsies in 11 patients; 6 had dysplasia (4 low-grade, 2 high-grade).
  • Of these patients, five had normal anal cytology.
  • The sensitivity of cytology to predict histologic evidence of dysplasia was 17%.
  • Overall, seven (18%) had dysplasia according to either cytology or histology specimens; two (5%) had high-grade dysplasia.
  • We found no significant associations between the tested variables and the presence of dysplasia.
  • CONCLUSIONS: A significant proportion of kidney transplant recipients harbor anal dysplasia.
  • One time anal cytology sampling was not predictive of histologic findings.
  • Although these findings confirm their high risk for dysplasia, a larger sample is required to more accurately quantify risk factors for dysplasia and progression to cancer.
  • [MeSH-major] Anus Neoplasms / immunology. Immunocompromised Host. Immunosuppressive Agents / adverse effects. Kidney Transplantation. Precancerous Conditions / immunology
  • [MeSH-minor] Anal Canal / pathology. Anus Diseases / immunology. Anus Diseases / pathology. Female. Humans. Male. Middle Aged. Prospective Studies

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  • (PMID = 19183539.001).
  • [ISSN] 1879-1190
  • [Journal-full-title] Journal of the American College of Surgeons
  • [ISO-abbreviation] J. Am. Coll. Surg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Immunosuppressive Agents
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23. Patel HS, Silver AR, Levine T, Williams G, Northover JM: Human papillomavirus infection and anal dysplasia in renal transplant recipients. Br J Surg; 2010 Nov;97(11):1716-21
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  • [Title] Human papillomavirus infection and anal dysplasia in renal transplant recipients.
  • BACKGROUND: Immunosuppression is a known risk factor for anal human papillomavirus (HPV) disease, including anal squamous cell carcinoma.
  • The demographics of anal HPV and associated risk factors were investigated in this population.
  • METHODS: Anal cytology and polymerase chain reaction were used to assess anal HPV disease in a cohort of transplant recipients at the Royal London Hospital.
  • Risk factors associated with increased immunosuppression and HPV exposure were collated to determine any association with anal disease.
  • RESULTS: Anal dysplasia was associated with anal oncogenic HPV infection (P < 0.001), duration of immunosuppression (P = 0.050), previous genital warts (P = 0.018) and receptive anal intercourse (P = 0.013).
  • CONCLUSION: Anal dysplasia was related to immunosuppression and patient factors in this cohort.
  • [MeSH-major] Anal Canal / pathology. Anus Neoplasms / etiology. Carcinoma, Squamous Cell / etiology. Immunosuppression / adverse effects. Kidney Transplantation. Papillomavirus Infections / complications

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  • [Copyright] Copyright © 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
  • (PMID = 20730855.001).
  • [ISSN] 1365-2168
  • [Journal-full-title] The British journal of surgery
  • [ISO-abbreviation] Br J Surg
  • [Language] eng
  • [Grant] United Kingdom / Cancer Research UK / /
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 9007-49-2 / DNA
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24. Pineda CE, Berry JM, Jay N, Palefsky JM, Welton ML: High resolution anoscopy in the planned staged treatment of anal squamous intraepithelial lesions in HIV-negative patients. J Gastrointest Surg; 2007 Nov;11(11):1410-5; discussion 1415-6
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  • [Title] High resolution anoscopy in the planned staged treatment of anal squamous intraepithelial lesions in HIV-negative patients.
  • Anal dysplasia (low-grade squamous intraepithelial lesions, LSIL; high-grade squamous intraepithelial lesions, HSIL) is a challenging disease for the surgeon.
  • We reviewed 42 patients that underwent high-resolution anoscopy (HRA)-targeted surgical therapy of anal dysplasia in the past 10 years.
  • Patients were followed up in the Anal Neoplasia Clinic with physical examination, cytology, HRA, and biopsy if indicated.
  • Progression to HSIL was seen in one patient with LSIL and to squamous cell carcinoma in one patient with HSIL despite therapy.
  • No patients with LSIL had dysplasia at last follow-up.
  • HRA-targeted surgical therapy coupled with surveillance and re-treatment with office-based therapies offered an effective method in controlling anal dysplasia in the immunocompetent patient.
  • [MeSH-major] Anus Neoplasms / surgery. Carcinoma in Situ / surgery. Carcinoma, Squamous Cell / surgery

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  • (PMID = 17710507.001).
  • [ISSN] 1091-255X
  • [Journal-full-title] Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
  • [ISO-abbreviation] J. Gastrointest. Surg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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25. Kreuter A, Brockmeyer NH, Wieland U: [Anal intraepithelial neoplasia and anal carcinoma: an increasing problem in HIV patients]. Hautarzt; 2010 Jan;61(1):21-6
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  • [Title] [Anal intraepithelial neoplasia and anal carcinoma: an increasing problem in HIV patients].
  • [Transliterated title] Anale intraepitheliale Neoplasie und Analkarzinom : Ein zunehmendes Problem bei Menschen mit HIV-Infektion.
  • Anal dysplasia is common in HIV patients, especially in HIV-positive men having sex with men (MSM).
  • High-grade anal dysplasia can progress to invasive anal cancer.
  • As in cervical carcinoma, there is a cause and effect relationship between anal cancer and human papillomavirus (HPV) infection, especially with high-risk types such as HPV16.
  • Several experts have recommended screening programs for anal cancer, including anal cytology along the lines of the Pap smear in women.
  • Clinical inspection, lesion biopsy, and treatment of anal dysplasia are performed under high-resolution anoscopy.
  • Anal cancer is divided into cancer of the anal margin and cancer of the anal canal.
  • Early cancer of the anal margin is excised akin to squamous cell cancer of the exposed skin, whereas cancer of the anal canal is treated by radiochemotherapy.
  • Physicians working in the field of HIV/AIDS should regularly screen their patients for the presence of anal dysplasia and anal cancer.
  • Basic diagnostic workup includes clinical inspection of the perianal area, digital rectal examination, and anal cytology.
  • [MeSH-major] Anus Neoplasms / diagnosis. Anus Neoplasms / prevention & control. Carcinoma in Situ / virology. HIV Infections / complications. Precancerous Conditions / diagnosis. Precancerous Conditions / prevention & control

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  • (PMID = 19967333.001).
  • [ISSN] 1432-1173
  • [Journal-full-title] Der Hautarzt; Zeitschrift für Dermatologie, Venerologie, und verwandte Gebiete
  • [ISO-abbreviation] Hautarzt
  • [Language] ger
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Germany
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26. Ho KS, Cranston RD: Anal cytology screening in HIV-positive men who have sex with men: what's new and what's now? Curr Opin Infect Dis; 2010 Feb;23(1):21-5
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  • [Title] Anal cytology screening in HIV-positive men who have sex with men: what's new and what's now?
  • PURPOSE OF REVIEW: This review will discuss current and future anal cytology screening programs to detect anal dysplasia in HIV-positive men who have sex with men (MSM), in addition to other interventions aimed at early detection of anal cancer in this population.
  • RECENT FINDINGS: Evidence of progression from high-grade anal dysplasia to anal cancer has been recently demonstrated and strengthens the clinical imperative to diagnose and treat this lesion in at-risk populations.
  • The use of adjunct molecular techniques that improve specificity of anal cytology screening may have the potential to rationalize current screening referral pathways and focus resources on those at highest risk of progressing to cancer.
  • SUMMARY: Anal cytology, although sensitive for the detection of any anal dysplastic abnormality, has poor specificity to detect high-grade anal dysplasia.
  • As new molecular techniques are evolving, the most important immediate clinical intervention is to educate HIV-positive MSM in order to increase awareness of both risk and clinical symptoms suggestive of progression to anal cancer.
  • [MeSH-major] Anal Canal / pathology. Anus Neoplasms / pathology. Anus Neoplasms / virology. Early Detection of Cancer / methods. HIV Infections / pathology. Homosexuality, Male

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  • (PMID = 19935419.001).
  • [ISSN] 1473-6527
  • [Journal-full-title] Current opinion in infectious diseases
  • [ISO-abbreviation] Curr. Opin. Infect. Dis.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 46
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27. Chiao EY, Giordano TP, Palefsky JM, Tyring S, El Serag H: Screening HIV-infected individuals for anal cancer precursor lesions: a systematic review. Clin Infect Dis; 2006 Jul 15;43(2):223-33
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Screening HIV-infected individuals for anal cancer precursor lesions: a systematic review.
  • Individuals with human immunodeficiency virus (HIV) infection are at increased risk for human papillomavirus-related squamous cell cancer of the anus.
  • Screening HIV-infected patients for squamous cell cancer of the anus and human papillomavirus-related anal dysplasia may prevent excess morbidity and mortality.
  • We have conducted a systematic review of the indirect evidence in the literature regarding the utility of anal Papanicolau (Pap) smear screening of HIV-infected individuals in the highly active antiretroviral therapy era.
  • Although there are no published studies evaluating the efficacy of anal Pap smear screening for preventing squamous cell cancer of the anus or anal intraepithelial neoplasia, we reviewed data regarding the burden of disease, anal Pap smear sensitivity and specificity, the prevalence of anal dysplasia, and 1 cost effectiveness study.
  • The available evidence demonstrates that HIV-infected individuals have an increased risk for squamous cell cancer of the anus and anal intraepithelial neoplasia.
  • This review identifies important areas for further study before routine anal Pap smear screening can be recommended.
  • [MeSH-major] Anus Neoplasms / diagnosis. Carcinoma, Squamous Cell / diagnosis. HIV Infections / complications. Papanicolaou Test. Papillomavirus Infections / diagnosis. Precancerous Conditions / diagnosis. Vaginal Smears
  • [MeSH-minor] Antiretroviral Therapy, Highly Active. Carcinoma in Situ / diagnosis. Carcinoma in Situ / etiology. Female. Humans. Male. Mass Screening. Papillomaviridae


28. Greenberg R, Greenwald B, Roth JS, Ioffe O, Cross R: Squamous dysplasia of the rectum in a patient with ulcerative colitis treated with 6-mercaptopurine. Dig Dis Sci; 2008 Mar;53(3):760-4
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  • [Title] Squamous dysplasia of the rectum in a patient with ulcerative colitis treated with 6-mercaptopurine.
  • Human papilloma virus (HPV) has been found to be a precursor and risk factor for both cervical and anal dysplasia.
  • Cervical dysplasia, which is the precursor to carcinoma, is associated with immunosuppression from a variety of causes; reports of anal dysplasia associated with immune suppression exist as well.
  • A recent study published in abstract form only demonstrated that women with inflammatory bowel disease (IBD) had high rates of cervical dysplasia and that those on immune suppressants had even higher rates of dysplasia.
  • We report a case of a 50-year-old woman with refractory ulcerative colitis chronically treated with 6-mercaptopurine that developed severe squamous dysplasia of the rectum.
  • This case highlights the importance of immune suppression in the development of dysplasia of the anus/cervix secondary to HPV infection.
  • [MeSH-major] 6-Mercaptopurine / adverse effects. Colitis, Ulcerative / drug therapy. Immunosuppressive Agents / adverse effects. Neoplasms, Squamous Cell / chemically induced. Rectal Neoplasms / chemically induced

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  • (PMID = 17717741.001).
  • [ISSN] 0163-2116
  • [Journal-full-title] Digestive diseases and sciences
  • [ISO-abbreviation] Dig. Dis. Sci.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Immunosuppressive Agents; E7WED276I5 / 6-Mercaptopurine
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29. Pitts MK, Fox C, Willis J, Anderson J: What do gay men know about human papillomavirus? Australian gay men's knowledge and experience of anal cancer screening and human papillomavirus. Sex Transm Dis; 2007 Mar;34(3):170-3
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] What do gay men know about human papillomavirus? Australian gay men's knowledge and experience of anal cancer screening and human papillomavirus.
  • OBJECTIVE: The objective of this study was to determine levels of experience and knowledge concerning anal dysplasia, anal Pap smear tests, and human papillomavirus (HPV) among gay and other homosexually active men.
  • On a range of measures, it was clear that the men knew very little about anal cancer (19% scored zero on a 12-point knowledge scale) and virtually nothing about HPV (47% scored zero on an 8-point knowledge scale).
  • A total of 55.1% had never heard of an anal Pap smear and 44.8% had ever heard of HPV; 56.4% did not know whether it affected men and/or women.
  • CONCLUSIONS: The test for anal dysplasia is still largely unknown among Australian gay men and they currently have poor sense of personal susceptibility to the disease.
  • [MeSH-major] Anus Neoplasms / prevention & control. Carcinoma in Situ / prevention & control. Health Knowledge, Attitudes, Practice. Homosexuality, Male / psychology. Papillomaviridae. Papillomavirus Infections / prevention & control

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  • (PMID = 16837830.001).
  • [ISSN] 0148-5717
  • [Journal-full-title] Sexually transmitted diseases
  • [ISO-abbreviation] Sex Transm Dis
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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30. Kreuter A, Wieland U: Human papillomavirus-associated diseases in HIV-infected men who have sex with men. Curr Opin Infect Dis; 2009 Apr;22(2):109-14
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • This review summarizes recent data on papillomavirus-induced anal intraepithelial neoplasia and anal cancer in these patients.
  • RECENT FINDINGS: The incidence of anal intraepithelial neoplasia rises in HIV-positive men who have sex with men despite the introduction of highly active antiretroviral therapy.
  • Increasing evidence indicates that high-grade lesions can progress to anal cancer over time.
  • Anal cytology has been recommended as the primary screening tool for anal dysplasia in the at-risk population.
  • Anal cancer has become one of the most common non-AIDS-defining tumors in HIV-infected individuals.
  • In the era of highly active antiretroviral therapy, the outcome of combined chemoradiotherapy in HIV-positive individuals with anal cancer is similar to that in HIV-negative persons.
  • SUMMARY: Diagnostic and therapeutic guidelines should be implemented for at-risk populations for anal dysplasia/anal cancer, such as HIV-positive men who have sex with men.
  • [MeSH-major] Anus Neoplasms / epidemiology. Anus Neoplasms / virology. HIV Infections / complications. Papillomaviridae / isolation & purification. Papillomavirus Infections / complications. Papillomavirus Infections / epidemiology

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  • (PMID = 19276878.001).
  • [ISSN] 1473-6527
  • [Journal-full-title] Current opinion in infectious diseases
  • [ISO-abbreviation] Curr. Opin. Infect. Dis.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 40
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31. Stier EA, Goldstone SE, Berry JM, Panther LA, Jay N, Krown SE, Lee J, Palefsky JM: Infrared coagulator treatment of high-grade anal dysplasia in HIV-infected individuals: an AIDS malignancy consortium pilot study. J Acquir Immune Defic Syndr; 2008 Jan 1;47(1):56-61
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  • [Title] Infrared coagulator treatment of high-grade anal dysplasia in HIV-infected individuals: an AIDS malignancy consortium pilot study.
  • OBJECTIVE: To evaluate prospectively the safety of the infrared coagulator (IRC) as a treatment for anal high-grade squamous intraepithelial lesions (HSILs) in HIV-infected individuals and to seek preliminary evidence for efficacy.
  • METHODS: HIV-infected patients with </=3 biopsy-proven internal anal HSILs received office-based treatment with the IRC at participating AIDS Malignancy Consortium sites.
  • Patients were evaluated every 3 months for a year with anal cytology and HRA with biopsy.
  • Twelve patients reported mild or moderate anal/rectal pain or bleeding.
  • CONCLUSIONS: The IRC is a well-tolerated method of treating discrete anal canal HSILs in HIV-infected patients.
  • [MeSH-major] Anus Neoplasms / therapy. HIV Infections / complications. Infrared Rays. Phototherapy. Precancerous Conditions / therapy

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  • (PMID = 18156992.001).
  • [ISSN] 1525-4135
  • [Journal-full-title] Journal of acquired immune deficiency syndromes (1999)
  • [ISO-abbreviation] J. Acquir. Immune Defic. Syndr.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / U01CA070047; United States / NCI NIH HHS / CA / U01CA071375; United States / NCI NIH HHS / CA / U01CA121947; United States / NCI NIH HHS / CA / U01CA70019; United States / NCI NIH HHS / CA / U01CA70054
  • [Publication-type] Journal Article; Multicenter Study; Research Support, N.I.H., Extramural
  • [Publication-country] United States
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32. Kreuter A, Jesse M, Potthoff A, Brockmeyer NH, Gambichler T, Stücker M, Bechara FG, Pfister H, Wieland U: Expression of proliferative biomarkers in anal intraepithelial neoplasia of HIV-positive men. J Am Acad Dermatol; 2010 Sep;63(3):490-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Expression of proliferative biomarkers in anal intraepithelial neoplasia of HIV-positive men.
  • BACKGROUND: Anal intraepithelial neoplasia (AIN), a human papillomavirus (HPV)-associated precursor lesion of anal carcinoma, is highly prevalent among HIV-infected individuals, especially in men having sex with men (MSM).
  • Early diagnosis and treatment of AIN might prevent development of anal cancer.
  • OBJECTIVES: We aimed to evaluate the expression of 8 promising proliferative biomarkers in anal dysplasia and to compare the efficacy of these markers in diagnosing high-grade AIN.
  • METHODS: Immunohistochemical analysis of minichromosome maintenance proteins (MCM3, MCM4, MCM6, and MCM7), p21, Ki-67, p16, and proliferating cell nuclear antigen (PCNA) was performed in a total of 49 specimens of normal anal mucosa and high- and low-grade anal dysplasia.
  • In the progression from normal epithelium to high-grade dysplasia, we found significant differences in the expression of all biomarkers.
  • A cutoff of 25% or 50% lesional immunopositivity for the 4 MCMs, Ki-67, and p16 resulted in 100% sensitivity and 100% specificity to diagnose high-grade AIN.
  • Sensitivity and specificity of PCNA and p21 for a high-grade AIN diagnosis were lower.
  • HPV-DNA was detectable in 100% of high-grade AIN and 87.5% of low-grade AIN lesions.
  • CONCLUSIONS: MCMs, Ki67, and p16 are reliable immunohistochemical adjuncts for diagnosing high-grade AIN.
  • [MeSH-major] Anus Neoplasms / pathology. Biomarkers, Tumor / analysis. Carcinoma in Situ / pathology. HIV Infections / diagnosis. Proliferating Cell Nuclear Antigen / metabolism
  • [MeSH-minor] Adult. Aged. Analysis of Variance. Antiretroviral Therapy, Highly Active / methods. Biopsy, Needle. DNA, Viral / analysis. HIV Seropositivity. Homosexuality, Male. Humans. Immunohistochemistry. Intestinal Mucosa / metabolism. Intestinal Mucosa / pathology. Male. Middle Aged. Neoplasm Staging. Papillomavirus Infections / complications. Papillomavirus Infections / diagnosis. Polymerase Chain Reaction / methods. Precancerous Conditions / pathology. Reference Values. Risk Assessment. Sensitivity and Specificity. Viral Load. Young Adult

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  • [Copyright] Copyright 2009 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.
  • (PMID = 20006407.001).
  • [ISSN] 1097-6787
  • [Journal-full-title] Journal of the American Academy of Dermatology
  • [ISO-abbreviation] J. Am. Acad. Dermatol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / DNA, Viral; 0 / Proliferating Cell Nuclear Antigen
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33. Truesdale MD, Goldstone SE: The fear factor: drivers and barriers to follow-up screening for human papillomavirus-related anal cancer in men who have sex with men. Int J STD AIDS; 2010 Jul;21(7):482-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The fear factor: drivers and barriers to follow-up screening for human papillomavirus-related anal cancer in men who have sex with men.
  • Human papillomavirus (HPV)-related anal cancer incidence is rising in men who have sex with men (MSM).
  • Retrospective chart review identified MSM with anal dysplasia.
  • Questionnaires were completed after anal dysplasia diagnosis.
  • RF were more likely to describe their HPV diagnosis as 'upsetting' (P = 0.003).
  • MSM with high-grade intraepithelial lesions (HSIL) were more likely to be RF versus those with low-grade intraepithelial lesions (P = 0.001.
  • Positive predictors for screening compliance include an upsetting experience during the HPV diagnosis, physical symptoms driving the initial visit and HSIL.
  • [MeSH-major] Anus Neoplasms / diagnosis. Anus Neoplasms / psychology. Early Detection of Cancer / psychology. Homosexuality, Male. Papillomavirus Infections / diagnosis. Patient Compliance / statistics & numerical data

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  • (PMID = 20852198.001).
  • [ISSN] 1758-1052
  • [Journal-full-title] International journal of STD & AIDS
  • [ISO-abbreviation] Int J STD AIDS
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
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34. Pineda CE, Berry JM, Welton ML: High resolution anoscopy and targeted treatment of high-grade squamous intraepithelial lesions. Dis Colon Rectum; 2006 Jan;49(1):126
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  • [Title] High resolution anoscopy and targeted treatment of high-grade squamous intraepithelial lesions.
  • PURPOSE: The purpose of this video is to illustrate the use of high resolution anoscopy in the diagnosis and treatment of anal high-grade squamous intraepithelial lesions.
  • METHODS: Five patients with anal dysplasia were examined in the operating room with acetic acid and the operative microscope.
  • Acetic acid is generously applied to aide in the recognition of high-grade squamous intraepithelial lesions.
  • Acetowhite regions are examined under the operative microscope to further distinguish lesions as either low-grade squamous intraepithelial lesions or high-grade squamous intraepithelial lesions.
  • Some pigmented lesions contain high-grade squamous intraepithelial lesions; the operative microscope is used in this setting to look for the vascular characteristics of high-grade disease.
  • RESULTS: The video reports five male patients treated for high-grade squamous intraepithelial lesions with the aide of high resolution anoscopy.
  • All lesions suspicious for high-grade squamous intraepithelial lesions based on observed vascular patterns were confirmed as such with permanent histopathology.
  • CONCLUSION: The use of acetic acid and the operative microscope with selective use of Lugol's solution accentuates the visual characteristics of high-grade lesions, enhancing the surgeon's ability to target treatment to high-grade squamous intraepithelial lesions.
  • High resolution anoscopy is useful in the targeted treatment of high-grade squamous intraepithelial lesions.
  • [MeSH-major] Anus Neoplasms / pathology. Carcinoma, Squamous Cell / pathology. Colonoscopy / methods. Image Enhancement. Video-Assisted Surgery / methods

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  • (PMID = 16222485.001).
  • [ISSN] 0012-3706
  • [Journal-full-title] Diseases of the colon and rectum
  • [ISO-abbreviation] Dis. Colon Rectum
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
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35. Kreuter A, Brockmeyer NH, Altmeyer P, Wieland U, German Competence Network HIV/AIDS: Anal intraepithelial neoplasia in HIV infection. J Dtsch Dermatol Ges; 2008 Nov;6(11):925-34
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Anal intraepithelial neoplasia in HIV infection.
  • In HIV-infected men who have sex with men (MSM), anal HPV prevalence is more than 90% and infections with multiple HPV types are common.
  • Anal intraepithelial neoplasia (AIN) is a potential precursor lesion of squamous cell carcinoma of the anus.
  • Like its cervical counterpart, cervical intraepithelial neoplasia (CIN), AIN is causally linked to persistent infections with high-risk HPV types such as HPV16 or HPV18.
  • As AIN and CIN share distinct biological similar-ities, AIN screenings analogous to Pap smear programs for CIN have been recommended in high-risk populations to reduce the incidence of anal carcinoma.
  • These screenings include cytological analysis followed by high resolution anoscopy in case of anal dysplasia.
  • Treatment guidelines for AIN are not yet available.
  • However, controlled studies on AIN treatment have not been performed.
  • The impact of HPV vaccination on AIN development will also need to be assessed.
  • [MeSH-major] Anus Neoplasms / diagnosis. Anus Neoplasms / therapy. HIV Infections / diagnosis. HIV Infections / therapy. Papillomavirus Infections / diagnosis. Papillomavirus Infections / therapy. Skin Neoplasms / diagnosis. Skin Neoplasms / therapy

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  • (PMID = 18410393.001).
  • [ISSN] 1610-0387
  • [Journal-full-title] Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG
  • [ISO-abbreviation] J Dtsch Dermatol Ges
  • [Language] eng; ger
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] Germany
  • [Number-of-references] 46
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36. Garland SM: Prevention strategies against human papillomavirus in males. Gynecol Oncol; 2010 May;117(2 Suppl):S20-5

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Oncogenic HPV is strongly associated with cancers and high-grade dysplasias of the anogenital tract, including the anus, penis, and also a proportion of oropharyngeal cancers.
  • In reducing male disease burden, some consider screening and treatment for high-grade anal dysplasia (AIN) to prevent anal cancer in high-risk populations.
  • Such strategies have wide implications for the workforce, and require more evidence for the optimal management of AIN.

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  • [Copyright] Copyright © 2010. Published by Elsevier Inc.
  • (PMID = 20138347.001).
  • [ISSN] 1095-6859
  • [Journal-full-title] Gynecologic oncology
  • [ISO-abbreviation] Gynecol. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Papillomavirus Vaccines
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37. Nahas SC, Nahas CS, Silva Filho EV, Levi JE, Atui FC, Marques CF: Perianal squamous cell carcinoma with high-grade anal intraepithelial neoplasia in an HIV-positive patient using highly active antiretroviral therapy: case report. Sao Paulo Med J; 2007 Sep 6;125(5):292-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Perianal squamous cell carcinoma with high-grade anal intraepithelial neoplasia in an HIV-positive patient using highly active antiretroviral therapy: case report.
  • CONTEXT: Highly active antiretroviral therapy (HAART) has turned human immunodeficiency virus (HIV) infection into a chronic condition, and this has led to increased incidence of anal dysplasia among HIV-positive patients.
  • Routine anal evaluation including the anal canal and perianal area is recommended for this population, especially for patients infected by oncogenic human papillomavirus (HPV) types.
  • CASE REPORT: A 54-year-old homosexual HIV-positive man presented with a six-year history of recurrent perianal and anal warts.
  • He presented some condylomatous spreading lesions occupying part of the anal canal and the perianal skin, and also a well-demarcated slightly painful perianal plaque of dimensions 1.0 x 1.0 cm.
  • Both anal canal Pap smears and biopsies guided by high-resolution anoscopy revealed high-grade squamous intraepithelial lesion.
  • Biopsies of the border of the perianal plaque also revealed high-grade squamous intraepithelial lesion.
  • HPV DNA testing of the anus detected the presence of HPV-16 type.
  • Histological analysis on the excised tissue revealed high-grade squamous intraepithelial lesion with one focus of microinvasive squamous cell cancer measuring 1 mm.
  • The patient showed pathological evidence of recurrent anal and perianal high-grade squamous intraepithelial lesions at the sixth-month follow-up and required further ablation of those lesions.
  • However no invasive squamous cell carcinoma recurrence has been detected so far.
  • [MeSH-major] Antiretroviral Therapy, Highly Active / adverse effects. Anus Neoplasms / pathology. Carcinoma, Squamous Cell / pathology. HIV Seropositivity / drug therapy. Human papillomavirus 16 / isolation & purification. Papillomavirus Infections / pathology
  • [MeSH-minor] Anal Canal / pathology. Anal Canal / virology. DNA, Viral / analysis. Humans. Male. Middle Aged. Neoplasm Invasiveness. Neoplasm Recurrence, Local / diagnosis


38. Goldstone SE, Moshier E: Detection of oncogenic human papillomavirus impacts anal screening guidelines in men who have sex with men. Dis Colon Rectum; 2010 Aug;53(8):1135-42
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Detection of oncogenic human papillomavirus impacts anal screening guidelines in men who have sex with men.
  • PURPOSE: It has been shown that testing for oncogenic human papillomavirus (HPV+) improves the sensitivity of cytologic diagnosis of atypical cells of undetermined significance in the cervix and anus, reducing the number of patients requiring colposcopy or high-resolution anoscopy.
  • We endeavored to determine whether HPV testing could predict future high-grade dysplasia (high-grade squamous intraepithelial lesions) and modify screening internals.
  • METHODS: This investigation was conducted via a retrospective chart review of subjects with atypical cells of undetermined significance anal cytology, high-resolution anoscopy, and HPV testing.
  • Of 224 subjects monitored for >2 years, the hazard ratio for developing high-grade dysplasia was 77% less for men who have sex with men who never had oncogenic HPV (HPV-) vs those who stayed HPV+ (P < .013).
  • The hazard ratio for high-grade dysplasia in those who were HPV- vs those who became HPV- was not different.
  • Risk of high-grade dysplasia was 28% within 6 months of becoming HPV+.
  • The 3-year high-grade dysplasia risk was 15% and 54% for HPV- vs HPV+ subjects (P = .0006).
  • Frequency of high-grade dysplasia in subjects who remained HPV- with predominantly atypical cells of undetermined significance cytology for 1, 2, or 3 years was 2%, 0% and 0% and was 17%, 0%, and 0% in HIV+ subjects.
  • Kaplan-Meier analysis for HIV- subjects with HPV- predominantly atypical cells of undetermined significance cytology for 1 year showed <5% incidence of high-grade dysplasia at 4 years.
  • CONCLUSIONS: Change in HPV status can predict the risk of high-grade dysplasia.
  • Subjects with predominantly HPV- atypical cells of undetermined significance cytology for 2 years have a decreased risk of high-grade dysplasia.
  • HPV testing when screening for anal dysplasia could alter screening parameters.
  • [MeSH-major] Anus Neoplasms / diagnosis. Homosexuality, Male. Mass Screening / standards. Papillomaviridae / isolation & purification. Papillomavirus Infections / diagnosis. Practice Guidelines as Topic. Tumor Virus Infections / diagnosis
  • [MeSH-minor] Adult. Anal Canal / pathology. Anal Canal / virology. Colonoscopy. Follow-Up Studies. HIV Seropositivity. Humans. Incidence. Male. Precancerous Conditions. Predictive Value of Tests. Retrospective Studies. United States / epidemiology

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  • (PMID = 20628276.001).
  • [ISSN] 1530-0358
  • [Journal-full-title] Diseases of the colon and rectum
  • [ISO-abbreviation] Dis. Colon Rectum
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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39. Kreuter A, Skrygan M, Gambichler T, Brockmeyer NH, Stücker M, Herzler C, Potthoff A, Altmeyer P, Pfister H, Wieland U: Human papillomavirus-associated induction of human beta-defensins in anal intraepithelial neoplasia. Br J Dermatol; 2009 Jun;160(6):1197-205
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Human papillomavirus-associated induction of human beta-defensins in anal intraepithelial neoplasia.
  • OBJECTIVES: The present study was performed to analyse expression of AMPs in human papillomavirus (HPV)-associated anal skin lesions of human immunodeficiency virus (HIV)-positive men who have sex with men (MSM), a special high-risk group for persistent HPV infections and anal dysplasia.
  • RESULTS: Skin biopsies of 45 HIV-positive MSM with anal intraepithelial neoplasia (AIN), anal condylomata acuminata or unaffected anal mucosa, as well as condylomata acuminata of eight HIV-negative MSM, were analysed for AMP mRNA expression.
  • Additionally, immunohistochemical analysis for hBD-2 and hBD-3 was performed in a total of 45 samples. hBD-2 and hBD-3 gene and protein expression was significantly increased in both AIN and condyloma, whereas LL-37, RNase 7 and hBD-1 gene expression did not differ significantly from unaffected anal mucosa.
  • CONCLUSIONS: hBD-2 and hBD-3 expression was shown to be significantly upregulated in HPV-associated anal skin lesions of both HIV-positive and HIV-negative MSM.
  • [MeSH-major] AIDS-Related Opportunistic Infections / complications. Anus Neoplasms / metabolism. Papillomavirus Infections / metabolism. beta-Defensins / metabolism

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  • (PMID = 19298269.001).
  • [ISSN] 1365-2133
  • [Journal-full-title] The British journal of dermatology
  • [ISO-abbreviation] Br. J. Dermatol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / DEFB1 protein, human; 0 / DEFB4A protein, human; 0 / beta-Defensins; 0 / beta-defensin 3, human
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40. Salit IE, Lytwyn A, Raboud J, Sano M, Chong S, Diong C, Chapman W, Mahony JB, Tinmouth J: The role of cytology (Pap tests) and human papillomavirus testing in anal cancer screening. AIDS; 2010 Jun 1;24(9):1307-13
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  • [Title] The role of cytology (Pap tests) and human papillomavirus testing in anal cancer screening.
  • OBJECTIVE: To assess anal oncogenic human papillomavirus (HPV) and anal cytology as screening tests for detecting high-grade anal intraepithelial neoplasia (AIN 2+), as this is an immediate anal cancer precursor.
  • The endpoint was histologically confirmed AIN 2+ obtained by high-resolution anoscopy.
  • METHODS: We did concomitant anal cytology, anal HPV testing and HRA with directed biopsies without knowing the results of each intervention.
  • The main outcome measures were the sensitivity, specificity, negative predictive value and positive predictive value of anal cytology and oncogenic HPV for the detection of AIN 2+.
  • RESULTS: Cytology was abnormal in 67% of patients: high-grade squamous intraepithelial lesion, 12%; low-grade squamous intraepithelial lesion, 43% and atypical squamous cells of undetermined significance, 12%.
  • Biopsies were abnormal in 68% of patients: AIN 2+, 25% and AIN 1, 43%.
  • Test performance characteristics for the detection of AIN 2+ using any abnormality on anal cytology were: sensitivity 84%, specificity 39%, negative predictive value 88% and positive predictive value 31%; using oncogenic HPV: sensitivity 100%, specificity 16%, negative predictive value 100% and positive predictive value 28%.
  • CONCLUSION: Anal cytology and HPV detection have high sensitivity but low specificity for detecting AIN 2+.
  • HIV-positive men who have sex with men have a high prevalence of AIN 2+ and require high-resolution anoscopy for optimal detection of high-grade anal dysplasia.
  • [MeSH-major] Anus Neoplasms / pathology. Carcinoma in Situ / pathology. Carcinoma, Squamous Cell / pathology. Cytodiagnosis / methods. Papillomavirus Infections / pathology. Precancerous Conditions / pathology
  • [MeSH-minor] Adult. Anal Canal / cytology. Anal Canal / pathology. Biopsy. Cross-Sectional Studies. Early Detection of Cancer. Homosexuality, Male. Humans. Male. Middle Aged. Sensitivity and Specificity. Sexual Behavior. Specimen Handling

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  • (PMID = 20442633.001).
  • [ISSN] 1473-5571
  • [Journal-full-title] AIDS (London, England)
  • [ISO-abbreviation] AIDS
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
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41. Wong AK, Chan RC, Aggarwal N, Singh MK, Nichols WS, Bose S: Human papillomavirus genotypes in anal intraepithelial neoplasia and anal carcinoma as detected in tissue biopsies. Mod Pathol; 2010 Jan;23(1):144-50
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  • [Title] Human papillomavirus genotypes in anal intraepithelial neoplasia and anal carcinoma as detected in tissue biopsies.
  • Human papillomavirus (HPV) infection strongly correlates with the development of anal intraepithelial neoplasias and carcinomas; however, few studies have characterized the distribution of the specific subtypes of the virus in the varying grades of dysplasia.
  • This report characterizes the distribution of HPV 16/18 in surgical specimens with anal intraepithelial neoplasia (AIN) I-III and histological variants of anal carcinoma.
  • A total of 111 anal surgical specimens with no dysplasia (10), AIN I-III (53), and anal carcinomas (48) were evaluated for the presence of high-risk HPV infection and subtyped by nested PCR or the Invader Assay.
  • High-risk virus types were detected in progressively greater number of anal intraepithelial lesions from 56% in low grade to 88% in high grade.
  • Most (89%) squamous carcinomas were associated with high-risk viruses, 68% with type 16, a prevalence similar to that noted in high-grade dysplasia.
  • Non-16/18 subtypes were encountered more frequently in squamous carcinomas from immunodeficient individuals (57% cases) as compared with immunocompetent individuals (18% cases).
  • The similarity in the prevalence of type 16 in high-grade dysplasia and squamous carcinomas suggests that anal intraepithelial lesion III is the true precursor of squamous carcinoma and warrants aggressive management.
  • Anal intraepithelial lesions II showed a virus distribution that was similar to low-grade dysplasia.
  • [MeSH-major] Anus Neoplasms / virology. Carcinoma in Situ / virology. Carcinoma, Squamous Cell / virology. Papillomavirus Infections / virology

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  • (PMID = 19838162.001).
  • [ISSN] 1530-0285
  • [Journal-full-title] Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc
  • [ISO-abbreviation] Mod. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / DNA, Viral
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42. Membrilla-Fernández E, Parés D, Alameda F, Pascual M, Courtier R, Gil MJ, Vallecillo G, Fusté P, Pera M, Grande L: [Anal intraepithelial neoplasia: application of a diagnostic protocol in risk patients using anal cytology]. Cir Esp; 2009 Jun;85(6):365-70
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  • [Title] [Anal intraepithelial neoplasia: application of a diagnostic protocol in risk patients using anal cytology].
  • [Transliterated title] Neoplasia intraepitelial anal: resultados de la aplicación de un protocolo diagnóstico en pacientes de riesgo mediante el uso de citología anal.
  • INTRODUCTION: Anal intraepithelial neoplasia is a precursor condition of squamous anal carcinoma.
  • The groups at risk of this lesion are patients with anogenital condylomata, cervical dysplasia, human immunodeficiency virus infection and, in general, patients with HPV infection.
  • The aim of this study was to analyse the results of a diagnostics protocol of Anal Intraepithelial Neoplasia in high risk population using anal cytology.
  • PATIENTS AND METHOD: The protocol is based on a visit in the outpatient department, clinical interview, physical examination and anal cytology evaluated by Bethesda criteria.
  • The cross-sectional observational study was designed to study the anal smear results and their relationship with risk factors.
  • In the overall series, 25 patients have been diagnosed with abnormal anal cytology: 9 atypical squamous cells of undetermined significance (ASCUS), 15 low-grade and 1 high-grade squamous intraepithelial lesions.
  • There were no significant associations between abnormal cytology results and the presence of anal condyloma (p = 0.22).
  • CONCLUSIONS: Our diagnostic protocol of anal intraepithelial neoplasia revealed 25% of patients with pre-invasive lesions of squamous anal cancer.
  • [MeSH-major] Anus Neoplasms / pathology. Carcinoma in Situ / pathology

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  • (PMID = 19303590.001).
  • [ISSN] 0009-739X
  • [Journal-full-title] Cirugía española
  • [ISO-abbreviation] Cir Esp
  • [Language] spa
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Spain
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43. Bean SM, Meara RS, Vollmer RT, Conner MG, Crowe DR, Novak L, Eltoum IA, Robboy SJ, Chhieng DC: p16 Improves interobserver agreement in diagnosis of anal intraepithelial neoplasia. J Low Genit Tract Dis; 2009 Jul;13(3):145-53
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  • [Title] p16 Improves interobserver agreement in diagnosis of anal intraepithelial neoplasia.
  • OBJECTIVES: Evaluation of anal intraepithelial neoplasia (AIN) is subjective.
  • Previous studies have shown p16 and Ki-67 expressions to correlate with AIN grade.
  • The objectives were (1) to determine the extent of interobserver agreement in evaluating AIN on routine hematoxylin and eosin (H&E) sections and (2) to test whether p16 and/or Ki-67 staining improve interobserver diagnostic agreement.
  • MATERIALS AND METHODS: Seventy-seven anal specimens were retrieved.
  • Diagnoses were normal/reactive, AIN I/HPV, AIN II, and AIN III.
  • Fair agreement was observed using H&E diagnosis alone (kappa = 0.38, S = 0.56).
  • CONCLUSIONS: Interobserver agreement for diagnosis of AIN was fair when based solely on H&E preparation. p16 alone improved interobserver agreement and demonstrated superior agreement when compared with H&E, Ki-67, and H&E/p16/Ki-67 combined.
  • [MeSH-major] Anus Neoplasms / diagnosis. Carcinoma in Situ / diagnosis. DNA, Neoplasm / analysis. Gene Expression Regulation, Neoplastic. Genes, p16 / physiology
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Antigens, Neoplasm / analysis. Biopsy. Clinical Competence. Diagnosis, Differential. Female. Humans. Male. Middle Aged. Observer Variation. Retrospective Studies

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  • (PMID = 19550211.001).
  • [ISSN] 1526-0976
  • [Journal-full-title] Journal of lower genital tract disease
  • [ISO-abbreviation] J Low Genit Tract Dis
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antigens, Neoplasm; 0 / DNA, Neoplasm
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44. Nadal SR, Calore EE, Nadal LR, Horta SH, Manzione CR: [Anal cytology for screening of pre-neoplasic lesions]. Rev Assoc Med Bras (1992); 2007 Mar-Apr;53(2):147-51
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  • [Title] [Anal cytology for screening of pre-neoplasic lesions].
  • [Transliterated title] Citologia anal para rastreamento de lesões pré-neoplásicas.
  • BACKGROUND: High grade intra-epithelial neoplasias (HAIN) are probable precursors of anal carcinoma, with association to high-risk types of Human Papillomavirus (HPV).
  • This progression could be related to severity of the dysplasia and, albeit not yet confirmed, treatment of these lesions would prevent the evolution to cancer.
  • The aim of this study was to evaluate if anal cytology, with a cytobrush, could be useful to screen clinic and pre-clinic lesions provoked by HPV.
  • METHODS: Brushes were used to obtain smears from the anal canal of 102 HIV-positive patients with proctologic complaints.
  • HPV infection was denied by 33 patients, 14 had treated anal warts in the past, 28 had condylomas in the anal verge, seven had internal clinical lesions and 20 had both internal and external condylomas.
  • T CD4+ lymphocyte counts were also evaluated to check if the immunologic status caused more advanced dysplasia.
  • Low grade AIN (LAIN) occurred in 30 and HAIN in 13 patients.
  • One patient with HAIN, without a history of HPV infection in the past, presented an anal canal ulcer which at biopsy was diagnosed as invasive squamous-cell carcinoma.
  • CONCLUSION: Results suggest that cytology could be used to diagnose anal cancer precursors.
  • [MeSH-major] Anus Neoplasms / pathology. Carcinoma in Situ / pathology. HIV Infections / virology. Papillomaviridae / isolation & purification. Papillomavirus Infections / pathology. Precancerous Conditions / pathology

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  • (PMID = 17568919.001).
  • [ISSN] 0104-4230
  • [Journal-full-title] Revista da Associação Médica Brasileira (1992)
  • [ISO-abbreviation] Rev Assoc Med Bras (1992)
  • [Language] por
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Brazil
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45. Wahl RU, Blazek C, Megahed M: [HPV type 16-associated anal intraepithelial neoplasia (AIN)]. Hautarzt; 2009 May;60(5):371-2
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  • [Title] [HPV type 16-associated anal intraepithelial neoplasia (AIN)].
  • [Transliterated title] HPV-Typ-16-assoziierte anale intraepitheliale Neoplasie (AIN).
  • A 25-year-old woman had suffered from a perianal ulcer for approximately 1 year.
  • Employing virologic and histologic techniques, we confirmed the diagnosis of an intraepithelial neoplasia.
  • Anal intraepithelial neoplasia (AIN) is induced by carcinogenic human papillomaviruses.
  • Because of its frequency, AIN is a crucial differential diagnosis for lesions of the anogenital area region failing to respond to standard therapies.
  • [MeSH-major] Anus Neoplasms / diagnosis. Anus Neoplasms / surgery. Carcinoma in Situ / diagnosis. Carcinoma in Situ / surgery. Human papillomavirus 16 / isolation & purification. Papillomavirus Infections / diagnosis. Papillomavirus Infections / surgery. Skin Neoplasms / diagnosis. Skin Neoplasms / surgery

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  • (PMID = 19430747.001).
  • [ISSN] 1432-1173
  • [Journal-full-title] Der Hautarzt; Zeitschrift für Dermatologie, Venerologie, und verwandte Gebiete
  • [ISO-abbreviation] Hautarzt
  • [Language] ger
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Germany
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46. Bean SM, Eltoum I, Horton DK, Whitlow L, Chhieng DC: Immunohistochemical expression of p16 and Ki-67 correlates with degree of anal intraepithelial neoplasia. Am J Surg Pathol; 2007 Apr;31(4):555-61
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Immunohistochemical expression of p16 and Ki-67 correlates with degree of anal intraepithelial neoplasia.
  • Anal intraepithelial neoplasia (AIN) is a human papilloma virus related lesion.
  • The objective of this study is to correlate p16 expression and cellular proliferation measured by Ki-67 staining with the degree of dysplasia in the anal canal and to determine the efficacy of these markers in diagnosing high-grade AIN.
  • Seventy-five anal specimens from 55 patients (37 men; 18 women; mean age: 48 y; median: 44 y; range 25 to 96 y) were studied including 35 normal/reactive lesions, 23 low-grade AIN (AIN I and condyloma), and 17 high-grade AIN (AIN II and III).
  • Expression of p16 in AIN correlated with that of Ki-67 (P<0.001).
  • High-grade AIN often demonstrated p16 staining in more than one-third of the thickness of the epithelium in a diffuse/continuous fashion. p16 expression in low-grade AIN was often restricted to the lower 1/3 of the epithelium and/or was focal and discontinuous.
  • The expression of both p16 and Ki-67 correlated with the degree of dysplasia (P<0.01).
  • When positive p16 staining was defined as the presence of diffuse/continuous staining in more than one-third of the thickness of epithelium, the sensitivity, specificity, and accuracy of p16 as a marker for diagnosing high-grade AIN were 76%, 86%, and 84%, respectively.
  • When positive Ki-67 staining was defined as the presence of nuclear staining in more than 25% of the cells in more than one-third of the thickness of epithelium, the sensitivity, specificity, and accuracy of Ki-67 as a marker for diagnosing high-grade AIN were 71%, 84%, and 83% respectively.
  • Both p16 and Ki-67 are reliable markers for diagnosing high-grade AIN.
  • [MeSH-major] Anus Neoplasms / diagnosis. Genes, p16. Ki-67 Antigen / metabolism. Papillomavirus Infections / diagnosis. Precancerous Conditions / diagnosis. Tumor Virus Infections / diagnosis
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Biomarkers, Tumor / analysis. Carcinoma, Squamous Cell / diagnosis. Carcinoma, Squamous Cell / metabolism. Carcinoma, Squamous Cell / virology. Female. History, 17th Century. Humans. Immunohistochemistry. Male. Sensitivity and Specificity

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  • (PMID = 17414102.001).
  • [ISSN] 0147-5185
  • [Journal-full-title] The American journal of surgical pathology
  • [ISO-abbreviation] Am. J. Surg. Pathol.
  • [Language] eng
  • [Publication-type] Historical Article; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Ki-67 Antigen
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47. Fox PA, Seet JE, Stebbing J, Francis N, Barton SE, Strauss S, Allen-Mersh TG, Gazzard BG, Bower M: The value of anal cytology and human papillomavirus typing in the detection of anal intraepithelial neoplasia: a review of cases from an anoscopy clinic. Sex Transm Infect; 2005 Apr;81(2):142-6
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  • [Title] The value of anal cytology and human papillomavirus typing in the detection of anal intraepithelial neoplasia: a review of cases from an anoscopy clinic.
  • BACKGROUND: Previous studies have reached differing conclusions about the utility of anal cytology as a screening tool for anal intraepithelial neoplasia (AIN).
  • Comparison was made between results of anal cytology using the sampling method of Palefsky, and histological findings of biopsies taken from abnormal areas seen on high resolution anoscopic examination of the anal canal.
  • At screening of 34 asymptomatic men, 83% had anal cytological dysplasia and 78% had AIN.
  • CONCLUSION: Anal cytology by the Palefsky method is simple to undertake, has a sensitivity and specificity comparable with cervical cytology, and can therefore be used as the basis of a pilot screening project in centres with large cohorts of HIV positive homosexual men who have a high risk of developing anal carcinoma.
  • [MeSH-major] Anus Neoplasms / pathology. Bisexuality. Carcinoma in Situ / pathology. Homosexuality, Male. Papillomavirus Infections / pathology

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  • [Cites] Eur J Cancer. 2000 Apr;36(6):754-8 [10762748.001]
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  • (PMID = 15800092.001).
  • [ISSN] 1368-4973
  • [Journal-full-title] Sexually transmitted infections
  • [ISO-abbreviation] Sex Transm Infect
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC1764665
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48. Pirog EC, Quint KD, Yantiss RK: P16/CDKN2A and Ki-67 enhance the detection of anal intraepithelial neoplasia and condyloma and correlate with human papillomavirus detection by polymerase chain reaction. Am J Surg Pathol; 2010 Oct;34(10):1449-55
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  • [Title] P16/CDKN2A and Ki-67 enhance the detection of anal intraepithelial neoplasia and condyloma and correlate with human papillomavirus detection by polymerase chain reaction.
  • The classification of anal intraepithelial neoplasia (AIN) in mucosal biopsies is subject to considerable interobserver variability.
  • Previous studies have shown that Ki-67 and p16/CDKN2A immunostains aid detection of dysplasia in biopsy samples from the uterine cervix.
  • The aim of this study was to determine whether Ki-67 and p16/CDKN2A immunolabeling enhanced diagnostic accuracy in the assessment of anal mucosal biopsies from patients with suspected human papillomavirus (HPV) infection.
  • The study consisted of 75 cases that were originally interpreted to represent normal anal transitional zone (n=15), fibroepithelial polyp (n=10), condyloma accuminatum (n=10), low-grade AIN (AIN1, n=20), and high-grade AIN (n=20), including 10 cases each of AIN2 and AIN3.
  • Thus, the final study group consisted of 17 samples of normal anal transition zone, 14 fibroepithelial polyps, 6 condylomata accuminata, and 38 cases of AIN (11 AIN1, 16 AIN2, and 11 AIN3).
  • A positive Ki-67 result was defined as the presence of a cluster of at least 2 strongly stained epithelial nuclei in the upper two-thirds of the epithelial thickness.
  • None of the anal transition zone samples or fibroepithelial polyps showed Ki-67 or p16/CDKN2A staining.
  • All condylomata and samples of AIN contained HPV DNA and showed positive Ki-67 labeling.
  • All cases of high-grade AIN showed positive p16/CDKN2A staining.
  • We conclude that Ki-67 labeling detects anal HPV-related changes with a high degree of sensitivity and specificity, whereas increased p16/CDKN2A staining is strongly associated with high-grade squamous neoplasia.
  • These results indicate that a combination of these markers may aid interpretation of anal mucosal biopsy samples.
  • [MeSH-major] Anus Neoplasms / diagnosis. Carcinoma in Situ / diagnosis. Condylomata Acuminata / diagnosis. Cyclin-Dependent Kinase Inhibitor p16 / metabolism. Ki-67 Antigen / metabolism. Papillomaviridae / isolation & purification. Papillomavirus Infections / diagnosis
  • [MeSH-minor] Adult. Aged. Biomarkers, Tumor / metabolism. Biopsy. Colonic Polyps / metabolism. Colonic Polyps / pathology. Colonic Polyps / virology. DNA Probes, HPV. Female. Humans. Immunohistochemistry. Male. Middle Aged. Precancerous Conditions / diagnosis. Precancerous Conditions / metabolism. Precancerous Conditions / virology. Predictive Value of Tests. Young Adult

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  • (PMID = 20871219.001).
  • [ISSN] 1532-0979
  • [Journal-full-title] The American journal of surgical pathology
  • [ISO-abbreviation] Am. J. Surg. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Cyclin-Dependent Kinase Inhibitor p16; 0 / DNA Probes, HPV; 0 / Ki-67 Antigen
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49. Sanclemente G, Herrera S, Tyring SK, Rady PL, Zuleta JJ, Correa LA, He Q, Wolff JC: Human papillomavirus (HPV) viral load and HPV type in the clinical outcome of HIV-positive patients treated with imiquimod for anogenital warts and anal intraepithelial neoplasia. J Eur Acad Dermatol Venereol; 2007 Sep;21(8):1054-60
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Human papillomavirus (HPV) viral load and HPV type in the clinical outcome of HIV-positive patients treated with imiquimod for anogenital warts and anal intraepithelial neoplasia.
  • OBJECTIVE: To evaluate the efficacy of 5% imiquimod in HIV-positive male patients with anogenital warts or anal intraepithelial neoplasia (AIN), and to elucidate whether human papillomavirus (HPV) type and viral load were important for clinical outcome and recurrences.
  • METHODS: Thirty-seven patients with histologically proven anogenital warts or AIN were enrolled.
  • The perianal area was the main lesion location.
  • Eighteen patients had a histopathological diagnosis of AIN-1.
  • CONCLUSIONS: The assumption that visible perianal warts are benign lesions in HIV-positive patients has to be reevaluated since an important number of such lesions could correspond to low-grade anal disease, which in turn could progress to high-grade anal disease or cancer.
  • In addition, our results in this preliminary study indicate that imiquimod appears to be effective in treating AIN in HIV-positive patients.
  • Further studies are needed to document its utility to prevent high-grade dysplasia and/or anal cancer.
  • [MeSH-major] AIDS-Related Opportunistic Infections / drug therapy. Adjuvants, Immunologic / therapeutic use. Aminoquinolines / therapeutic use. Anus Diseases / drug therapy. Anus Neoplasms / drug therapy. Condylomata Acuminata / drug therapy. Genital Diseases, Male / drug therapy. Papillomavirus Infections / drug therapy


50. Devaraj B, Cosman BC: Expectant management of anal squamous dysplasia in patients with HIV. Dis Colon Rectum; 2006 Jan;49(1):36-40
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Expectant management of anal squamous dysplasia in patients with HIV.
  • PURPOSE: Anal squamous dysplasia is commonly found in patients with HIV infection.
  • This study reviews a series of patients with HIV and an abnormal anal examination who had squamous dysplasia and who have been followed with physical examination alone and with repeat biopsies as necessary for new or suspicious lesions.
  • METHODS: We reviewed the charts of 40 HIV-positive men who had squamous dysplasia of the anal canal and anal margin, focusing on history, physical findings, histologic diagnosis, and the occurrence of invasive squamous-cell carcinoma.
  • RESULTS: Forty HIV-positive men (mean age, 39 years) were followed for anal squamous dysplasia.
  • Biopsies revealed dysplasia, which was usually multifocal.
  • The grade of dysplasia varied, but 28 of 40 patients had at least one area of severe dysplasia.
  • CONCLUSIONS: Extensive excision for dysplasia in the context of HIV confers high morbidity and questionable benefit, and other treatments are of uncertain value.
  • Physical examination surveillance for invasive carcinoma may be acceptable for following patients with HIV and biopsy-proven squamous dysplasia.
  • [MeSH-major] Anus Neoplasms / surgery. Carcinoma, Squamous Cell / surgery. Colectomy / methods. Decision Making. HIV / immunology. HIV Antibodies / immunology. HIV Infections / complications

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  • [CommentIn] Dis Colon Rectum. 2006 Oct;49(10):1648-9; author reply 1649-50 [16972138.001]
  • (PMID = 16283561.001).
  • [ISSN] 0012-3706
  • [Journal-full-title] Diseases of the colon and rectum
  • [ISO-abbreviation] Dis. Colon Rectum
  • [Language] eng
  • [Publication-type] Case Reports; Comparative Study; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / HIV Antibodies
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51. Parés D, Mullerat J, Pera M: [Anal intraepithelial neoplasia]. Med Clin (Barc); 2006 Nov 18;127(19):749-55
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Anal intraepithelial neoplasia].
  • [Transliterated title] Neoplasia intraepitelial anal.
  • Human papillomavirus (HPV) is responsible for anal condylomata, anal intraepithelial neoplasia (AIN) and anal squamous cell carcinoma.
  • AIN is a premalignant condition that can progress to invasive carcinoma through different grades of severity of the disease called AIN I, AIN II and AIN III.
  • This paper looks at the current definition, diagnostic methods and management of AIN.
  • The incidence of AIN has increased significantly in the last decades.
  • The groups at risk are mainly patients with infection with human immunodeficiency virus, immunossuppressed patients and patients affected by HPV related diseases (e.g., cervical cancer or anal condyloma).
  • Accurate diagnosis of AIN lesions consists of accurate grading and disease extension.
  • Low grade AIN (AIN I) or in extensive lesions, follow-up is advised to determine the possible evolution to anal squamous cell carcinoma.
  • In cases of more severe and localized lesions (AIN II and AIN III), surgical resection should be considered if the predictive postoperative morbidity is low.
  • Screening programs for AIN are not currently in place and there might be much effort to study the management of HPV in these patients.
  • [MeSH-major] Anus Neoplasms / pathology. Carcinoma in Situ / pathology
  • [MeSH-minor] Anal Canal / pathology. Anal Canal / surgery. Humans

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  • (PMID = 17198654.001).
  • [ISSN] 0025-7753
  • [Journal-full-title] Medicina clínica
  • [ISO-abbreviation] Med Clin (Barc)
  • [Language] spa
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Spain
  • [Number-of-references] 58
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52. van der Snoek EM, van der Ende ME, Schouten WR, den Hollander JC, van der Meijden WI: [Anorectal malignancies and dysplasia in HIV-positive men who have sex with men]. Ned Tijdschr Geneeskd; 2005 Sep 3;149(36):1989-93
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Anorectal malignancies and dysplasia in HIV-positive men who have sex with men].
  • Persistent human papillomavirus (HPV) infection is a major risk factor for the development of anal (pre)malignancies.
  • Less is known about the natural history of anal intraepithelial neoplasia (AIN).
  • Screening in HIV-positive and HIV-negative MSM for anorectal malignancies or dysplasia is cost-effective if the incidence is sufficiently high.
  • Treatment options range from watchful waiting for asymptomatic grade-1 AIN to excision or radio(chemo)therapy for anorectal carcinoma.
  • [MeSH-major] Anus Neoplasms / epidemiology. HIV Infections / complications. Homosexuality, Male. Precancerous Conditions / epidemiology. Rectal Neoplasms / epidemiology

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  • (PMID = 16171110.001).
  • [ISSN] 0028-2162
  • [Journal-full-title] Nederlands tijdschrift voor geneeskunde
  • [ISO-abbreviation] Ned Tijdschr Geneeskd
  • [Language] dut
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Netherlands
  • [Number-of-references] 35
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53. Varnai AD, Bollmann M, Griefingholt H, Speich N, Schmitt C, Bollmann R, Decker D: HPV in anal squamous cell carcinoma and anal intraepithelial neoplasia (AIN). Impact of HPV analysis of anal lesions on diagnosis and prognosis. Int J Colorectal Dis; 2006 Mar;21(2):135-42
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] HPV in anal squamous cell carcinoma and anal intraepithelial neoplasia (AIN). Impact of HPV analysis of anal lesions on diagnosis and prognosis.
  • BACKGROUND AND AIMS: Majority of cases of anal squamous cell carcinoma are human papilloma virus (HPV)-induced and result from anal intraepithelial neoplasia (AIN).
  • This study was conducted to examine methods which may enable the routine diagnosis of HPV-induced changes in the anal rim and the consequences of such detection especially in view of a more sensitive diagnosis of AIN.
  • METHODS: The study included biopsy samples from 87 patients who had been diagnosed with the following disease patterns: 47 invasive anal carcinoma, 33 AIN of varying severity and seven condylomatous lesions.
  • RESULTS: In 38 of 47 cases of anal carcinoma, HPV DNA could be detected via PCR (80.9%), the majority of which were HPV 16 (33/38=86.8%).
  • In 29 of the 33 cases of AIN, HPV DNA was detected (87.9%), most of these in AIN III (15/16=93.8%).
  • DISCUSSION: In our series, the clinical diagnosis of the invasive anal carcinoma had a high sensitivity of 93.6%, with a specificity of 80%.
  • In contrast, AIN had been detected clinically in none of the cases.
  • In this situation, especially with high-risk patients, our findings recommend anal HPV screening in combination with anal cytology and anoscopy.
  • CONCLUSION: Based on our results, we urgently recommend for any histological report on excision of anal lesions to include a statement whether histological markers of HPV infection were detected.
  • [MeSH-major] Alphapapillomavirus / genetics. Anus Neoplasms / virology. Carcinoma in Situ / virology. Carcinoma, Squamous Cell / virology. DNA, Viral / analysis
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Biopsy. Diagnosis, Differential. Female. Humans. Male. Middle Aged. Polymerase Chain Reaction. Prognosis. Retrospective Studies

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  • [CommentIn] Int J Colorectal Dis. 2007 Oct;22(10):1289 [16703315.001]
  • (PMID = 15864603.001).
  • [ISSN] 0179-1958
  • [Journal-full-title] International journal of colorectal disease
  • [ISO-abbreviation] Int J Colorectal Dis
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / DNA, Viral
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54. Walts AE, Lechago J, Bose S: P16 and Ki67 immunostaining is a useful adjunct in the assessment of biopsies for HPV-associated anal intraepithelial neoplasia. Am J Surg Pathol; 2006 Jul;30(7):795-801
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] P16 and Ki67 immunostaining is a useful adjunct in the assessment of biopsies for HPV-associated anal intraepithelial neoplasia.
  • HPV is also associated with anal squamous dysplasias and carcinomas.
  • Significant interobserver and intraobserver variation exists in the interpretation of biopsies for anal intraepithelial neoplasia (AIN).
  • This study was undertaken to assess the potential role of p16 and Ki67 immunohistochemical expression in refining the diagnosis and grading of AIN.One-hundred and four anal biopsies from 74 patients were retrieved from the surgical pathology files of the department.
  • After discrepancies were resolved and concurrence was achieved by at least 2 of 3 reviewing pathologists, the diagnoses were as follows: 37 negative, 12 condylomas without overt dysplasia, 14 AIN I, 25 AIN II, and 16 AIN III. p16 and Ki67 expression was evaluated by ABC immunoperoxidase staining whereas the presence of the high-risk subtypes of HPV virus was determined by in situ hybridization on a subset of the biopsies.
  • Nuclear and/or nuclear and cytoplasmic staining was considered as positive for p16 when present in >10% of squamous cells.
  • A band-like pattern of p16 immunoreactivity was seen in 21.4% AIN I, 80% AIN II, and 87.5% AIN III cases.
  • Spotty p16 immunoreactivity was observed in 8.1% negative, 8.3% condyloma, 14.3% AIN I, 12.0% AIN II, and 12.5% AIN III cases.
  • More than 50% of nuclei stained positive for Ki67 in 28.6% AIN I, 48.0% AIN II, and 75.0% AIN III cases but in none of the negative or condyloma cases.
  • On the basis of these results, a band-like pattern of p16 staining and Ki67 positivity in >50% of the squamous cell nuclei were strongly associated with high-grade AIN.
  • Most AIN I lesions stained similar to the nondysplastic cases.
  • A small subset of biopsies studied did not conform to the pattern described above: 4 of 14 (28.6%) AIN I lesions showed a band-like pattern of p16 staining and/or >50% Ki67 positive nuclei.
  • 4 of 25 (16.0%) AIN II lesions comprising 9.8% of the 41 high-grade AINs (AIN II and III) showed spotty p16 positivity and <50% Ki67 positive nuclei.
  • We conclude that when used together and evaluated in conjunction with H&E stained sections, p16 and Ki67 immunoexpression is a useful adjunct in the diagnosis and grading of AIN.
  • [MeSH-major] Anus Neoplasms / pathology. Carcinoma in Situ / pathology. Cyclin-Dependent Kinase Inhibitor p16 / metabolism. Ki-67 Antigen / metabolism. Papillomavirus Infections / pathology. Precancerous Conditions / pathology

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  • (PMID = 16819320.001).
  • [ISSN] 0147-5185
  • [Journal-full-title] The American journal of surgical pathology
  • [ISO-abbreviation] Am. J. Surg. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Cyclin-Dependent Kinase Inhibitor p16; 0 / DNA, Viral; 0 / Ki-67 Antigen
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55. Kreuter A, Potthoff A, Brockmeyer NH, Gambichler T, Swoboda J, Stücker M, Schmitt M, Pfister H, Wieland U, German Competence Network HIV/AIDS: Anal carcinoma in human immunodeficiency virus-positive men: results of a prospective study from Germany. Br J Dermatol; 2010 Jun;162(6):1269-77
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Anal carcinoma in human immunodeficiency virus-positive men: results of a prospective study from Germany.
  • BACKGROUND: Anal intraepithelial neoplasia (AIN), a human papillomavirus (HPV)-associated potential precursor lesion of anal cancer, is frequent among human immunodeficiency virus (HIV)-positive men who have sex with men (MSM).
  • There is a paucity of data published on the progression of high-grade AIN to invasive cancer as well as on clinical and virological characteristics comparing anal margin and anal canal carcinoma.
  • OBJECTIVES: To search for anal carcinoma and AIN in a large series of HIV-positive MSM, to assess treatment response of anal carcinoma, and to analyse lesional HPV spectrum of anal cancers.
  • METHODS: Detection of anal carcinoma and AIN was performed using cytology, high-resolution anoscopy, and histology in case of abnormal findings.
  • Additionally, HPV analyses for 36 high- and low-risk α-HPV types were performed in patients with anal carcinoma.
  • Of these, 116 (26·0%) patients had normal findings, 163 (36·5%) had low-grade AIN, 156 (35·0%) had high-grade AIN, and 11 (2·5%) had anal carcinoma as evidenced by the highest grade of cytology/histology.
  • Five patients with anal cancer, who had refused treatment of their precancerous lesions, had progressed from high-grade AIN to invasive cancer within a median time of 8·6 months.
  • All anal cancers carried high-risk α-HPV types.
  • All five squamous cell carcinomas (SCCs) of the anal canal were HPV16 positive.
  • In contrast, only one of the four anal margin SCCs were HPV16 positive (HPV31, HPV33 and HPV33 + HPV68 were found in the other three anal margin SCCs).
  • In contrast to the cancer biopsies, a broad spectrum of surface high- and low-risk HPV types was found in anal swabs of the patients.
  • Surgical excision resulted in long-term disease control of all anal margin carcinomas, whereas combined chemoradiotherapy in carcinomas of the anal canal was associated with high recurrence rates, high toxicity, and high mortality.
  • CONCLUSIONS: Anal carcinoma and AIN are frequent in HIV-positive men, even in patients participating in anal cancer prevention programmes.
  • High-grade dysplasia in these patients can progress to invasive cancer within a short period of time.
  • Anal margin carcinoma and anal canal carcinoma differ substantially in their lesional HPV spectrum, prognosis and treatment response.
  • [MeSH-major] Anus Neoplasms / virology. Carcinoma in Situ / virology. Carcinoma, Squamous Cell / virology. HIV Seropositivity / complications. Papillomaviridae / isolation & purification

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  • [Copyright] © 2010 The Authors. Journal Compilation © 2010 British Association of Dermatologists.
  • (PMID = 20184584.001).
  • [ISSN] 1365-2133
  • [Journal-full-title] The British journal of dermatology
  • [ISO-abbreviation] Br. J. Dermatol.
  • [Language] eng
  • [Databank-accession-numbers] ClinicalTrials.gov/ NCT00365729
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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56. Darvishian F, Stier EA, Soslow RA, Lin O: Immunoreactivity of p16 in anal cytology specimens: histologic correlation. Cancer; 2006 Feb 25;108(1):66-71
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Immunoreactivity of p16 in anal cytology specimens: histologic correlation.
  • BACKGROUND: Cytology has been proposed as a potential screening tool in the evaluation of squamous anorectal disease in view of the morphologic similarities between anal and cervical squamous lesions.
  • Previous studies have demonstrated that p16 overexpression correlates with the degree of dysplasia in the uterine cervix with promising results.
  • Due to potential diagnostic pitfalls in anal cytology, p16 overexpression in these specimens was studied.
  • RESULTS: Twenty-eight of the 43 cases demonstrated the presence of squamous cells immunoreactive for p16 in cytology specimens.
  • The p16-positive cells were identified in cases of low-grade squamous intraepithelial lesion (LSIL) (n = 3 cases), high-grade squamous intraepithelial lesion (HSIL) (n = 22 cases), and invasive squamous carcinoma (n = 1 case), and in 2 cases with negative follow-up biopsies.
  • The sensitivity and specificity of p16 immunoreactivity in the detection of anal intraepithelial neoplasia or carcinoma were 72% and 71%, respectively.
  • CONCLUSIONS: The presence of p16 immunoreactivity is a good predictor of dysplasia in anal specimens.
  • [MeSH-major] Anus Neoplasms / pathology. Biomarkers, Tumor / analysis. Carcinoma in Situ / pathology. Neoplasms, Squamous Cell / pathology

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  • [Copyright] (c) 2006 American Cancer Society.
  • (PMID = 16404747.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Cyclin-Dependent Kinase Inhibitor p16
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57. Papaconstantinou HT, Lee AJ, Simmang CL, Ashfaq R, Gokaslan ST, Sokol S, Huber PJ Jr, Gregorcyk SG: Screening methods for high-grade dysplasia in patients with anal condyloma. J Surg Res; 2005 Jul 1;127(1):8-13
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Screening methods for high-grade dysplasia in patients with anal condyloma.
  • HPV infection can cause anal condylomas and is a risk factor for dysplasia.
  • High-grade dysplasia may progress to squamous cell carcinoma.
  • Currently, biopsy and histological examination are required to grade dysplasia.
  • The purpose of this study is to determine whether anal cytology, morphological characteristics, and/or the presence of high-risk oncogenic HPV-types are effective noninvasive methods to detect high-risk anal condylomas.
  • PATIENTS AND METHODS: From November 2003 to June 2004, all patients with anal condyloma were prospectively evaluated for anal cytology, high-risk oncogenic HPV-types, and tissue biopsies.
  • RESULTS: Forty-seven patients with anal condyloma were studied; 43 (91.5%) were men, and the mean age was 39 +/- 11 years.
  • CONCLUSION: Anal cytology alone is not accurate for detecting HRL in patients with anal condylomas.
  • Combining oncogenic HPV-testing with cytology is more sensitive in detecting HRL in patients with anal condyloma, and therefore, a more effective screening tool.
  • [MeSH-major] Anal Canal / pathology. Anus Diseases / pathology. Anus Neoplasms / pathology. Condylomata Acuminata / pathology. Papillomaviridae. Papillomavirus Infections / pathology. Tumor Virus Infections / pathology

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  • (PMID = 15964301.001).
  • [ISSN] 0022-4804
  • [Journal-full-title] The Journal of surgical research
  • [ISO-abbreviation] J. Surg. Res.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
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58. Charúa-Guindic L, Esquivel-Ocampo EA, Villanueva-Herrero JA, Jiménez-Bobadilla B, Muñoz-Cortés SB, Leal-Tamez M, Avendaño-Espinosa O: [Anal intraepithelial neoplasia (NIA) and infection with human papillomavirus (HPV) in anoreceptive patients]. Rev Gastroenterol Mex; 2009;74(3):195-201
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Anal intraepithelial neoplasia (NIA) and infection with human papillomavirus (HPV) in anoreceptive patients].
  • [Transliterated title] La neoplasia intraepitelial anal y la infección por virus del papiloma humano en pacientes anorreceptivos.
  • BACKGROUND: An association between human papilloma virus (HPV) infection and progression to anal intraepithelial neoplasia (AIN) and epidermoid cancer has been established.
  • OBJECTIVE: To know the prevalence of low and high grade AIN, as well as HPV infection in an anoreceptive patients group, infected or not, by human immunodeficiency virus (HIV).
  • Patients who accepted anal citology and high definition anoscopy and biopsies with a follow-up not minor of 3 months were included.
  • Anal cytology showed inflammatory alterations in 21 patients (28%), low grade intraepithelial lesion in 23 (52%); there were not patients with high grade epithelial lesion.
  • According to the high definition anoscopy, there were low grade intraepithelial lesion in 42 patients (95%) and high grade in 2 (5%).
  • Biopsy showed low grade intraepithelial in 26 patients (59%), high grade in 4 (9%) and inflammatory alterations in 14 (32%).
  • The prevalence of AIN and HPV infection was 68% in both diseases.
  • The HIV infection was associated with the presence of high grade AIN (p=0.002, OR 47.7) CONCLUSIONS: There is a high prevalence of AIN and HPV infection between patients with anoreceptive sexual relations.
  • The HIV infection is a risk factor for the development of high grade AIN.
  • [MeSH-major] Anus Neoplasms / complications. Carcinoma in Situ / complications. Papillomavirus Infections / complications. Sexual Behavior / statistics & numerical data
  • [MeSH-minor] Adolescent. Adult. Anal Canal / pathology. Biopsy. Disease Progression. Female. HIV Infections / complications. Humans. Male. Middle Aged. Risk Factors. Young Adult

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  • (PMID = 19858007.001).
  • [ISSN] 0375-0906
  • [Journal-full-title] Revista de gastroenterología de México
  • [ISO-abbreviation] Rev Gastroenterol Mex
  • [Language] spa
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Mexico
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59. Walts AE, Lechago J, Hu B, Shwayder M, Sandweiss L, Bose S: P16 and Ki67 Immunostains Decrease Intra- and Interobserver Variability in the Diagnosis and Grading of Anal Intraepithelial Neoplasia (AIN). Clin Med Pathol; 2008;1:7-13

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] P16 and Ki67 Immunostains Decrease Intra- and Interobserver Variability in the Diagnosis and Grading of Anal Intraepithelial Neoplasia (AIN).
  • BACKGROUND: Significant variation is reported in the diagnosis of HPV-associated AIN.
  • We previously observed that band-like positivity for p16 in >90% of contiguous cells coupled with Ki67 positivity in >50% of lesional cells is strongly associated with high grade AIN.
  • This study was undertaken to determine if addition of p16 and Ki67 immunostaining would reduce inter- and intraobserver variability in diagnosis and grading of AIN.
  • DESIGN: H&E stained slides of 60 anal biopsies were reviewed by three pathologists and consensus diagnoses were achieved: 25 negative, 12 low (condyloma and/or AIN I) and 23 high (9 AIN II and 14 AIN III) grade lesions.
  • RESULTS: Addition of p16 and Ki67 immunostains reduced intra- and interobserver variability, improved concurrence with consensus diagnoses and reduced two-step differences in diagnosis.
  • Negative and high grade AIN diagnoses showed the most improvement in concurrence levels.
  • CONCLUSION: Addition of p16 and Ki67 immunostains is helpful in the diagnosis and grading of AIN.

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  • (PMID = 21876646.001).
  • [ISSN] 1178-1181
  • [Journal-full-title] Clinical medicine. Pathology
  • [ISO-abbreviation] Clin Med Pathol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] New Zealand
  • [Other-IDs] NLM/ PMC3159996
  • [Keywords] NOTNLM ; Ki67 / P16 / anal intraepithelial neoplasia (AIN) / condyloma / human papilloma virus (HPV) / interobserver variability / intraobserver variability
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60. Mori M, Matsubara K, Abe E, Matsubara Y, Katayama T, Fujioka T, Kusanagi Y, Ito M: Prenatal diagnosis of persistent cloaca associated with VATER (vertebral defects, anal atresia, tracheo-esophageal fistula, and renal dysplasia). Tohoku J Exp Med; 2007 Dec;213(4):291-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Prenatal diagnosis of persistent cloaca associated with VATER (vertebral defects, anal atresia, tracheo-esophageal fistula, and renal dysplasia).
  • The cloaca is a single canal from which the urinary, genital, and intestinal tracts arise around gestational weeks 5-6.
  • VATER association, which is a spectrum of anomalies, manifested by vertebral defects, anal atresia, tracheo-esophageal fistula with esophageal atresia, and renal dysplasia, arises from abnormalities in mesodermal differentiation.
  • By ultrasonography, we detected a polycystic left kidney, a single umbilical artery, a ventricular septal defect, an esophageal atresia, ascites, an anal atresia, and a cystic mass with debris behind the bladder.
  • [MeSH-major] Abnormalities, Multiple / diagnosis. Anus, Imperforate / diagnosis. Cloaca / abnormalities. Multicystic Dysplastic Kidney / diagnosis. Prenatal Diagnosis. Spine / abnormalities. Tracheoesophageal Fistula / diagnosis


61. Abbasakoor F, Boulos PB: Anal intraepithelial neoplasia. Br J Surg; 2005 Mar;92(3):277-90
MedlinePlus Health Information. consumer health - Anal Cancer.

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Anal intraepithelial neoplasia.
  • BACKGROUND: Anal intraepithelial neoplasia (AIN) is believed to be a precursor of anal squamous cell cancer and its incidence is rising in high-risk groups, particularly those infected with the human immunodeficiency virus (HIV).
  • The natural history of AIN is unclear and management strategies are lacking.
  • METHODS: This review is based on a literature search (Medline and PubMed) with manual cross-referencing of all articles related to AIN.
  • RESULTS AND CONCLUSIONS: The aetiology of AIN is intricately linked with human papilloma viruses.
  • The pathological processes involved in the progression of AIN are becoming clearer but the natural history, particularly the rate of progression to invasive cancer, remains unknown.
  • There is no standard management for AIN and this is mainly due to difficulties in both diagnosis and treatment.
  • Long-term follow-up of these patients is essential until the natural history of AIN becomes clearer.
  • [MeSH-major] Anal Canal / pathology. Anus Neoplasms. Carcinoma in Situ. Carcinoma, Squamous Cell

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  • [Copyright] Copyright (c) 2005 British Journal of Surgery Society Ltd.
  • (PMID = 15736144.001).
  • [ISSN] 0007-1323
  • [Journal-full-title] The British journal of surgery
  • [ISO-abbreviation] Br J Surg
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Number-of-references] 131
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62. Pineda CE, Welton ML: Management of anal squamous intraepithelial lesions. Clin Colon Rectal Surg; 2009 May;22(2):94-101
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Management of anal squamous intraepithelial lesions.
  • Anal squamous intraepithelial lesions include both low-grade squamous intraepithelial lesions (LSIL) and high-grade squamous intraepithelial lesions (HSIL) and are caused by chronic infection with the human papillomavirus (HPV).
  • Although the natural history of the disease is unknown, there is significant evidence that untreated HSIL progresses to squamous cell carcinoma in 11% of patients and in up to 50% of patients with extensive disease and immunosuppression.
  • Anal cytology and reflex HPV DNA testing are used to screen for disease, particularly among patients with the aforementioned risk factors.

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  • (PMID = 20436833.001).
  • [ISSN] 1530-9681
  • [Journal-full-title] Clinics in colon and rectal surgery
  • [ISO-abbreviation] Clin Colon Rectal Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Other-IDs] NLM/ PMC2780238
  • [Keywords] NOTNLM ; Anal squamous dysplasia / high-grade squamous intraepithelial lesions / high-resolution anoscopy
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63. Hernández JD, Jiménez-Huyke C, Rosado K, González-Keelan C, Lojo JJ, Torres EA: Surveillance for dysplasia in patients with ileal pouch-anal anastomosis for ulcerative colitis: an interim analysis. Dig Dis Sci; 2010 Aug;55(8):2332-6
MedlinePlus Health Information. consumer health - Ulcerative Colitis.

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Surveillance for dysplasia in patients with ileal pouch-anal anastomosis for ulcerative colitis: an interim analysis.
  • Dysplasia in the pouch is quite rare.
  • METHODS: Endoscopy and biopsies of the ileal pouch were performed at 3, 6, and/or 12 months after ileal pouch-anal anastomosis (IPAA) became functional.
  • Ten of 38 cases (26%) had colonic dysplasia prior to surgery.
  • Dysplasia within the pouch was reported in one patient 6 months after IPAA became functional.
  • This patient demonstrated no dysplasia at 12 months or statistical divergence by age, duration of disease or history of colonic dysplasia prior to IPAA.
  • No subgroup of patients with dysplasia was identified to calculate cumulative risk or perform comparative statistical analysis.
  • However, the finding of dysplasia early after surgery underscores the importance of early pouch surveillance in our population, at least until definite predisposing variables are identified.

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  • (PMID = 19842036.001).
  • [ISSN] 1573-2568
  • [Journal-full-title] Digestive diseases and sciences
  • [ISO-abbreviation] Dig. Dis. Sci.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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64. Zmora O, Spector D, Dotan I, Klausner JM, Rabau M, Tulchinsky H: Is stapled ileal pouch anal anastomosis a safe option in ulcerative colitis patients with dysplasia or cancer? Int J Colorectal Dis; 2009 Oct;24(10):1181-6
MedlinePlus Health Information. consumer health - Ulcerative Colitis.

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Is stapled ileal pouch anal anastomosis a safe option in ulcerative colitis patients with dysplasia or cancer?
  • PURPOSE: The purpose of this study was to investigate the oncological and clinical outcome of ulcerative colitis (UC) patients with coexisting colorectal cancer/dysplasia following stapled ileal pouch-anal anastomosis (IPAA).
  • They were divided into three groups: colorectal cancer, dysplasia, and no cancer/dysplasia.
  • RESULTS: Sixteen patients had cancer and 14 had dysplasia.
  • All other cancer/dysplasia patients were disease-free at 62 months (median).
  • Overall pouch failure rates were 19%, 7%, and 6% for cancer, dysplasia, and no-cancer/dysplasia patients, respectively (p = 0.13).
  • CONCLUSIONS: Stapled IPAA is a reasonable option for UC patients with cancer/dysplasia.
  • Close long-term follow-up for UC patients with cancer/dysplasia is recommended for early detection of possible recurrence.


65. Chambers WM, McC Mortensen NJ: Should ileal pouch-anal anastomosis include mucosectomy? Colorectal Dis; 2007 Jun;9(5):384-92
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Should ileal pouch-anal anastomosis include mucosectomy?
  • Potential reasons for functional problems were investigated, as were rates of 'cuffitis', dysplasia, polyposis and cancer in the ileal pouch and anal canal.
  • The most likely reason for functional impairment following pouch surgery was the degree of anal manipulation.
  • CONCLUSION: Stapled anastomosis avoiding mucosectomy is the approach of choice for ileal pouch anal anastomosis because this leads to superior functional outcome.
  • Performing mucosectomy results in some clinical benefits in terms of lower rates of inflammation and dysplasia in the retained mucosa in UC patients and lower rates of cuff polyposis in FAP patients.
  • [MeSH-minor] Adenocarcinoma / prevention & control. Adenomatous Polyposis Coli / surgery. Anastomosis, Surgical / adverse effects. Anastomosis, Surgical / methods. Anus Neoplasms / prevention & control. Arsenates. Colitis, Ulcerative / surgery. Humans. Ileal Neoplasms / prevention & control. Randomized Controlled Trials as Topic

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  • (PMID = 17504334.001).
  • [ISSN] 1462-8910
  • [Journal-full-title] Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland
  • [ISO-abbreviation] Colorectal Dis
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Arsenates; N7CIZ75ZPN / arsenic acid
  • [Number-of-references] 70
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66. Chien JC, Chen SJ, Tiu CM, Chen YJ, Hwang B, Niu DM: Is urorectal septum malformation sequence a variant of the vertebral defects, anal atresia, tracheo-oesophageal fistula, renal defects and radial dysplasia association? Report of a case and a review of the literature. Eur J Pediatr; 2005 Jun;164(6):350-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Is urorectal septum malformation sequence a variant of the vertebral defects, anal atresia, tracheo-oesophageal fistula, renal defects and radial dysplasia association? Report of a case and a review of the literature.
  • The urorectal septum malformation sequence (URSMS) consists of multiple systems anomalies including ambiguous genitalia, the absence of a perineal opening, an imperforate anus, and urogenital, colonic and lumbosacral anomalies.
  • We also compare its characteristics with those of the vertebral defects, anal atresia, tracheo-oesophageal fistula, renal defects and radial dysplasia (VATER) association.
  • CONCLUSION: Although defects of the urorectal septum malformation sequence and the vertebral defects, anal atresia, tracheo-oesophageal fistula, renal defects and radial dysplasia association overlap, we believe that they are separate entities.
  • Differentiating the urorectal septum malformation sequence from vertebral defects, anal atresia, tracheo-oesophageal fistula, renal defects and radial dysplasia association is helpful to develop appropriate clinical investigations and search for the aetiology and pathogenesis of these diseases.
  • [MeSH-major] Abnormalities, Multiple / diagnosis. Anus, Imperforate / diagnosis. Urogenital Abnormalities / diagnosis

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  • (PMID = 15729561.001).
  • [ISSN] 0340-6199
  • [Journal-full-title] European journal of pediatrics
  • [ISO-abbreviation] Eur. J. Pediatr.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] Germany
  • [Number-of-references] 25
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67. Lovegrove RE, Constantinides VA, Heriot AG, Athanasiou T, Darzi A, Remzi FH, Nicholls RJ, Fazio VW, Tekkis PP: A comparison of hand-sewn versus stapled ileal pouch anal anastomosis (IPAA) following proctocolectomy: a meta-analysis of 4183 patients. Ann Surg; 2006 Jul;244(1):18-26
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] A comparison of hand-sewn versus stapled ileal pouch anal anastomosis (IPAA) following proctocolectomy: a meta-analysis of 4183 patients.
  • OBJECTIVE: Using meta-analytical techniques, the study compared postoperative adverse events and functional outcomes of stapled versus hand-sewn ileal pouch-anal anastomosis (IPAA) following restorative proctocolectomy.
  • BACKGROUND: The choice of mucosectomy and hand-sewn versus stapled pouch-anal anastomosis has been a subject of debate with no clear consensus as to which method provides better functional results and long-term outcomes.
  • Endpoints were classified into postoperative complications and functional and physiologic outcomes measured at least 3 months following closure of ileostomy or surgery if no proximal diversion was used, quality of life following surgery, and neoplastic transformation within the anal transition zone.
  • The stapled IPAA group showed a higher incidence of dysplasia in the anal transition zone that did not reach statistical significance (OR = 0.42, P = 0.080).
  • A risk of increased incidence of dysplasia in the ATZ may exist in the stapled group that cannot be quantified by this study.

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  • (PMID = 16794385.001).
  • [ISSN] 0003-4932
  • [Journal-full-title] Annals of surgery
  • [ISO-abbreviation] Ann. Surg.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Meta-Analysis
  • [Publication-country] United States
  • [Other-IDs] NLM/ PMC1570587
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68. Shen B, Fazio VW, Remzi FH, Lashner BA: Clinical approach to diseases of ileal pouch-anal anastomosis. Am J Gastroenterol; 2005 Dec;100(12):2796-807
MedlinePlus Health Information. consumer health - Ulcerative Colitis.

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Clinical approach to diseases of ileal pouch-anal anastomosis.
  • Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) is the surgical treatment of choice for ulcerative colitis (UC) patients with medically refractory disease or dysplasia.
  • Accurate diagnosis and classification are important for appropriate management.
  • Endoscopic evaluation is the most important tool for the diagnosis and differential diagnosis.
  • [MeSH-minor] Adrenal Cortex Hormones / therapeutic use. Anti-Bacterial Agents / therapeutic use. Colonoscopy / methods. Crohn Disease / drug therapy. Crohn Disease / pathology. Drug Therapy, Combination. Female. Humans. Irritable Bowel Syndrome / diagnosis. Irritable Bowel Syndrome / drug therapy. Male. Prognosis. Risk Assessment. Severity of Illness Index. Treatment Outcome

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  • (PMID = 16393238.001).
  • [ISSN] 0002-9270
  • [Journal-full-title] The American journal of gastroenterology
  • [ISO-abbreviation] Am. J. Gastroenterol.
  • [Language] eng
  • [Grant] United States / NIDDK NIH HHS / DK / R03 DK 067275
  • [Publication-type] Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Adrenal Cortex Hormones; 0 / Anti-Bacterial Agents
  • [Number-of-references] 97
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69. Guo X, Feng J, Wang G: Anorectal electromanometrical patterns in children with isolated neuronal intestinal dysplasia. Eur J Pediatr Surg; 2008 Jun;18(3):176-9
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  • [Title] Anorectal electromanometrical patterns in children with isolated neuronal intestinal dysplasia.
  • BACKGROUND: The aim of this study was to report our new findings on anorectal electromanometrical patterns in patients with isolated neuronal intestinal dysplasia (IND) type B.
  • The diagnosis of IND was made based on a pathological examination.
  • The electromanometric examination showed no significant difference in anal resting pressure and the length of the high pressure zone between the IND and the functional constipation (FC) groups.
  • The frequency of anal peristalsis in the IND group, however, was significantly lower than that in the FC group.
  • [MeSH-major] Digestive System Abnormalities / diagnosis. Electrodiagnosis. Enteric Nervous System / abnormalities. Intestinal Diseases / diagnosis. Manometry
  • [MeSH-minor] Anal Canal. Child. Child, Preschool. Female. Humans. Infant. Male. Rectum

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  • (PMID = 18493893.001).
  • [ISSN] 0939-7248
  • [Journal-full-title] European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift für Kinderchirurgie
  • [ISO-abbreviation] Eur J Pediatr Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
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70. Bernard JE, Butler MO, Sandweiss L, Weidner N: Anal intraepithelial neoplasia: correlation of grade with p16INK4a immunohistochemistry and HPV in situ hybridization. Appl Immunohistochem Mol Morphol; 2008 May;16(3):215-20
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Anal intraepithelial neoplasia: correlation of grade with p16INK4a immunohistochemistry and HPV in situ hybridization.
  • Accurate diagnosis and grading of anal intraepithelial neoplasia (AIN) can be problematic, especially in separating AIN from anal transitional-zone epithelium.
  • To investigate if p16 would help in more accurately diagnosing and grading AIN, particularly when attempting to distinguish benign transitional-zone epithelium from high-grade AIN, we separately assessed these stains in a blinded manner on a large number of consecutive anal biopsies and anal tissues and correlated the findings with the diagnosis and grade of AIN.
  • One hundred thirty-three consecutive anal tissue specimens, from 128 patients were studied.
  • One hundred and eight were anal biopsies and 25 were hemorrhoidectomy specimens.
  • The comparisons included AIN grade (negative, 1, 2, 3) with nuclear intensity of p16 IHC (0 to 3+), AIN grade with IHC nuclear staining patterns (contiguous, patchy/rare), AIN grade with HPV-ISH [negative, low-risk (LR), high-risk (HR)] and, nuclear intensity of p16 IHC with HPV-ISH.
  • Yet, 33% of AIN negative cases were positive for nuclear p16, although with less nuclear intensity than for AIN2 or 3.
  • The kappa value for AIN/nuclear p16 intensity agreement was 0.61 (ie, substantial agreement).
  • Yet, 12.5% of AIN negative cases were positive for HPV for both LR and HR types.
  • The kappa value for AIN/HPV agreement was 0.62 (ie, substantial agreement).
  • Of interest, 30 cases were negative for AIN and p16 staining and of these, 2 (7%) were positive for HPV (both LR subtype).
  • Three cases positive for HR HPV were negative for AIN with only patchy nuclear p16 positivity.
  • We conclude that the correlation between AIN and p16 and HPV is strong enough to be quite useful in distinguishing true AIN from benign mimics, such as benign transitional-zone epithelium.

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  • (PMID = 18301250.001).
  • [ISSN] 1533-4058
  • [Journal-full-title] Applied immunohistochemistry & molecular morphology : AIMM
  • [ISO-abbreviation] Appl. Immunohistochem. Mol. Morphol.
  • [Language] ENG
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Cyclin-Dependent Kinase Inhibitor p16; 0 / DNA Probes, HPV
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71. Calore EE, Nadal SR, Manzione CR, Horta SC, Santos RR, Nadal LM: Anal cytology in patients with AIDS. Diagn Cytopathol; 2010 Apr;38(4):260-3
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Anal cytology in patients with AIDS.
  • The objective of the present study was to study the prevalence of abnormal anal cytology in patients with AIDS.
  • Anal smears, obtained with a cytobrush, of 102 HIV-positive patients of the Emilio Ribas Institute (Sao Paulo, Brazil) were collected, and only after that, the patients were submitted to anoscopy.
  • Squamous intra-epithelial lesions were also observed in 38% of the patients without condyloma (18/47): in 9 of the 33 patients without history of condyloma (27%) and in 9 of the 14 patients who had previously treated condyloma (64%).
  • An invasive squamous cell carcinoma was observed in one patient without history of condyloma.
  • In all 13 patients with HSIL, biopsies guided by high resolution anoscopy confirmed high grade dysplasia.
  • Our findings suggest that anal cytology is mandatory in AIDS even in patients without macroscopic anal lesions or without previous history of anal condyloma.
  • [MeSH-major] Acquired Immunodeficiency Syndrome / pathology. Anal Canal / pathology

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  • [Copyright] Copyright 2009 Wiley-Liss, Inc.
  • (PMID = 19813269.001).
  • [ISSN] 1097-0339
  • [Journal-full-title] Diagnostic cytopathology
  • [ISO-abbreviation] Diagn. Cytopathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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72. Lytwyn A, Salit IE, Raboud J, Chapman W, Darragh T, Winkler B, Tinmouth J, Mahony JB, Sano M: Interobserver agreement in the interpretation of anal intraepithelial neoplasia. Cancer; 2005 Apr 1;103(7):1447-56
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  • [Title] Interobserver agreement in the interpretation of anal intraepithelial neoplasia.
  • BACKGROUND: Anal carcinoma incidence is increasing, and is highest among men with human immunodeficiency virus (HIV) infection who have sex with men.
  • Anal carcinoma and anal intraepithelial neoplasia (AIN) are ascertained on tissue histology, but requires invasive procedures.
  • Screening for AIN using anal cytology was suggested.
  • The authors evaluated agreement on cytologic and biopsy specimens from HIV-positive men undergoing anal carcinoma screening.
  • METHODS: One hundred twenty-nine HIV-positive men with a history of anal-receptive intercourse underwent anal cytology, anoscopy, and biopsy.
  • Reliability for the Bethesda classification system was at least moderate, except for the cytologic category of atypical squamous cells of undetermined significance (kappa = 0.12).
  • Fourteen of 29 (48.3%) cytology specimens and 36 of 47 (76.6%) biopsy specimens with consensus interpretation of high-grade squamous intraepithelial lesions (HSIL) were interpreted originally as HSIL by > or = 3 pathologists.
  • [MeSH-major] Anus Neoplasms / pathology. Carcinoma in Situ / pathology. Observer Variation

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  • [Copyright] Copyright 2005 American Cancer Society.
  • (PMID = 15726546.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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73. Longacre TA, Kong CS, Welton ML: Diagnostic problems in anal pathology. Adv Anat Pathol; 2008 Sep;15(5):263-78
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Diagnostic problems in anal pathology.
  • Anal squamous cell carcinoma and its precursor lesions are increasing in incidence in the United States and Europe.
  • This trend predates human immunodeficiency virus/acquired immune deficiency syndrome and has been associated with persistent high-risk human papilloma virus (HPV) genotype infection, previous lower genital tract dysplasia/carcinoma, high frequency anoreceptive intercourse, heavy cigarette smoking, immunosuppression in solid organ transplant and immune disorders, and human immunodeficiency virus seropositivity.
  • Screening protocols for at-risk patients are under active investigation and pathologists are often asked to assess anal canal and perianal biopsies for the presence of dysplasia and/or invasive carcinoma.
  • Because underdiagnosis and overdiagnosis of anal cancer and precancer may lead to inappropriate treatment, it is important for the pathologist to be aware of current screening strategies, specific risk lesions, and the role of pathology in initial diagnosis and evaluation of anal biopsy and/or resection specimens.
  • Standardized histologic criteria and uniform terminology should be used for reporting all anal canal and perianal squamous intraepithelial lesions.
  • HPV subtyping, anal cytology, and recently identified biomarkers, such as p16 and Becton Dickinson ProEx C may provide additional information in problematic cases, but it is important to be aware of the limitations of these assays.
  • HPV has been linked to all the major histologic subtypes of anal carcinoma (eg, basaloid, cloacogenic, transitional, etc.) and this association is strongest for anal canal lesions.
  • With the possible exception of the microcystic pattern, histologic subtype does not seem to predict prognosis; and anal squamous cell carcinomas should be classified as either keratinizing or nonkeratinizing.
  • Poorly differentiated squamous cell carcinomas have a worse prognosis and should be distinguished from poorly differentiated adenocarcinoma, melanoma, and neuroendocrine tumors.
  • Very well differentiated squamous cell carcinoma with pushing margins (so-called giant condyloma of Buschke and Lowenstein) should be classified as verrucous carcinoma; this tumor shows aggressive local infiltration but does not metastasize.
  • As all anal condylomata may harbor foci of high-grade dysplasia or invasive carcinoma, careful sectioning and complete histologic examination is required.
  • [MeSH-major] Anal Canal / pathology. Anus Neoplasms / pathology. Carcinoma, Squamous Cell / pathology
  • [MeSH-minor] Carcinoma, Verrucous / pathology. Condylomata Acuminata / pathology. Diagnosis, Differential. Humans. Papillomaviridae / genetics. Risk Factors. Terminology as Topic

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  • (PMID = 18724100.001).
  • [ISSN] 1533-4031
  • [Journal-full-title] Advances in anatomic pathology
  • [ISO-abbreviation] Adv Anat Pathol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 73
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74. Das P, Johnson MW, Tekkis PP, Nicholls RJ: Risk of dysplasia and adenocarcinoma following restorative proctocolectomy for ulcerative colitis. Colorectal Dis; 2007 Jan;9(1):15-27
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Risk of dysplasia and adenocarcinoma following restorative proctocolectomy for ulcerative colitis.
  • The ileal mucosa in the reservoir and the anorectal columnar epithelium below the ileo-anal anastomosis are at risk of neoplastic transformation.
  • RESULTS: Dysplasia in the ileal reservoir is rare.
  • Twelve of these had histopathological data on either dysplasia or carcinoma in the original operative specimen.
  • Patients with dysplasia or carcinoma in the original specimen, those with type C ileal mucosal changes and patients with sclerosing cholangitis should be selected for surveillance.
  • This will involve multiple biopsies of the ileal reservoir and the anorectal mucosa below the ileo-anal anastomosis.

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  • [CommentIn] Colorectal Dis. 2007 Nov;9(9):856 [17931176.001]
  • (PMID = 17181842.001).
  • [ISSN] 1462-8910
  • [Journal-full-title] Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland
  • [ISO-abbreviation] Colorectal Dis
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Number-of-references] 96
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75. Goldstone SE, Enyinna CS, Davis TW: Detection of oncogenic human papillomavirus and other predictors of anal high-grade dysplasia in men who have sex with men with abnormal cytology. Dis Colon Rectum; 2009 Jan;52(1):31-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Detection of oncogenic human papillomavirus and other predictors of anal high-grade dysplasia in men who have sex with men with abnormal cytology.
  • PURPOSE: The incidence of anal high-grade dysplasia in men who have sex with men is increasing.
  • Anal cytology that shows atypical squamous cells of undetermined significance is common, nonspecific, and rarely predicts high-grade squamous intraepithelial lesion.
  • We want to know whether Hybrid-Capture II(R) testing for oncogenic human papillomavirus (human papillomavirus+) in men who have sex with men with atypical squamous cells of undetermined significance is beneficial and whether other predictors of high-grade squamous intraepithelial lesion exist.
  • METHODS: We performed a retrospective chart review of men who have sex with men undergoing anal screening with atypical squamous cells of undetermined significance cytology, Hybrid-Capture(R) II testing, and biopsy.
  • RESULTS: A total of 597 men who have sex with men enrolled and had 1,015 atypical squamous cells of undetermined significance cytology results: 185 (18.2 percent) had high-grade squamous intraepithelial lesion and 156 (84 percent) were human papillomavirus+.
  • Of 390 low-grade squamous intraepithelial lesion cytology results, high-grade squamous intraepithelial lesion was found in 141 and 127 (90 percent) were human papillomavirus+.
  • Those with previous high-grade squamous intraepithelial lesions or human immunodeficiency virus had increased risk of high-grade squamous intraepithelial lesion (hazard ratio = 2.2 and hazard ratio = 1.95, respectively).
  • CONCLUSIONS: Hybrid-Capture II(R) testing is useful in men who have sex with men with atypical squamous cells of undetermined significance.
  • Referring only those with oncogenic human papillomavirus for biopsy reduces the number requiring this by almost half but some high-grade squamous intraepithelial lesions are missed.
  • History of high-grade squamous intraepithelial lesion and human immunodeficiency virus are predictors of high-grade squamous intraepithelial lesion while screening intervals might be lengthened absent oncogenic human papillomavirus or in those free of high-grade squamous intraepithelial lesion for long periods.
  • [MeSH-major] Anus Neoplasms / virology. Homosexuality, Male. Papillomaviridae / isolation & purification. Papillomavirus Infections / diagnosis. Precancerous Conditions / virology. Tumor Virus Infections / diagnosis
  • [MeSH-minor] Adolescent. Adult. Aged. Anal Canal / pathology. Anal Canal / virology. HIV Seropositivity. Humans. Male. Middle Aged. Predictive Value of Tests. Sensitivity and Specificity. Young Adult

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  • (PMID = 19273953.001).
  • [ISSN] 1530-0358
  • [Journal-full-title] Diseases of the colon and rectum
  • [ISO-abbreviation] Dis. Colon Rectum
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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76. Pineda CE, Welton ML: Controversies in the management of anal high-grade squamous intraepithelial lesions. Minerva Chir; 2008 Oct;63(5):389-99
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Controversies in the management of anal high-grade squamous intraepithelial lesions.
  • Anal squamous dysplasia is recognized as a spectrum of disease that ranges from low-grade intraepithelial lesions (LSIL) to high-grade squamous intraepithelial lesions (HSIL) to invasive anal squamous cell carcinoma (SCC).
  • Recent reports have shown a significant increase in both the incidence and prevalence of both HSIL and anal SCC, particularly in immunocompromised patients and in men who have sex with men.
  • However, there is evidence that screening of high-risk patients with anal cytology is useful in identifying those that require further evaluation.
  • [MeSH-major] Anus Neoplasms. Carcinoma in Situ. Carcinoma, Squamous Cell. HIV Seropositivity / complications. Homosexuality, Male

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  • (PMID = 18923350.001).
  • [ISSN] 0026-4733
  • [Journal-full-title] Minerva chirurgica
  • [ISO-abbreviation] Minerva Chir
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Review
  • [Publication-country] Italy
  • [Chemical-registry-number] 0 / Immunologic Factors
  • [Number-of-references] 73
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77. Rossi E, Villanacci V, Bassotti G, Donato F, Festa A, Cengia G, Grisanti S, Cestari R: TOPOIIalpha and HER-2/neu overexpression/amplification in Barrett's oesophagus, dysplasia and adenocarcinoma. Histopathology; 2010 Jul;57(1):81-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] TOPOIIalpha and HER-2/neu overexpression/amplification in Barrett's oesophagus, dysplasia and adenocarcinoma.
  • METHODS AND RESULTS: Forty-four patients [18 BO, 13 BO with dysplasia (five low-grade dysplasia, eight high-grade dysplasia) and 13 ADC in BO] were evaluated by immunohistochemistry and fluorescence in situ hybridization (FISH).
  • Patients with BO, dysplasia and ADC were compared.
  • Gene amplification (HER-2/neu, TOPOIIalpha), protein overexpression (HER-2/TOPOIIalpha), and chromosome 17 aneusomy were associated with dysplasia or ADC.
  • Most BO patients showed no amplification/overexpression/aneusomy for the above genes, proteins and chromosome, with no differences between dysplasia and ADC.
  • CONCLUSIONS: HER-2/neu and TOPOIIalpha amplification/overexpression might discriminate between BO and dysplasia/ADC.
  • Chromosome 17 aneusomy is associated with dysplasia or ADC in BO.
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Aneuploidy. Chromosomes, Human, Pair 17 / genetics. Diagnosis, Differential. Female. Gene Amplification. Gene Expression. Humans. In Situ Hybridization, Fluorescence. Male. Middle Aged. Receptor, ErbB-2 / metabolism. Retrospective Studies

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  • (PMID = 20557373.001).
  • [ISSN] 1365-2559
  • [Journal-full-title] Histopathology
  • [ISO-abbreviation] Histopathology
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antigens, Neoplasm; 0 / DNA-Binding Proteins; EC 2.7.10.1 / ERBB2 protein, human; EC 2.7.10.1 / Receptor, ErbB-2; EC 5.99.1.3 / DNA Topoisomerases, Type II; EC 5.99.1.3 / DNA topoisomerase II alpha
  • [Other-IDs] NLM/ PMC2916224
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78. Al Kaissi A, Grill F, Alexander K, Varga F, Klaushofer K: Progressive noninfectious anterior vertebral fusion in a girl with axial mesodermal dysplasia spectrum. Clin Dysmorphol; 2008 Jan;17(1):65-8
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  • [Title] Progressive noninfectious anterior vertebral fusion in a girl with axial mesodermal dysplasia spectrum.
  • We report a 7-year-old-girl who presented with the clinical criteria of the axial mesodermal dysplasia spectrum.
  • The urogenital and the anal-recto regions were normal.
  • To the best of our knowledge, this is the first clinical report of a child with axial mesodermal dysplasia in association with progressive noninfectious anterior vertebral fusion.

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  • (PMID = 18049085.001).
  • [ISSN] 0962-8827
  • [Journal-full-title] Clinical dysmorphology
  • [ISO-abbreviation] Clin. Dysmorphol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
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79. Lepistö A, Kärkkäinen P, Järvinen HJ: Prevalence of primary sclerosing cholangitis in ulcerative colitis patients undergoing proctocolectomy and ileal pouch-anal anastomosis. Inflamm Bowel Dis; 2008 Jun;14(6):775-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Prevalence of primary sclerosing cholangitis in ulcerative colitis patients undergoing proctocolectomy and ileal pouch-anal anastomosis.
  • METHODS: The study sample included 441 consecutive patients who underwent proctocolectomy with ileal pouch-anal anastomosis from 1993 to 2004 at the Helsinki University Central Hospital.
  • The cumulative incidence of colorectal dysplasia or cancer in the UC patients with PSC (19% after 10 years and 43% after 20 years) was not significantly different than that of UC patients without PSC (24% after 10 years and 39% after 20 years).
  • The failure rate of ileal pouch-anal anastomosis did not significantly differ between the 2 groups.
  • [MeSH-minor] Adolescent. Adult. Aged. Anal Canal / surgery. Bile Duct Neoplasms / etiology. Bile Ducts, Intrahepatic. Biopsy. Cholangiocarcinoma / etiology. Female. Humans. Liver / pathology. Liver Transplantation. Male. Middle Aged. Pouchitis / etiology. Prevalence. Treatment Failure

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  • (PMID = 18253951.001).
  • [ISSN] 1078-0998
  • [Journal-full-title] Inflammatory bowel diseases
  • [ISO-abbreviation] Inflamm. Bowel Dis.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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80. McLaughlin SD, Clark SK, Thomas-Gibson S, Tekkis PP, Ciclitira PJ, Nicholls RJ: Guide to endoscopy of the ileo-anal pouch following restorative proctocolectomy with ileal pouch-anal anastomosis; indications, technique, and management of common findings. Inflamm Bowel Dis; 2009 Aug;15(8):1256-63
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  • [Title] Guide to endoscopy of the ileo-anal pouch following restorative proctocolectomy with ileal pouch-anal anastomosis; indications, technique, and management of common findings.
  • Restorative proctocolectomy (RPC) with ileal pouch-anal anastomosis is the surgical procedure of choice for patients with ulcerative colitis (UC).
  • The risk of developing dysplasia following RPC is low.
  • Surveillance pouchoscopy is only recommended in those with FAP, those with a previous history of dysplasia or carcinoma, primary sclerosing cholangitis, those with a retained rectal cuff, and those with Type C histological changes.
  • [MeSH-major] Anal Canal / surgery. Anastomosis, Surgical. Colitis, Ulcerative / surgery. Colonic Pouches. Endoscopy, Gastrointestinal / methods. Ileum / surgery. Proctocolectomy, Restorative

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  • (PMID = 19180580.001).
  • [ISSN] 1536-4844
  • [Journal-full-title] Inflammatory bowel diseases
  • [ISO-abbreviation] Inflamm. Bowel Dis.
  • [Language] eng
  • [Publication-type] Journal Article; Practice Guideline; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] United States
  • [Number-of-references] 45
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81. Gagne SE, Jensen R, Polvi A, Da Costa M, Ginzinger D, Efird JT, Holly EA, Darragh T, Palefsky JM: High-resolution analysis of genomic alterations and human papillomavirus integration in anal intraepithelial neoplasia. J Acquir Immune Defic Syndr; 2005 Oct 1;40(2):182-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] High-resolution analysis of genomic alterations and human papillomavirus integration in anal intraepithelial neoplasia.
  • Anal intraepithelial neoplasia (AIN) is the likely precursor to anal cancer.
  • AIN is associated with human papillomavirus (HPV) infection, and HPV-associated genomic instability may play an important role in the progression of squamous intraepithelial neoplasia to cancer.
  • Microarray-based comparative genome hybridization (aCGH) was performed on DNA from AIN specimens to determine the host genomic alterations and their correlation with HPV DNA integration or rearrangement.
  • Of 27 high-grade AIN specimens tested by CGH, 8 (30%) showed regional DNA copy number abnormalities (CNAs).
  • Our data suggest that there may be several oncogenes in this region that are coactivated to contribute to progression to high-grade AIN.
  • [MeSH-major] Anus Neoplasms / virology. Carcinoma in Situ / virology. Genome, Viral. Papillomaviridae / physiology. Virus Integration

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  • (PMID = 16186736.001).
  • [ISSN] 1525-4135
  • [Journal-full-title] Journal of acquired immune deficiency syndromes (1999)
  • [ISO-abbreviation] J. Acquir. Immune Defic. Syndr.
  • [Language] eng
  • [Grant] United States / NCRR NIH HHS / RR / 5 M01-RR-00079; United States / NCI NIH HHS / CA / R01CA54053; United States / NCI NIH HHS / CA / U01 CA66529; United States / NCI NIH HHS / CA / U01 CA70019
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
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82. Lisi G, Illiceto MT, Rossi C, Broto JM, Jil-Vernet JM, Lelli Chiesa P: Anal canal duplication: a retrospective analysis of 12 cases from two European pediatric surgical departments. Pediatr Surg Int; 2006 Dec;22(12):967-73

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Anal canal duplication: a retrospective analysis of 12 cases from two European pediatric surgical departments.
  • Anal canal duplication (ACD) represents an extremely rare intestinal congenital anomaly of unknown origin.
  • The confirmative diagnosis is histopathological, with evidence of an anal mucosal lining (squamous +/- transitional epithelium), surrounded from a smooth muscle coat and anal glands.
  • From 1970 to 2005, 12 patients were observed, seven in Pescara, Italy (1997-2005), five in Barcelona, Spain (1970-2004) - mean age at diagnosis 17.8 months, range 0-60; M:F = 1:11.
  • According to clinical presentation, patients could be divided in three age groups: asymptomatic (mean age 4.8 months, six patients - one with an associated complex genitourinary malformation, one with a presacral mature teratoma, one with ACD evidenced hysthologically on a retroanal mass removed during the correction of an ARM), mildly symptomatic - constipation, mucous discharge (mean age 29.2 months, four patients - one with associated presacral ependymoma and intestinal neuronal dysplasia type B, one with presacral mass) and complicated - perineal abscess, recurrent fistula (mean age 34 months, two patients).
  • In 11 cases a perianal orifice was evident (ten posteriorly located).
  • Histopathological findings confirmed the diagnosis in operated cases (11).
  • When facing a perianal orifice, attention should be paid to ACD, particularly in female patients with coexistent genitourinary or intestinal malformations.
  • [MeSH-major] Anal Canal / abnormalities. Anal Canal / surgery
  • [MeSH-minor] Child, Preschool. Constipation / etiology. Female. Humans. Infant. Infant, Newborn. Italy. Magnetic Resonance Imaging. Male. Rectal Fistula / diagnosis. Retrospective Studies. Spain. Surgery Department, Hospital

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  • (PMID = 17061104.001).
  • [ISSN] 0179-0358
  • [Journal-full-title] Pediatric surgery international
  • [ISO-abbreviation] Pediatr. Surg. Int.
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study
  • [Publication-country] Germany
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83. Cortés-Gutiérrez EI, Dávila-Rodríguez MI, Zamudio-González EA, Aguado-Barrera ME, Vargas-Villarreal J, Cerda-Flores RM: DNA damage in Mexican women with cervical dysplasia evaluated by comet assay. Anal Quant Cytol Histol; 2010 Aug;32(4):207-13

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] DNA damage in Mexican women with cervical dysplasia evaluated by comet assay.
  • OBJECTIVE: To investigate the association between the progressive stage of cervical dysplasia and DNA damage by comet assay.
  • DNA damage levels (none, low, medium and high) in the cervical epithelial cells of 31 women (10 with low grade squamous intraepithelial lesions [LSIL], 10 with high grade [HSIL] and 11 with no cervical lesion) were evaluated using the comet assay.

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  • (PMID = 21434521.001).
  • [ISSN] 0884-6812
  • [Journal-full-title] Analytical and quantitative cytology and histology
  • [ISO-abbreviation] Anal. Quant. Cytol. Histol.
  • [Language] ENG
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] United States
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84. Bengtsson J, Börjesson L, Willén R, Oresland T, Hultén L: Can a failed ileal pouch anal anastomosis be left in situ? Colorectal Dis; 2007 Jul;9(6):503-8

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Can a failed ileal pouch anal anastomosis be left in situ?
  • OBJECTIVE: Failure after ileal pouch-anal anastomosis (IPAA) is reported with a frequency of 10-20%.
  • Morphological changes were grouped into three types modified according to Veress and assessed for dysplasia.
  • No case of dysplasia or carcinoma was found.
  • There was no case of dysplasia.

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  • (PMID = 17573744.001).
  • [ISSN] 1462-8910
  • [Journal-full-title] Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland
  • [ISO-abbreviation] Colorectal Dis
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
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85. Nganvongpanit K, Itthiarbha A, Ong-Chai S, Kongtawelert P: Evaluation of serum chondroitin sulfate and hyaluronan: biomarkers for osteoarthritis in canine hip dysplasia. J Vet Sci; 2008 Sep;9(3):317-25
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  • [Title] Evaluation of serum chondroitin sulfate and hyaluronan: biomarkers for osteoarthritis in canine hip dysplasia.
  • Hip dysplasia (HD) is one of the most important bone and joint diseases in dogs.
  • Making the radiographic diagnosis is sometime possible when the disease has markedly progressed.
  • [MeSH-major] Biomarkers / blood. Chondroitin Sulfates / blood. Dog Diseases / blood. Hip Dysplasia, Canine / blood. Hyaluronic Acid / blood. Osteoarthritis / veterinary

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  • (PMID = 18716453.001).
  • [ISSN] 1229-845X
  • [Journal-full-title] Journal of veterinary science
  • [ISO-abbreviation] J. Vet. Sci.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Korea (South)
  • [Chemical-registry-number] 0 / Biomarkers; 9004-61-9 / Hyaluronic Acid; 9007-28-7 / Chondroitin Sulfates
  • [Other-IDs] NLM/ PMC2811845
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86. Hochman DJ, Pemberton JH: Hand-assisted laparoscopic total proctocolectomy and ileal pouch-anal anastomosis after liver transplant for primary sclerosing cholangitis. Surg Laparosc Endosc Percutan Tech; 2007 Feb;17(1):56-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Hand-assisted laparoscopic total proctocolectomy and ileal pouch-anal anastomosis after liver transplant for primary sclerosing cholangitis.
  • The onset of PSC can precede the diagnosis of CUC, and require liver transplantation in some patients.
  • Surgical management of CUC posttransplant has traditionally been open total proctocolectomy and ileal pouch-anal anastomosis.
  • Herein, we present a case of a woman with a previous liver transplant for PSC who subsequently developed CUC with dysplasia, successfully treated with hand-assisted laparoscopic total proctocolectomy and ileal pouch-anal anastomosis.

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  • (PMID = 17318059.001).
  • [ISSN] 1530-4515
  • [Journal-full-title] Surgical laparoscopy, endoscopy & percutaneous techniques
  • [ISO-abbreviation] Surg Laparosc Endosc Percutan Tech
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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87. Scholefield JH, Castle MT, Watson NF: Malignant transformation of high-grade anal intraepithelial neoplasia. Br J Surg; 2005 Sep;92(9):1133-6
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  • [Title] Malignant transformation of high-grade anal intraepithelial neoplasia.
  • BACKGROUND: The natural history of anal intraepithelial neoplasia (AIN) is uncertain.
  • METHODS: All patients were diagnosed with high-grade AIN (AIN III) between 1994 and 2003.
  • Diagnosis was by full-thickness biopsy and histopathological examination.
  • Excision of localized high-grade AIN was carried out in 28 patients with minimal morbidity.
  • Six patients were systemically immunosuppressed at diagnosis, all of whom had multifocal perianal lesions.
  • Three immunosuppressed patients developed invasive anal squamous carcinoma during follow-up.
  • By contrast, no invasive carcinomas were identified among immunocompetent patients with either localized or multifocal perianal disease.
  • CONCLUSION: AIN III appears to have a relatively low potential for malignant transformation in the immunocompetent patient.
  • However, immunosuppressed patients are more likely to have extensive AIN III and a greater risk of malignant change.
  • [MeSH-major] Anus Neoplasms / pathology. Carcinoma in Situ / pathology. Cell Transformation, Neoplastic / pathology
  • [MeSH-minor] Adult. Carcinoma, Squamous Cell / pathology. Female. Follow-Up Studies. Humans. Male. Middle Aged. Neoplasm Invasiveness / pathology. Neoplasm Recurrence, Local. Prospective Studies

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  • [Copyright] Copyright 2005 British Journal of Surgery Society Ltd.
  • (PMID = 16044425.001).
  • [ISSN] 0007-1323
  • [Journal-full-title] The British journal of surgery
  • [ISO-abbreviation] Br J Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
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88. Navaneethan U, Shen B: Laboratory tests for patients with ileal pouch-anal anastomosis: clinical utility in predicting, diagnosing, and monitoring pouch disorders. Am J Gastroenterol; 2009 Oct;104(10):2606-15
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Laboratory tests for patients with ileal pouch-anal anastomosis: clinical utility in predicting, diagnosing, and monitoring pouch disorders.
  • Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) is the surgical treatment of choice for patients with medically refractory ulcerative colitis (UC) or UC-associated dysplasia, and for the majority of patients with familial adenomatous polyposis.
  • There are scant data on laboratory markers for the evaluation and diagnosis of pouch disorders.
  • Laboratory evaluation provides information on the etiology and pathogenesis of pouchitis, and it also helps practicing clinicians with accurate diagnosis, differential diagnosis, disease stratification, and management of ileal pouch disorders.
  • [MeSH-major] Clostridium Infections / diagnosis. Colitis, Ulcerative / surgery. Colonic Pouches. Postoperative Complications / diagnosis. Pouchitis / diagnosis. Proctocolectomy, Restorative
  • [MeSH-minor] Biomarkers / analysis. Clostridium difficile. Diagnosis, Differential. Genetic Markers. Humans. Risk Factors

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  • (PMID = 19603012.001).
  • [ISSN] 1572-0241
  • [Journal-full-title] The American journal of gastroenterology
  • [ISO-abbreviation] Am. J. Gastroenterol.
  • [Language] eng
  • [Grant] United States / NIDDK NIH HHS / DK / R03 DK 067275
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers; 0 / Genetic Markers
  • [Number-of-references] 141
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89. Sagayama K, Ikeuchi H, Nishigami T, Nakano H, Uchino M, Nakamura M, Noda M, Yanagi H, Yamamura T: Incidence of and risk factors for dysplasia in mucosectomy area in ulcerative colitis patients undergoing restorative proctocolectomy. Int J Colorectal Dis; 2007 Apr;22(4):439-43
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Incidence of and risk factors for dysplasia in mucosectomy area in ulcerative colitis patients undergoing restorative proctocolectomy.
  • BACKGROUND AND AIMS: We evaluated the incidence of dysplasia in the mucosectomy area using resected specimens to determine preoperative risk factors for the occurrence of dysplasia in this area.
  • PATIENTS AND METHODS: We prospectively studied a consecutive series of 137 patients, each of whom underwent a restorative proctocolectomy with a mucosectomy and hand-sewn ileal J-pouch anal anastomosis between January 2003 and December 2004.
  • Sections from the anal transitional zone mucosa were taken from the dentate line to 2.5 cm above the resected line and stained with hematoxylin and eosin then characterized as indefinite for dysplasia, low-grade dysplasia, and high-grade dysplasia based on the criteria of an international working group for rectal mucosal atypia.
  • RESULTS: Dysplasia of the mucosectomy area was present in six (4.4%) of the patients, including one with low-grade and five with high-grade dysplasia.
  • A multivariate analysis showed relations between age at time of surgery (>or=40 years) and duration of disease (>or=10 years) with a risk for development of mucosectomy area dysplasia.
  • CONCLUSION: The incidence of dysplasia of the mucosectomy area was 4.4%, and preoperative risk factors were shown to be duration of disease and age at time of surgery.

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  • (PMID = 16937110.001).
  • [ISSN] 0179-1958
  • [Journal-full-title] International journal of colorectal disease
  • [ISO-abbreviation] Int J Colorectal Dis
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
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90. Chin-Hong PV, Berry JM, Cheng SC, Catania JA, Da Costa M, Darragh TM, Fishman F, Jay N, Pollack LM, Palefsky JM: Comparison of patient- and clinician-collected anal cytology samples to screen for human papillomavirus-associated anal intraepithelial neoplasia in men who have sex with men. Ann Intern Med; 2008 Sep 2;149(5):300-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Comparison of patient- and clinician-collected anal cytology samples to screen for human papillomavirus-associated anal intraepithelial neoplasia in men who have sex with men.
  • BACKGROUND: Human papillomavirus (HPV)-associated anal cancer is increasing in prevalence and is more common among men who have sex with men and HIV-positive individuals than cervical cancer is among women in the United States.
  • Cytology screening can detect the anal cancer precursor, anal intraepithelial neoplasia (AIN).
  • Little is known about self-collected samples for AIN screening, and few community-based AIN estimates exist.
  • OBJECTIVE: To compare the sensitivity of self-collected versus clinician-collected anal cytology specimens to detect biopsy-confirmed AIN and the prevalence estimate of AIN in a community sample.
  • Participants were mailed anal cytology self-collection kits with instructions.
  • Clinicians repeated anal cytology and performed high-resolution anoscopy with biopsies as the diagnostic reference standard.
  • MEASUREMENTS: Prevalence of anal HPV and AIN.
  • Sensitivity and specificity of self-collected and clinician-collected anal cytology specimens to diagnose AIN were calculated.
  • RESULTS: Biopsy-proven AIN was diagnosed in 57% of HIV-positive and 35% of HIV-negative participants (P = 0.04), and 80% provided adequate self-collected specimens for interpretation.
  • The sensitivity of cytology to detect AIN in HIV-positive men was 75% (95% CI, 51% to 93%) when self-collected and 90% (CI, 68% to 99%) when clinician-collected; respective values in HIV-negative men were 48% (CI, 26% to 70%) and 62% (CI, 38% to 82%).
  • The specificity of cytology to detect AIN in HIV-positive men was 50% (CI, 22% to 78%) when self-collected and 64% (CI, 36% to 86%) when clinician-collected; respective values in HIV-negative men were 86% (CI, 71% to 94%) and 85% (CI, 72% to 93%).
  • CONCLUSION: In a community-based sample, a high proportion of HIV-positive and HIV-negative men who have sex with men have AIN.
  • The sensitivity of cytology to detect AIN is higher for clinician-collected versus self-collected specimens and for HIV-positive versus HIV-negative men.
  • The specificity of cytology to detect AIN is higher in HIV-negative versus HIV-positive men.
  • However, the probability of AIN in a patient with a negative cytology result may not be low enough (23% for HIV-negative men and 45% for HIV-positive men with a patient-collected specimen) for clinicians to be comfortable recommending no anoscopy for those with a negative cytology result if done as a one-time test.
  • [MeSH-major] Anus Neoplasms / pathology. Carcinoma in Situ / pathology. Cytological Techniques / methods. Homosexuality. Papillomavirus Infections / pathology. Specimen Handling / methods
  • [MeSH-minor] Adult. Aged. Anal Canal / pathology. Biopsy. Endoscopy, Gastrointestinal. HIV Seronegativity. HIV Seropositivity / epidemiology. HIV Seropositivity / pathology. HIV Seropositivity / virology. Humans. Male. Middle Aged. Prevalence. San Francisco / epidemiology. Sensitivity and Specificity

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  • [CommentIn] Ann Intern Med. 2009 Feb 17;150(4):283-4; author reply 284-5 [19221387.001]
  • [SummaryForPatientsIn] Ann Intern Med. 2008 Sep 2;149(5):I38 [18765696.001]
  • (PMID = 18765699.001).
  • [ISSN] 1539-3704
  • [Journal-full-title] Annals of internal medicine
  • [ISO-abbreviation] Ann. Intern. Med.
  • [Language] eng
  • [Grant] United States / NCRR NIH HHS / RR / 5 M01-RR-00079; United States / NIAID NIH HHS / AI / K23 AI054157; United States / NIAID NIH HHS / AI / R01 CA/AI 88739; United States / NCI NIH HHS / CA / R01 CA54053; United States / NIMH NIH HHS / MH / R01 MH54320
  • [Publication-type] Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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91. Abramowitz L, Benabderrahmane D, Ravaud P, Walker F, Rioux C, Jestin C, Bouvet E, Soulé JC, Leport C, Duval X: Anal squamous intraepithelial lesions and condyloma in HIV-infected heterosexual men, homosexual men and women: prevalence and associated factors. AIDS; 2007 Jul 11;21(11):1457-65
MedlinePlus Health Information. consumer health - HIV/AIDS in Women.

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Anal squamous intraepithelial lesions and condyloma in HIV-infected heterosexual men, homosexual men and women: prevalence and associated factors.
  • OBJECTIVE: To assess the prevalence of and factors associated with squamous intraepithelial lesions and condyloma [human papillomavirus (HPV)-related lesions) in HIV-infected patients.
  • INTERVENTION: A systematic examination for macroscopic HPV-related lesions through anoscopy with histological confirmation, evaluation of dysplasia and HPV typing.
  • RESULTS: Of 473 patients examined, (200 homosexual men, 123 heterosexual men, 150 women), 108 (23%) had histologically confirmed anal HPV-related lesions (36, 15 and 11% of the respective populations), including 51 (47%) with only endoanal localization.
  • Among these 108 patients, histological dysplasia of grades I or II and grade III were noted in 59 and two patients, respectively, invasive endoanal cancer in one; three patients also had high-risk oncogenicity HPV without dysplasia.
  • Independent identified associated factors of HPV-related condyloma were the number of incidents of sexual intercourse per month [odds ratio (OR) 1.04; 95% confidence interval (CI) 1.01-1.06], CD4 cell count below 200 x 10 cells/l (OR 3.22; 95% CI 1.37-7.60), history of anal HPV lesion (OR 4.57; 95% CI 2.13-9.81), and receptive anal intercourse (OR 2.30; 95% CI 1.11-4.77).
  • The two latter factors remained associated with histological dysplasia (OR 2.82; 95% CI 1.38-5.76 for history of anal condyloma, and OR 4.29; 95% CI 2.18-8.44 for receptive anal intercourse).
  • CONCLUSION: The high rate of condyloma and histological dysplasia seen argues for a systematic screening for these lesions in HIV-infected individuals.
  • [MeSH-major] Anus Diseases / virology. Anus Neoplasms / virology. Carcinoma in Situ / virology. Condylomata Acuminata / diagnosis. HIV Infections / virology. Sexual Behavior
  • [MeSH-minor] Adult. Anal Canal / pathology. Anal Canal / virology. Cross-Sectional Studies. Female. Heterosexuality. Homosexuality. Humans. In Situ Hybridization. Male. Middle Aged. Odds Ratio. Papilloma / diagnosis. Papilloma / pathology. Papilloma / virology. Prevalence. Risk


92. Gorgun E, Remzi FH, Manilich E, Preen M, Shen B, Fazio VW: Surgical outcome in patients with primary sclerosing cholangitis undergoing ileal pouch-anal anastomosis: a case-control study. Surgery; 2005 Oct;138(4):631-7; discussion 637-9
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  • [Title] Surgical outcome in patients with primary sclerosing cholangitis undergoing ileal pouch-anal anastomosis: a case-control study.
  • The purpose of this study was to determine the surgical outcome, risk of dysplasia/cancer, morbidity/mortality, long-term results, and functional and quality of life results in patients with inflammatory bowel disease (IBD) and PSC who underwent restorative proctocolectomy with ileal pouch-anal anastomosis and compare them in a case-matched study.
  • This study group was matched for age, gender, diagnosis, duration of disease, anastomosis technique, and proximal diversion to a cohort of IBD patients with no associated PSC who underwent restorative proctocolectomy during the same period of time.
  • Postoperative morbidity, incidence of neoplasia/cancer in the resected specimen, pouchitis, pouch failure, long-term mortality, and 5-year survival rates were compared between the groups.
  • For each group, matched Kaplan-Meier survival analysis was also conducted comparing 5-year survival between the 2 cohorts, matching for diagnosis, duration of disease, age, gender, anastomosis type, and proximal diversion.
  • RESULTS: Sixty-five patients with PSC and IBD underwent restorative proctocolectomy with ileal pouch-anal anastomosis during the study period.
  • A higher incidence of cancer (14% vs 5%, P = .02) and dysplasia in the resected specimen (40% vs 7%, P < .001), an associated increased risk of postoperative pelvic sepsis (14% vs 5%, P = .02), and higher long-term mortality (35% vs 4%, P < .001) were found in the PSC group compared with control group with no associated PSC.
  • CONCLUSIONS: PSC-associated IBD patients after restorative proctocolectomy have a higher risk of neoplasia/cancer in the resected specimen, postoperative pelvic sepsis, and higher long-term mortality.

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  • (PMID = 16269291.001).
  • [ISSN] 0039-6060
  • [Journal-full-title] Surgery
  • [ISO-abbreviation] Surgery
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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93. Berman DM, Wincovitch S, Garfield S, Romeo MJ: Grading melanocytic dysplasia in paraffin wax embedded tissue by the nucleic acid index. J Clin Pathol; 2005 Nov;58(11):1206-10
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Grading melanocytic dysplasia in paraffin wax embedded tissue by the nucleic acid index.
  • BACKGROUND: Although nucleic acid derangements are the hallmark of melanocytic dysplasia, the gold standard for its diagnosis remains the microscopic evaluation of haematoxylin and eosin stained slides.
  • CONCLUSION: By providing a quantitative measure for melanocytic neoplasia, the NAI may improve the diagnosis of melanocytic lesions and the selection of treatment.
  • [MeSH-major] DNA, Neoplasm / analysis. Dysplastic Nevus Syndrome / diagnosis. Melanoma / diagnosis. Skin Neoplasms / diagnosis
  • [MeSH-minor] Diagnosis, Differential. Humans. Image Processing, Computer-Assisted / methods. Melanocytes / pathology. Microscopy, Confocal / methods. Mitotic Index. Nevus, Pigmented / diagnosis. Nevus, Pigmented / genetics. Nevus, Pigmented / pathology. Paraffin Embedding. RNA, Neoplasm / analysis

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  • (PMID = 16254113.001).
  • [ISSN] 0021-9746
  • [Journal-full-title] Journal of clinical pathology
  • [ISO-abbreviation] J. Clin. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / DNA, Neoplasm; 0 / RNA, Neoplasm
  • [Other-IDs] NLM/ PMC1770753
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94. Fichera A, Ragauskaite L, Silvestri MT, Elisseou NM, Rubin MA, Hurst RD, Michelassi F: Preservation of the anal transition zone in ulcerative colitis. Long-term effects on defecatory function. J Gastrointest Surg; 2007 Dec;11(12):1647-52; discussion 1652-3
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Preservation of the anal transition zone in ulcerative colitis. Long-term effects on defecatory function.
  • INTRODUCTION: The anal transition zone (ATZ) after ileal pouch anal anastomosis (IPAA) for ulcerative colitis is considered at risk for dysplasia and persistent or recurrent disease activity.
  • METHODS: To evaluate the inflammatory and preneoplastic changes of the ATZ in patients without preoperative dysplasia, yearly biopsies of the ATZ were obtained and functional results recorded on a questionnaire/diary.
  • There was no dysplasia found.
  • New onset dysplasia was not noted.
  • [MeSH-major] Anal Canal / pathology. Colitis, Ulcerative / pathology. Defecation / physiology

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  • (PMID = 17906906.001).
  • [ISSN] 1091-255X
  • [Journal-full-title] Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
  • [ISO-abbreviation] J. Gastrointest. Surg.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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95. Al-Sukhni W, McLeod RS, MacRae H, O'Connor B, Huang H, Cohen Z: Oncologic outcome in patients with ulcerative colitis associated with dyplasia or cancer who underwent stapled or handsewn ileal pouch-anal anastomosis. Dis Colon Rectum; 2010 Nov;53(11):1495-500
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Oncologic outcome in patients with ulcerative colitis associated with dyplasia or cancer who underwent stapled or handsewn ileal pouch-anal anastomosis.
  • Restorative proctocolectomy with ileal pouch-anal anastomosis is a standard surgical management of patients with ulcerative colitis who have cancer or dysplasia, but the oncologic risk of stapled anastomosis vs mucosectomy with handsewn anastomosis is debated.
  • The patients with ulcerative colitis associated with colorectal dysplasia or cancer who underwent ileal pouch-anal anastomosis between 1981 and 2009 were evaluated.
  • The development of dysplasia or cancer at ileoanal anastomosis or in the pelvic pouch was assessed.
  • RESULTS: Eighty-one patients underwent stapled (n = 59) or handsewn (n = 22) ileal pouch-anal anastomosis; 52 had evidence of dysplasia and 29 had colorectal cancer (24 colon; 5 rectum) at the time of surgery.
  • One patient with a 33-year history of colitis, a previously resected right-sided colon cancer, and subsequent high-grade dysplasia in the rectum underwent a handsewn pelvic pouch and developed an unresectable adenocarcinoma at the cuff 4 years later.
  • A second patient with a 10-year history of colitis underwent handsewn pelvic pouch and developed dysplasia in the pouch 8 years after surgery.
  • CONCLUSIONS: Performing a stapled ileal pelvic anal anastomosis does not appear to be inferior to mucosectomy and handsewn anastomosis in oncologic outcome, and it seems appropriate in patients with ulcerative colitis associated with coexisting dysplasia or cancer.


96. Wieland U, Brockmeyer NH, Weissenborn SJ, Hochdorfer B, Stücker M, Swoboda J, Altmeyer P, Pfister H, Kreuter A: Imiquimod treatment of anal intraepithelial neoplasia in HIV-positive men. Arch Dermatol; 2006 Nov;142(11):1438-44
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Imiquimod treatment of anal intraepithelial neoplasia in HIV-positive men.
  • OBJECTIVE: To evaluate the treatment of anal intraepithelial neoplasia (AIN) with the local immune response modifier imiquimod in human immunodeficiency virus (HIV)-positive men who have sex with men (MSM).
  • Patients Twenty-eight consecutive HIV-positive MSM with histologically confirmed perianal (n = 23) or intra-anal (n = 5) AIN.
  • Intervention Overnight treatment with self-applied imiquimod cream (perianal AIN) or suppositories (intra-anal AIN) 3 times a week for 16 weeks.
  • RESULTS: Seventeen (61%) of all 28 patients included in the study and 17 (77%) of the 22 patients with AIN, who applied imiquimod as instructed, showed clinical and histologic clearance at the end of therapy.
  • Four patients had residual AIN and 1 patient did not improve.
  • In the follow-up period, AIN cleared in 3 patients with residual AIN.
  • CONCLUSIONS: Imiquimod appears to be a safe and effective treatment option for AIN in HIV-positive MSM.
  • These results should encourage controlled randomized studies of imiquimod treatment of AIN.
  • [MeSH-major] Aminoquinolines / therapeutic use. Antineoplastic Agents / therapeutic use. Anus Neoplasms / drug therapy. Carcinoma in Situ / drug therapy. HIV Infections


97. Kreuter A, Hochdorfer B, Brockmeyer NH, Altmeyer P, Pfister H, Wieland U, Competence Network HIV/AIDS: A human papillomavirus-associated disease with disseminated warts, depressed cell-mediated immunity, primary lymphedema, and anogenital dysplasia: WILD syndrome. Arch Dermatol; 2008 Mar;144(3):366-72
NCI CPTC Antibody Characterization Program. NCI CPTC Antibody Characterization Program .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] A human papillomavirus-associated disease with disseminated warts, depressed cell-mediated immunity, primary lymphedema, and anogenital dysplasia: WILD syndrome.
  • Although skin cancer frequently develops in the sun-exposed cutaneous lesions of patients with EV, the anogenital area is usually not affected by squamous cell carcinomas related to mucosal HPV types.
  • Histological and cytological evaluation revealed multifocal anogenital dysplasia and benign genital and cutaneous warts.
  • We suggest the acronym WILD (warts, immunodeficiency, lymphedema, dysplasia) to characterize this syndrome.
  • [MeSH-major] Epidermodysplasia Verruciformis / diagnosis. Immunocompromised Host. Lymphedema / diagnosis. Papillomavirus Infections / diagnosis
  • [MeSH-minor] Adult. Anal Canal / pathology. Diagnosis, Differential. Female. Genitalia, Female / pathology. Humans. Papillomaviridae / classification. Papillomaviridae / isolation & purification. Syndrome

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  • (PMID = 18347293.001).
  • [ISSN] 1538-3652
  • [Journal-full-title] Archives of dermatology
  • [ISO-abbreviation] Arch Dermatol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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98. Kreuter A, Potthoff A, Brockmeyer NH, Gambichler T, Stücker M, Altmeyer P, Swoboda J, Pfister H, Wieland U, German Competence Network HIV/AIDS: Imiquimod leads to a decrease of human papillomavirus DNA and to a sustained clearance of anal intraepithelial neoplasia in HIV-infected men. J Invest Dermatol; 2008 Aug;128(8):2078-83
Hazardous Substances Data Bank. Imiquimod .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Imiquimod leads to a decrease of human papillomavirus DNA and to a sustained clearance of anal intraepithelial neoplasia in HIV-infected men.
  • Anal intraepithelial neoplasia (AIN), a human papillomavirus (HPV)-associated precursor lesion of anal carcinoma, is highly prevalent in HIV-infected men having sex with men (MSM).
  • This prospective follow-up study evaluated the long-term results of imiquimod treatment of AIN in 19 HIV-infected MSM.
  • Standardized follow-up examinations included high-resolution anoscopy, anal cytology/histology, HPV typing, and DNA load determination for HPV types 16, 18, 31, and 33.
  • A total of 74% (14/19) of the patients remained free of AIN at the previously treated site.
  • Five patients (26%) had recurrent high-grade AIN after a mean time of 24.6 months.
  • During follow-up, 58% of all patients (11/19) developed new anal cytological abnormalities in previously normal, untreated anal regions.
  • 55% of these new AIN lesions were high-grade lesions and most of them were located intra-anally and associated with high-risk HPV types not detectable before therapy.
  • These results demonstrate that imiquimod leads to a high rate of long-term clearance of AIN in HIV-positive men together with a prolonged decrease of high-risk HPV-DNA load.
  • However, new AIN lesions associated with previously undetected HPV types frequently occur in untreated areas.
  • [MeSH-major] Aminoquinolines / therapeutic use. Antineoplastic Agents / therapeutic use. Anus Neoplasms / drug therapy. Carcinoma in Situ / drug therapy. DNA, Viral / drug effects. HIV Infections / complications. Papillomaviridae / genetics

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  • (PMID = 18273049.001).
  • [ISSN] 1523-1747
  • [Journal-full-title] The Journal of investigative dermatology
  • [ISO-abbreviation] J. Invest. Dermatol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Aminoquinolines; 0 / Antineoplastic Agents; 0 / DNA, Viral; 99011-02-6 / imiquimod
  • [Investigator] Adam A; Schewe K; Weitner L; Aratesh K; Arendt G; Bartz C; Behrens G; Beichert M; Bieniek B; Cordes C; Bochow M; Brockmeyer N; Buchholz B; Bogner JR; Buhk T; Clad A; Dannecker M; Dupke S; von Einsiedel R; Esser S; Faetkenheuer G; Fischer K; Freiwald M; Friebe-Hoffmann U; Fenske S; Funk M; Ganschow R; Gingelmaier A; Glaunsinger T; Goebel FD; Gölz J; Grosch-Wörner I; Haberl A; Hamouda O; Harrer T; Hartmann M; Hartl H; Hölscher M; Hower M; Husstedt IW; Jansen K; Jäger H; Jessen H; Jessen A; Karwat M; Klausen G; Kirchhoff F; Knechten H; Köppe S; Kreuter A; Kuhlmann B; Langer P; Lauenroth-Mai; Lehmacher W; Lehmann M; Levin C; Lübke M; Maschke M; Marcus U; Mauss S; Meyerhans A; Meyer-Olson D; ter Meulen V; Michalik C; Moll A; Mosthaf FA; Mutz A; Neuen-Jacob E; Niehues T; Oette M; Paulus U; Plettenberg A; Potthoff A; Racz P; Racz K; Rasokat H; Rausch M; Reichelt D; Reitter A; Rieke A; Rockstroh J; Salzberger B; Schafberger A; Schauer J; Schlote F; Schmidt B; Schranz D; Scholten S; Schuler C; Schwab M; Schmidt W; Schmidt R; Schwarze S; Siffert W; Skaletz-Rorowski A; Sonnenberg-Schwan U; Sopper S; Spengler U; Staszewski S; Steffan E; Stellbrink HJ; Stoll M; Goecke T; Taubert S; Telschik A; Ulmer A; Ullrich R; Uberla K; Usadel S; Vogel M; Wagner R; Walter H; Warnatz K; Wasem J; Wiesel W; Von Weizsäcker K; Wieland U; Wintergerst U; Wolf E; Wolf H; Wünsche T; Wyen Ch; Zeitz M; Zylka-Menhorn V
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99. Abramowitz L, Benabderrahmane D, Baron G, Walker F, Yeni P, Duval X: Systematic evaluation and description of anal pathology in HIV-infected patients during the HAART era. Dis Colon Rectum; 2009 Jun;52(6):1130-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Systematic evaluation and description of anal pathology in HIV-infected patients during the HAART era.
  • PURPOSE: This study aimed to determine the prevalence of macroscopic anal lesions and associated factors in HIV-infected outpatients during the era of highly active antiretroviral therapy.
  • METHODS: A randomly selected sample of patients with HIV-infection receiving follow-up care in the infectious diseases department of Bichat University Hospital was invited to participate in a systematic screening program consisting of anal examination with anoscopy and a standardized questionnaire.
  • Overall, 208 patients (44 percent) had at least one anal macroscopic lesion: 108 patients (22.8 percent) had human papilloma (HPV)-related lesions (condyloma with or without dysplasia), 67 (14.2 percent) had hemorrhoidal disease, 50 (10.6 percent) had anal fissures, and 44 (9.3) percent had other anal lesions.
  • Independent significantly associated factors for anal condyloma were history of anal condyloma (OR, 2.09) and median number of episodes of sexual intercourse per month (OR, 1.03) in men who have sex with men; history of genital condyloma (OR, 26.74), and unprotected sexual intercourse (OR, 7.47) in heterosexual men; and CD4 cell count below 200/mm3 (OR, 6.02), receptive anal intercourse (OR, 6.37), and history of anal condyloma (OR, 16.69) in women.
  • Neither sexual behavior nor characteristics related to HIV infection were associated with hemorrhoidal disease or anal fissure.
  • CONCLUSIONS: Because patients with HIV infections have a high prevalence of unreported anal lesions that may be highly contagious, involve risk of anal neoplasia, or negatively affect quality of life, systematic anal screening should be conducted in the HIV-infected population.
  • [MeSH-major] Anus Diseases / epidemiology. HIV Infections / complications

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  • [CommentIn] Dis Colon Rectum. 2010 Mar;53(3):364-5 [20173491.001]
  • (PMID = 19581857.001).
  • [ISSN] 1530-0358
  • [Journal-full-title] Diseases of the colon and rectum
  • [ISO-abbreviation] Dis. Colon Rectum
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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100. Kreuter A, Brockmeyer NH, Hochdorfer B, Weissenborn SJ, Stücker M, Swoboda J, Altmeyer P, Pfister H, Wieland U: Clinical spectrum and virologic characteristics of anal intraepithelial neoplasia in HIV infection. J Am Acad Dermatol; 2005 Apr;52(4):603-8
HIV InSite. treatment guidelines - Human Herpesvirus-8 .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Clinical spectrum and virologic characteristics of anal intraepithelial neoplasia in HIV infection.
  • BACKGROUND: Anal intraepithelial neoplasia (AIN) represents a precursor lesion of invasive squamous cell carcinoma with a clear association to high-risk human papillomavirus (HPV) types.
  • HIV infection is strongly associated with a higher prevalence of genital HPV infection, a higher incidence of AIN, and, consecutively, an increased risk for anal cancer.
  • OBJECTIVE: The aim of this study was to determine the clinical spectrum of AIN and lesional HPV colonization in a cohort of homosexual men who were HIV positive and had a history of receptive anal intercourse.
  • RESULTS: Of all patients, 86% had anal HPV infection at their first visit.
  • AIN was diagnosed in 20 of the 103 patients (19.4%).
  • High-risk HPV types were present in all AIN cases with up to 7 different high-risk and up to 5 different low-risk types per lesion.
  • Histologically, 7 (35%), 7 (35%), and 6 (30%) of the patients had AIN grade I, II, or III, respectively.
  • Four different types of clinical presentation could be distinguished in the 20 patients with AIN: bowenoid (1 case, 5%); erythroplakic (2 cases, 10%); verrucous (6 cases, 30%); and leukoplakic (11 cases, 55%).
  • All verrucous lesions were graded as high-grade intraepithelial lesions in cytology, whereas 6 of the 11 leukoplakic lesions (55%) were low grade.
  • All verrucous AIN carried at least 4 different HPV types, always including HPV-16, and the mean number of HPV types was higher in verrucous lesions than in leukoplakic lesions (5.5 vs 3.8, respectively).
  • CONCLUSION: These data confirm the high incidence and prevalence of AIN in patients who are HPV positive with HIV infection.
  • Four different clinical types of AIN can be distinguished that might have prognostic implications.
  • Standardized screening programs for anal cancer prevention and treatment protocols for AIN in patients infected with HIV must be implemented.
  • [MeSH-major] Anus Neoplasms / virology. Carcinoma in Situ / virology. HIV Seropositivity / complications. Papillomaviridae / isolation & purification

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  • (PMID = 15793509.001).
  • [ISSN] 1097-6787
  • [Journal-full-title] Journal of the American Academy of Dermatology
  • [ISO-abbreviation] J. Am. Acad. Dermatol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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