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1. Zhang J, Martins CR, Fansler ZB, Roemer KL, Kincaid EA, Gustafson KS, Heitjan DF, Clark DP: DNA methylation in anal intraepithelial lesions and anal squamous cell carcinoma. Clin Cancer Res; 2005 Sep 15;11(18):6544-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] DNA methylation in anal intraepithelial lesions and anal squamous cell carcinoma.
  • PURPOSE: Anal intraepithelial neoplasia is associated with human papillomavirus infection and may progress to invasive squamous cell carcinoma (SCC), which is increasing in immunocompromised patients.
  • We hypothesize that anal intraepithelial neoplasia is associated with abnormal DNA methylation and that detection of these events may be used to improve screening programs.
  • EXPERIMENTAL DESIGN: Seventy-six patients were identified who underwent anal cytology screening and subsequent biopsy at our institution between 1999 and 2004.
  • The specimens from these patients included 184 anal biopsies [normal, n = 57; low-grade squamous intraepithelial lesion (LSIL), n = 74; high-grade squamous intraepithelial lesion (HSIL), n = 41; and invasive SCC, n = 12] and 37 residual liquid-based anal cytology specimens (normal, n = 11; LSIL, n = 12; HSIL, n = 14).
  • CONCLUSIONS: Aberrant DNA methylation is a frequent event in anal HSIL and SCC.
  • [MeSH-major] Anal Canal / pathology. Anus Neoplasms / pathology. Carcinoma, Squamous Cell / pathology. DNA Methylation

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  • (PMID = 16166431.001).
  • [ISSN] 1078-0432
  • [Journal-full-title] Clinical cancer research : an official journal of the American Association for Cancer Research
  • [ISO-abbreviation] Clin. Cancer Res.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Adaptor Proteins, Signal Transducing; 0 / Adenomatous Polyposis Coli Protein; 0 / CADM1 protein, human; 0 / Carrier Proteins; 0 / Cell Adhesion Molecules; 0 / Cyclin-Dependent Kinase Inhibitor p16; 0 / DNA-Binding Proteins; 0 / HIC1 protein, human; 0 / Immunoglobulins; 0 / Kruppel-Like Transcription Factors; 0 / MLH1 protein, human; 0 / Membrane Proteins; 0 / Neoplasm Proteins; 0 / Nuclear Proteins; 0 / RASSF1 protein, human; 0 / Receptors, Retinoic Acid; 0 / Transcription Factors; 0 / Tumor Suppressor Protein p14ARF; 0 / Tumor Suppressor Proteins; 0 / retinoic acid receptor beta; EC 2.1.1.63 / O(6)-Methylguanine-DNA Methyltransferase; EC 2.7.11.1 / Protein-Serine-Threonine Kinases
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2. 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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  • [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.
  • The patient underwent local full-thickness excision of the lesion.
  • 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


3. 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.
  • Type 16 was the prevalent subtype and was noted in 28% of low grade and 68% of high-grade lesions.
  • Moderate dysplasias showed type 16 in 20%, a prevalence similar to that in low-grade lesions.
  • 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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4. Li AH, Phanuphak N, Sahasrabuddhe VV, Chaithongwongwatthana S, Vermund SH, Jenkins CA, Shepherd BE, Teeratakulpisarn N, van der Lugt J, Avihingsanon A, Ruxrungtham K, Shikuma C, Phanuphak P, Ananworanich J: Anal squamous intraepithelial lesions among HIV positive and HIV negative men who have sex with men in Thailand. Sex Transm Infect; 2009 Dec;85(7):503-7
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  • [Title] Anal squamous intraepithelial lesions among HIV positive and HIV negative men who have sex with men in Thailand.
  • OBJECTIVES: To evaluate the prevalence and risk factors of anal squamous intraepithelial lesions (ASIL), the putative anal cancer precursor, in Asian HIV positive and HIV negative men who have sex with men (MSM).
  • METHODS: Men who underwent anal Pap smear reported clinical, sociodemographic and behavioural information collected through questionnaire and interview between January 2007 and April 2008.
  • Overall, 27% had abnormal anal cytology: 13.2% had atypical squamous cells of undetermined significance (ASC-US), 11.5% had low-grade squamous intraepithelial lesion (LSIL) and 2.3% had high-grade squamous intraepithelial lesion (HSIL).
  • Anal condyloma was detected in 22% of HIV positive and 16.1% (9/56) of HIV negative MSM (p = 0.5).
  • In HIV positive MSM, anal condyloma (OR 3.42, 95% CI 1.29 to 9.04; p = 0.01) was a significant risk factor for ASIL.
  • Thus, as greater numbers of HIV positive MSM live longer due to increasing access to HAART worldwide, effective strategies to screen and manage anal precancerous lesions are needed.
  • [MeSH-major] Anus Neoplasms / epidemiology. Carcinoma in Situ / epidemiology. Carcinoma, Squamous Cell / epidemiology. HIV Seronegativity / physiology. HIV Seropositivity / epidemiology. Homosexuality, Male / statistics & numerical data

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  • (PMID = 19525263.001).
  • [ISSN] 1472-3263
  • [Journal-full-title] Sexually transmitted infections
  • [ISO-abbreviation] Sex Transm Infect
  • [Language] eng
  • [Grant] United States / NIAID NIH HHS / AI / P30 AI050410; United States / NCRR NIH HHS / RR / TL1 RR024978
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Other-IDs] NLM/ NIHMS527353; NLM/ PMC3875384
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5. 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.
  • 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.
  • However, the sensitivity and specificity of this marker are not high.
  • [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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6. Troicki F, Pappas A, Noone R, Denittis A: Radiation therapy of recurrent anal squamous cell carcinoma in-situ: a case report. J Med Case Rep; 2010;4:67

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Radiation therapy of recurrent anal squamous cell carcinoma in-situ: a case report.
  • INTRODUCTION: High-grade anal intraepithelial neoplasia, also referred to as anal squamous carcinoma in-situ, or Bowen's disease of the anus, make up less than 1% of all digestive system cancers in the United States.
  • The treatment of choice is surgical resection with anal mapping.
  • This can compromise the anal sphincter leading to leakage.
  • CASE PRESENTATION: An 84-year-old Caucasian woman presented with post-excisional persistent/recurrent squamous cell carcinoma in-situ.
  • The initial lesion measured 3 cm in diameter on the right lateral side of the anal margin.
  • A standard surgery consisting of wide local excision with anal mapping was performed.
  • Our patient recurred with a 1.2 x 0.8 cm lesion on the left anal verge extending to the anal canal.
  • A biopsy along with mapping was done, and 2 of the 17 mapping specimens were positive for carcinoma in-situ, one in the anal canal.
  • Due to the location of the positive anal mapping, and in order to prevent sphincter compromise on re-excision, our patient was offered definitive radiation therapy.

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  • (PMID = 20181236.001).
  • [ISSN] 1752-1947
  • [Journal-full-title] Journal of medical case reports
  • [ISO-abbreviation] J Med Case Rep
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC2841077
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7. Negri G, Moretto G, Menia E, Vittadello F, Kasal A, Mian C, Egarter-Vigl E: Immunocytochemistry of p16INK4a in liquid-based cervicovaginal specimens with modified Papanicolaou counterstaining. J Clin Pathol; 2006 Aug;59(8):827-30
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  • METHODS: Immunocytochemical analyses were carried out with p16(INK4a) and modified Papanicolaou counterstain on 81 liquid-based samples, including 23 of within normal limits (WNL), 6 of low-grade squamous intraepithelial lesion (LSIL), 20 of high-grade squamous intraepithelial lesion (HSIL), 16 of atypical squamous cells of undetermined significance (ASC-US) and 16 of atypical squamous cells, high-grade lesion cannot be excluded (ASC-H).
  • The intensity of immunostaining in cases of squamous intraepithelial lesion (SIL) was assessed using a 0-3 scoring system.
  • Excluding two cases with no residual dysplastic cells in the immunocytochemistry, all cases of cervical intraepithelial neoplasia (CIN)2 or CIN3 at follow-up expressed p16(INK4a) and none of the p16(INK4a)-negative cases showed a high-grade lesion at follow-up.
  • [MeSH-minor] Carcinoma, Squamous Cell / diagnosis. Cervical Intraepithelial Neoplasia / diagnosis. Diagnosis, Differential. Feasibility Studies. Female. Humans. Neoplasm Proteins / analysis. Papanicolaou Test. Staining and Labeling / methods. Uterine Cervical Dysplasia / diagnosis. Vaginal Smears / methods

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  • (PMID = 16467166.001).
  • [ISSN] 0021-9746
  • [Journal-full-title] Journal of clinical pathology
  • [ISO-abbreviation] J. Clin. Pathol.
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Cyclin-Dependent Kinase Inhibitor p16; 0 / Neoplasm Proteins
  • [Other-IDs] NLM/ PMC1860457
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8. Tsai TF, Kuo GT, Kuo LT, Hsiao CH: Prevalence status and association with human papilloma virus of anal squamous proliferative lesions in a patient sample in Taiwan. Sex Transm Dis; 2008 Aug;35(8):721-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Prevalence status and association with human papilloma virus of anal squamous proliferative lesions in a patient sample in Taiwan.
  • BACKGROUND AND OBJECTIVE: Anal squamous proliferative lesions, including condyloma, anal high-grade squamous intraepithelial lesion (AHSIL) and squamous cell carcinoma (SCC), are associated with human papilloma virus (HPV) infection.
  • The objectives of the study were to investigate the HPV prevalence of anal squamous proliferative lesion in Taiwan.
  • RESULTS: Anal condyloma mainly occurred in young males, but AHSIL and anal SCC developed in older patients.
  • High-risk HPVs (type 16, 58, etc.) were mainly detected in the AHSIL and SCC.
  • CONCLUSION: HPV58 is a unique high-risk HPV prevalent in Taiwan.
  • In our study, emerging HIV-positive AHSIL in recent years indicates that we should devote more efforts to promote sexual safety among the people who engaged in anal intercourse.
  • [MeSH-major] Anus Neoplasms / epidemiology. Carcinoma, Squamous Cell / epidemiology. Papillomaviridae / isolation & purification. Papillomavirus Infections / epidemiology. Warts / epidemiology

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  • (PMID = 18650771.001).
  • [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
  • [Chemical-registry-number] 0 / DNA, Viral
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9. Goldstone SE, Kawalek AZ, Huyett JW: Infrared coagulator: a useful tool for treating anal squamous intraepithelial lesions. Dis Colon Rectum; 2005 May;48(5):1042-54
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Infrared coagulator: a useful tool for treating anal squamous intraepithelial lesions.
  • PURPOSE: The incidence of invasive anal squamous carcinoma in men who have sex with men is rising, particularly in those with human immunodeficiency virus.
  • As in the cervix the high-grade squamous intraepithelial lesion is thought to be an invasive squamous cell carcinoma precursor.
  • Cervical high-grade squamous intraepithelial lesions are treated by removing the squamocolumnar transition zone.
  • Better office-based techniques to treat anal high-grade squamous intraepithelial lesions are needed.
  • We employed the infrared coagulator in an office setting to ablate high-grade squamous intraepithelial lesions.
  • METHODS: A retrospective review of medical records was performed on 68 human immunodeficiency virus-positive men who have sex with men who underwent infrared coagulator ablation of biopsy-proven high-grade dysplasia from the time we began using the procedure in 1999.
  • Procedures were performed with local anesthesia on patients with discrete high-grade squamous intraepithelial lesions.
  • Follow-up consisted of anal cytology with high-resolution anoscopy and biopsy of suspicious areas every three to six months.
  • New or recurrent high-grade dysplasia was retreated.
  • However, 44 patients (65 percent) developed a new or persistent high-grade squamous intraepithelial lesion within a median time of 217 days (range 27-566 days) after infrared coagulation.
  • The remaining 24 patients (35 percent) were free of high-grade dysplasia for a median of 413 days (range 162-1313 days) after infrared coagulation.
  • When patients were treated a second or third time, the incidence of new or persistent high-grade dysplasia dropped to 58 percent and 40 percent, respectively.
  • The probability of curing a retreated lesion was 72 percent.
  • Using generalized estimating equations, the incidence of high-grade dysplasia decreased with repeated infrared coagulator treatments.
  • No patient developed squamous-cell carcinoma, had a serious adverse event, or developed anal stenosis.
  • CONCLUSIONS: The infrared coagulator is a safe, office-based modality for treating anal high-grade squamous intraepithelial lesion in human immunodeficiency virus-positive men who have sex with men.
  • [MeSH-major] Anus Neoplasms / surgery. Carcinoma, Squamous Cell / surgery. HIV Seropositivity. Infrared Rays / therapeutic use. Light Coagulation / methods. Precancerous Conditions / surgery


10. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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).
  • Neither were there statistical associations found with high risk-HPV infection (p = 0.84), HIV infection (p = 0.98) or tobacco use (p = 0.14).
  • CONCLUSIONS: Our diagnostic protocol of anal intraepithelial neoplasia revealed 25% of patients with pre-invasive lesions of squamous anal cancer.

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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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11. Goldstone SE, Hundert JS, Huyett JW: Infrared coagulator ablation of high-grade anal squamous intraepithelial lesions in HIV-negative males who have sex with males. Dis Colon Rectum; 2007 May;50(5):565-75
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Infrared coagulator ablation of high-grade anal squamous intraepithelial lesions in HIV-negative males who have sex with males.
  • PURPOSE: The incidence of anal squamous carcinoma in males who have sex with males is rising.
  • We reported that infrared coagulation of high-grade squamous intraepithelial lesions in HIV-positive males who have sex with males yielded a recurrence rate after the first ablation of 65 percent and 58 percent after a second ablation.
  • The cure rate of an individual lesion was 72 percent.
  • METHODS: We performed a retrospective review of medical records on HIV-negative males who have sex with males who had infrared coagulation ablation of anal high-grade squamous intraepithelial lesions.
  • Patients had at least six months' follow-up with cytology, high-resolution anoscopy, and biopsy.
  • Recurrent high-grade squamous intraepithelial lesions were retreated.
  • The probability of successfully treating an individual lesion at first infrared coagulation was 81 percent and 93 percent when retreated.
  • HIV-positive patients were twice as likely to have lesions persist and 1.7 times more likely to develop a recurrent high-grade squamous intraepithelial lesion.
  • No patient developed squamous-cell carcinoma, anal stenosis, or had a serious complication.
  • CONCLUSIONS: Infrared coagulation is a safe and effective office-based procedure for treating anal high-grade squamous intraepithelial lesions.
  • Although recurrence was high after the first infrared coagulation, repeated treatment led to resolution of high-grade squamous intraepithelial lesions.
  • [MeSH-major] Anus Neoplasms / surgery. Carcinoma, Squamous Cell / surgery. HIV Seronegativity. Homosexuality, Male. Infrared Rays / therapeutic use. Light Coagulation / methods. Precancerous Conditions / surgery

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  • (PMID = 17380365.001).
  • [ISSN] 0012-3706
  • [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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12. Santoso JT, Long M, Crigger M, Wan JY, Haefner HK: Anal intraepithelial neoplasia in women with genital intraepithelial neoplasia. Obstet Gynecol; 2010 Sep;116(3):578-82
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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 women with genital intraepithelial neoplasia.
  • OBJECTIVE: To estimate the prevalence of anal intraepithelial neoplasia in heterosexual women with genital intraepithelial neoplasia, and to compare anal cytology with colposcopy for their effectiveness in anal intraepithelial neoplasia screening.
  • METHODS: Women with confirmed intraepithelial neoplasia on the cervix, vagina, or vulva were referred for gynecologic oncology care.
  • All patients underwent anal cytology and high-resolution anoscopy.
  • Any lesion detected on anoscopy was biopsied.
  • RESULTS: Women with average age of 39.6 years (range 14 to 83 years) underwent anal cytology and anoscopy (N=205).
  • Of the 205 patients with genital intraepithelial neoplasia, 25 patients (12.2%) had biopsy-proven anal intraepithelial neoplasia.
  • Twelve patients (5.9%) had abnormal anal cytology (nine with atypical squamous cells of undetermined significance [ASC-US], three with low-grade squamous intraepithelial lesions [LSIL]).
  • None of the nine patients with anal ASC-US had biopsy-proven anal intraepithelial neoplasia.
  • Of the three patients with anal LSIL, two had anal intraepithelial neoplasia II and one had condyloma on biopsy.
  • However, 78 patients (38%) had abnormal anoscopy findings that resulted in 25 biopsy-proven anal intraepithelial neoplasias (8 anal intraepithelial neoplasia I, 5 anal intraepithelial neoplasia II, 12 anal intraepithelial neoplasia III)), condylomas (n=11), and hyperkeratosis (n=8).
  • Anoscopy identified 32% (25 patients) with anal intraepithelial neoplasia out of 78 abnormal anoscopic examinations.
  • In diagnosing anal intraepithelial neoplasia, anoscopy has 100% sensitivity and 71% specificity; anal cytology has 8% sensitivity and 94% specificity.
  • CONCLUSION: Patients with cervical, vulvar, and vaginal intraepithelial neoplasia have 12.2% prevalence of anal intraepithelial neoplasia and should be screened with high-resolution anoscopy.
  • In anal intraepithelial neoplasia screening, anoscopy is more sensitive but less specific than anal cytology.

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  • [CommentIn] Obstet Gynecol. 2010 Sep;116(3):566-7 [20733435.001]
  • [ErratumIn] Obstet Gynecol. 2010 Nov;116(5):1224
  • (PMID = 20733438.001).
  • [ISSN] 1873-233X
  • [Journal-full-title] Obstetrics and gynecology
  • [ISO-abbreviation] Obstet Gynecol
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
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13. Giraldo P, Jacyntho C, Costa C, Iglesias M, Gondim C, Carvalho F, Giraldo H, Gonçalves AK: Prevalence of anal squamous intra-epithelial lesion in women presenting genital squamous intra-epithelial lesion. Eur J Obstet Gynecol Reprod Biol; 2009 Jan;142(1):73-5
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  • [Title] Prevalence of anal squamous intra-epithelial lesion in women presenting genital squamous intra-epithelial lesion.
  • OBJECTIVE: To determine the frequency of anal squamous intra-epithelial lesions (ASIL) in women with genital squamous intra-epithelial lesions (GSIL).
  • All the women were HIV-negative with anal aceto-white lesions were biopsed for histological diagnosis.
  • RESULTS: The frequency of ASIL was 17.4% in the GSIL group (3.2% high grade ASIL) and only 2.6% in the control group (0% high grade ASIL) (p<0.001).
  • All the high grade ASIL diagnoses were found in women with cervical SIL.
  • CONCLUSION: Women presenting GSIL have high prevalence of ASIL.
  • [MeSH-minor] Adult. Cervical Intraepithelial Neoplasia / epidemiology. Cross-Sectional Studies. Female. Humans. Muscular Diseases / epidemiology

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  • (PMID = 19019529.001).
  • [ISSN] 1872-7654
  • [Journal-full-title] European journal of obstetrics, gynecology, and reproductive biology
  • [ISO-abbreviation] Eur. J. Obstet. Gynecol. Reprod. Biol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Ireland
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14. Voss JS, Kipp BR, Campion MB, Sokolova IA, Henry MR, Halling KC, Clayton AC: Assessment of fluorescence in situ hybridization and hybrid capture 2 analyses of cervical cytology specimens diagnosed as low grade squamous intraepithelial lesion for the detection of high grade cervical intraepithelial neoplasia. Anal Quant Cytol Histol; 2010 Jun;32(3):121-30
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Assessment of fluorescence in situ hybridization and hybrid capture 2 analyses of cervical cytology specimens diagnosed as low grade squamous intraepithelial lesion for the detection of high grade cervical intraepithelial neoplasia.
  • OBJECTIVE: To assess Hybrid Capture 2 (HC2) and fluorescence in situ hybridization (FISH) for the detection of cervical intraepithelial neoplasia 2 or worse (CIN 2+) in patients with a cytologic diagnosis of low grade squamous intraepithelial lesion (LSIL).
  • STUDY DESIGN: Residual samples from 115 LSIL-diagnosed cervical cytology specimens were evaluated by high-risk human papillomavirus (HR-HPV) HC2 testing and FISH using biotin-labeled probes to HR-HPV and chromosomal probes to 3q26 (TERC) and 8q24 (CMYC).
  • A cervical biopsy diagnosis of CIN 2+ was considered as evidence of high grade disease.


15. 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
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  • [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.
  • 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-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


16. Fox PA, Nathan M, Francis N, Singh N, Weir J, Dixon G, Barton SE, Bower M: A double-blind, randomized controlled trial of the use of imiquimod cream for the treatment of anal canal high-grade anal intraepithelial neoplasia in HIV-positive MSM on HAART, with long-term follow-up data including the use of open-label imiquimod. AIDS; 2010 Sep 24;24(15):2331-5
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  • [Title] A double-blind, randomized controlled trial of the use of imiquimod cream for the treatment of anal canal high-grade anal intraepithelial neoplasia in HIV-positive MSM on HAART, with long-term follow-up data including the use of open-label imiquimod.
  • OBJECTIVE: To determine whether imiquimod was more effective than placebo for the treatment of high-grade anal canal intraepithelial neoplasia (HG-ACIN).
  • METHODS: Sixty-four HIV-positive patients were randomized to self-application of imiquimod cream or matched placebo into the anal canal three times a week for 4 months.
  • Response was assessed by cytology, high-resolution anoscopy and biopsy 2 months after therapy.
  • In the imiquimod group, four patients resolved and eight patients downgraded to low-grade squamous intraepithelial lesion (LSIL) with a median follow-up of 33 months.
  • Five of these patients cleared their anal canal intraepithelial neoplasia (ACIN) and four patients downgraded to LSIL.
  • During this extended follow-up period, 61% have exhibited sustained absence of high-grade squamous intraepithelial lesion (HSIL).
  • [MeSH-major] Aminoquinolines / administration & dosage. Anus Neoplasms / drug therapy. Carcinoma, Squamous Cell / drug therapy. HIV Infections / drug therapy. HIV-1 / drug effects


17. 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.

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  • (PMID = 19967333.001).
  • [ISSN] 1432-1173
  • [Journal-full-title] Der Hautarzt; Zeitschrift fur Dermatologie, Venerologie, und verwandte Gebiete
  • [ISO-abbreviation] Hautarzt
  • [Language] ger
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Germany
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18. 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
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  • [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.
  • 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.
  • All verrucous lesions were graded as high-grade intraepithelial lesions in cytology, whereas 6 of the 11 leukoplakic lesions (55%) were low grade.
  • CONCLUSION: These data confirm the high incidence and prevalence of AIN in patients who are HPV positive with HIV infection.
  • Standardized screening programs for anal cancer prevention and treatment protocols for AIN in patients infected with HIV must be implemented.

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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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19. 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.
  • It has been shown that infection with high-risk human papilloma virus results in up-regulation of p16 and increased cellular proliferation.
  • 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).
  • 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.
  • 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-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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20. Nahas CS, Lin O, Weiser MR, Temple LK, Wong WD, Stier EA: Prevalence of perianal intraepithelial neoplasia in HIV-infected patients referred for high-resolution anoscopy. Dis Colon Rectum; 2006 Oct;49(10):1581-6
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  • [Title] Prevalence of perianal intraepithelial neoplasia in HIV-infected patients referred for high-resolution anoscopy.
  • PURPOSE: This study was designed to describe perianal disease in a cohort of HIV-infected patients referred for high-resolution anoscopy.
  • METHODS: A retrospective chart review was performed on 52 HIV-infected patients referred for high-resolution anoscopy from 2001 to 2005.
  • All patients underwent anal canal and perianal high-resolution anoscopy in the office with biopsy of suspicious areas.
  • Patients with high-grade intraepithelial perianal lesions underwent multiple biopsies under general anesthesia in the operating room to rule out malignancy.
  • RESULTS: Of the 52 patients, 19 (37 percent) had perianal abnormalities noted on high-resolution anoscopy and underwent punch biopsy.
  • Office perianal biopsies diagnosed two patients with invasive squamous-cell carcinoma and nine with high-grade squamous intraepithelial lesion.
  • Seven of the nine patients with perianal high-grade squamous intraepithelial lesion on office biopsy were submitted to multiple biopsies under general anesthesia.
  • One of these seven had an occult perianal squamous-cell carcinoma.
  • CONCLUSIONS: Perianal disease was common in this group of HIV-infected patients; 11 patients (21 percent of total) were diagnosed with squamous-cell carcinoma or high-grade squamous intraepithelial lesion.
  • Our data suggest that anal canal neoplasia often is accompanied by perianal disease and illustrates the need for biopsy of any suspicious perianal lesions.
  • [MeSH-major] Anus Neoplasms / etiology. Carcinoma in Situ / etiology. Carcinoma, Squamous Cell / epidemiology. HIV Infections / complications. Proctoscopy / methods


21. 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
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] 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-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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22. 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
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] 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.
  • Each lesion was treated with the IRC with re-biopsy of the treatment site a mean of 140 days later.
  • 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.

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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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23. 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.
  • P16 is a tumor suppressor gene product, shown to be overexpressed in most cervical carcinomas and dysplasias associated with high-risk human papilloma virus (HPV) infection.
  • 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.
  • (1) "spotty" in which positive cells were scattered throughout the lesion and (2) "band" in which >90% of contiguous cells in the lesion stained positive.
  • 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.
  • Band like p16 staining also correlated strongly with the presence of high-risk HPV.
  • Two of these cases were positive for high-risk HPV DNA.
  • 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.
  • One was positive for high-risk HPV DNA.

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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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24. Walts AE, Thomas P, Bose S: Anal cytology: is there a role for reflex HPV DNA testing? Diagn Cytopathol; 2005 Sep;33(3):152-6
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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: is there a role for reflex HPV DNA testing?
  • There is an increased incidence of anal squamous carcinoma and its precursor lesions (anal intraepithelial neoplasia [AIN]) among persons who engage in anal-receptive sex.
  • Analogous to cervical cancer screening, anal Papanicplaou (Pap) smears currently are used to screen these high-risk populations.
  • Human papilloma virus (HPV) has been implicated in anal carcinoma pathogenesis and this study was performed to assess the potential role of HPV DNA testing as an adjunct to anal cytology.
  • We correlated cytological diagnoses and HPV DNA (Digene Hybrid Capture [HC II] assay) in anal specimens collected in SurePath liquid medium from 118 patients; 54.8% of cases diagnosed as atypical squamous cells of undetermined significance (ASC-US) and 87.8% diagnosed as low-grade squamous intraepithelial lesion (LSIL) or above tested positive for high- risk HPV DNA (B+).
  • High-grade SIL (HSIL) was present in 31 of the 51 patients with follow-up.
  • Although a cytological diagnosis of ASC-US or above was a reliable indicator for AIN, cytology frequently did not accurately predict the grade of SIL in subsequent biopsy.
  • [MeSH-major] Anal Canal / virology. Anus Neoplasms / diagnosis. Carcinoma in Situ / diagnosis. Carcinoma, Squamous Cell / diagnosis. Papillomavirus Infections / diagnosis. Tumor Virus Infections / diagnosis

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  • [Copyright] Copyright (c) 2005 Wiley-Liss, Inc.
  • (PMID = 16078257.001).
  • [ISSN] 8755-1039
  • [Journal-full-title] Diagnostic cytopathology
  • [ISO-abbreviation] Diagn. Cytopathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / DNA, Viral
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25. Fox P: Anal cancer screening in men who have sex with men. Curr Opin HIV AIDS; 2009 Jan;4(1):64-7
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  • [Title] Anal cancer screening in men who have sex with men.
  • PURPOSE OF REVIEW: To determine whether current evidence and expert opinion support the routine use of anal cytology and high-resolution anoscopy in men who have sex with men.
  • RECENT FINDINGS: Most recently published guidelines do not recommend routine anal cytology, but anal cancer is undoubtedly a serious and growing problem for HIV-positive patients.
  • Two recent cohort studies have provided data that suggest that the precursor lesion (high-grade squamous intraepithelial lesion) might not be more prevalent in patients on highly active antiretroviral therapy than in historical pre-highly active antiretroviral therapy cohorts or in HIV-negative men who have sex with men.
  • If substantiated by further studies, this would make it easier to focus intervention with high-resolution anoscopy on a smaller group of patients.
  • This would be helpful because high-resolution anoscopy remains a resource that is both costly and difficult to access in most countries.
  • The sensitivity and specificity of anal cytology is poor and adjuncts to cytology such as p16(ink4a) staining and human papillomavirus viral loads might be utilized to further reduce the number of patients requiring high-resolution anoscopy.
  • Despite the burden of high-grade squamous intraepithelial lesion in HIV negative men who have sex with men, anal cancer remains uncommon in this group.
  • SUMMARY: Although routine anal cytology is not advisable for men who have sex with men at present, be they HIV positive or negative, clinicians should be regularly performing digital rectal examination in those at high risk of anal cancer, both to facilitate early detection of anal cancer and in the interests of health promotion.
  • [MeSH-minor] Anal Canal / pathology. Antiretroviral Therapy, Highly Active. Biomarkers, Tumor / analysis. Clinical Trials as Topic. Early Detection of Cancer. Epidemiologic Studies. HIV Infections / complications. HIV Infections / drug therapy. Humans. Male. Papillomavirus Infections / diagnosis. Papillomavirus Infections / etiology. Papillomavirus Infections / pathology. Proctoscopy. Sensitivity and Specificity. Viral Load

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  • (PMID = 19343830.001).
  • [ISSN] 1746-6318
  • [Journal-full-title] Current opinion in HIV and AIDS
  • [ISO-abbreviation] Curr Opin HIV AIDS
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor
  • [Number-of-references] 25
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26. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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%.
  • 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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27. 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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  • [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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28. Bean SM, Chhieng DC, Roberson J, Raper JL, Broker TR, Hoesley CJ, Eltoum IA, Jin G: Anal-rectal cytology: correlation with human papillomavirus status and biopsy diagnoses in a population of HIV-positive patients. J Low Genit Tract Dis; 2010 Apr;14(2):90-6
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  • [Title] Anal-rectal cytology: correlation with human papillomavirus status and biopsy diagnoses in a population of HIV-positive patients.
  • OBJECTIVES: We describe the cytological distribution of disease, correlate cytological diagnoses with human papillomavirus (HPV) DNA status and surgical biopsy diagnoses, determine if CD4 counts correlate with lesion severity, and compare anal-rectal data of HIV-infected patients (primarily men) with cervical data.
  • MATERIALS AND METHODS: A retrospective search of the computerized database identified 118 HIV-positive patients who had anal-rectal cytology.
  • Cytology results were compared with available follow-up data including repeat anal-rectal cytology tests, surgical biopsy, CD4 counts, and HPV DNA polymerase chain reaction-based genotyping.
  • RESULTS: Cytological diagnoses included 3% unsatisfactory for diagnosis, 41% negative for intraepithelial lesion or malignancy (NILM), 23% atypical squamous cells of undermined significance (ASC-US), 31% low-grade squamous intraepithelial lesion (LSIL), and 2% high-grade squamous intraepithelial lesion (HSIL) (ASC-US/squamous intraepithelial lesion, 0.7:1).
  • Two anal intraepithelial neoplasia (AIN) II, 10 AIN III, and 1 invasive squamous cell carcinoma were histologically detected (11%).
  • CONCLUSIONS: Anal-rectal cytology is a useful screening test.
  • A high percentage of AIN II lesions were detected in this at-risk population, and the majority was detected following cytological abnormality.
  • [MeSH-major] Anal Canal / pathology. HIV Infections / complications. Papillomaviridae / isolation & purification. Papillomavirus Infections / epidemiology. Rectal Neoplasms / epidemiology. Rectum / pathology

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  • (PMID = 20354415.001).
  • [ISSN] 1526-0976
  • [Journal-full-title] Journal of lower genital tract disease
  • [ISO-abbreviation] J Low Genit Tract Dis
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA83679
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural
  • [Publication-country] United States
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29. Herat A, Shirato K, Damian DL, Finlayson R, Whitfeld M: Invasive squamous cell carcinoma arising in refractory perianal Bowen's disease in a HIV-positive individual. Australas J Dermatol; 2006 May;47(2):120-3
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  • [Title] Invasive squamous cell carcinoma arising in refractory perianal Bowen's disease in a HIV-positive individual.
  • Perianal Bowen's disease represents high-grade anal intraepithelial neoplasia, which is considered a precursor lesion of invasive anal squamous cell carcinoma.
  • This patient's anal intraepithelial neoplasia was unresponsive to multiple treatment modalities including cryotherapy, serial curettage and cautery, topical 5-fluorouracil and 5-aminolaevulinic acid photodynamic therapy.
  • He progressed to develop a poorly differentiated squamous cell carcinoma of the anus three and a half years after the Bowen's disease was diagnosed.
  • The squamous cell carcinoma was treated with combined chemoradiation.
  • A recurrence of high-grade anal intraepithelial neoplasia was noted 6 months after completion of chemoradiation.
  • [MeSH-major] Bowen's Disease / diagnosis. Carcinoma, Squamous Cell / diagnosis. HIV Infections. Neoplasm Recurrence, Local / diagnosis. Skin Neoplasms / diagnosis
  • [MeSH-minor] Anal Canal. Combined Modality Therapy. Diagnosis, Differential. Homosexuality, Male. Humans. Male. Middle Aged. Neoplasm Invasiveness


30. Etienney I, Vuong S, Daniel F, Mory B, Taouk M, Sultan S, Thomas C, Bourguignon J, de Parades V, Méary N, Balaton A, Atienza P, Bauer P: Prevalence of anal cytologic abnormalities in a French referral population: a prospective study with special emphasis on HIV, HPV, and smoking. Dis Colon Rectum; 2008 Jan;51(1):67-72
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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 anal cytologic abnormalities in a French referral population: a prospective study with special emphasis on HIV, HPV, and smoking.
  • PURPOSE: Studying anal cytology to detect intraepithelial neoplasia has been demonstrated to be useful in highly selected populations.
  • METHODS: An anal smear was proposed during each consultation during a three-month period.
  • No case of high-grade squamous intraepithelial lesion was found.
  • Four cases of low-grade squamous intraepithelial lesion were found, all in HIV patients with a history of condylomatous lesions.
  • Forty smears were interpreted as atypical squamous cells of undetermined significance and 159 were normal.
  • The prevalence in this population of low-grade squamous intraepithelial lesion was 19 percent (4/21) in HIV seropositive males, and 15 percent (4/26) in the case of a past history of condyloma.
  • The factors associated with an abnormal smear (low-grade squamous intraepithelial lesion or atypical squamous cells of undetermined significance) were a history of anal condylomatous lesions (odd ratio, 4.9; range, 2.1-11.5), HIV seropositivity (odd ratio, 4; range, 1.6-9.9), and smoking (odd ratio, 2.1; range, 1.1-11.5).
  • CONCLUSIONS: This work confirms that the frequency of low-grade squamous intraepithelial lesion is raised in HIV-seropositive males and also where there is a history of condyloma, which corroborates the necessity for regular monitoring and screening of these patients at risk.
  • This study also suggests that the use of tobacco is associated with anal cytologic abnormalities.

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  • (PMID = 18046607.001).
  • [ISSN] 0012-3706
  • [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
  • [Chemical-registry-number] 0 / Polyethylene Terephthalates
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31. Theelen W, Speel EJ, Herfs M, Reijans M, Simons G, Meulemans EV, Baldewijns MM, Ramaekers FC, Somja J, Delvenne P, Hopman AH: Increase in viral load, viral integration, and gain of telomerase genes during uterine cervical carcinogenesis can be simultaneously assessed by the HPV 16/18 MLPA-assay. Am J Pathol; 2010 Oct;177(4):2022-33
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  • Oncogenic human papillomavirus (HPV) infection is the most important risk factor in cervical carcinogenesis cases; high viral loads, viral integration into the host genome, and gain of the telomerase-related genes, TERT and TERC, are all factors associated with progression to cancer.
  • A recently developed multiparameter HPV 16/18 multiplex ligation-dependent probe amplification (MLPA) assay, which allows the simultaneous assessment of these factors, was applied to a series of 67 normal and (pre)malignant frozen uterine cervical samples, as well as to 91 cytological preparations, to test the ability of the MLPA assay to identify high-risk lesions on the basis of these factors.
  • Only 5 out of 37 normal tissue samples or low-grade cervical lesions (ie, CIN1 and condyloma) showed either an HPV16 viral load higher than 25 copies per cell, viral integration, and/or gain of one of the telomerase-related genes, whereas for the high-grade cervical lesions, one or more of these risk factors was found in 25 of 30 cases.
  • Furthermore, the feasibility of the MLPA assay was shown for cytological samples, where in 57% of high-grade squamous intraepithelial lesion cases, the high-risk factors were detected using this assay.
  • [MeSH-minor] Adult. Aged. Carcinoma, Squamous Cell / diagnosis. Carcinoma, Squamous Cell / etiology. Cell Transformation, Neoplastic / genetics. Cell Transformation, Neoplastic / pathology. Cervical Intraepithelial Neoplasia / diagnosis. Cervical Intraepithelial Neoplasia / etiology. DNA, Viral / genetics. Feasibility Studies. Female. Humans. In Situ Hybridization, Fluorescence. Middle Aged. Nucleic Acid Amplification Techniques. Polymerase Chain Reaction. Uterus / metabolism. Uterus / pathology. Young Adult

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  • (PMID = 20813962.001).
  • [ISSN] 1525-2191
  • [Journal-full-title] The American journal of pathology
  • [ISO-abbreviation] Am. J. Pathol.
  • [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; EC 2.7.7.49 / TERT protein, human; EC 2.7.7.49 / Telomerase
  • [Other-IDs] NLM/ PMC2947296
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32. 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.
  • 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.
  • A significant increase in high DNA damage was also observed in women with LSIL (23 +/- 15.4) or HSIL (32 +/- 13.1) relative to that in the control women (12 +/- 7.9).
  • CONCLUSION: These findings confirm that the grade of a cervical lesion correlates with the degree of genomic instability.

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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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33. Misra JS, Das V, Srivastava AN, Singh U, Singh M: AgNOR counts in cervical smears under normal and other cytopathologic conditions. Anal Quant Cytol Histol; 2005 Dec;27(6):337-40
International Agency for Research on Cancer - Screening Group. diagnostics - A practical manual on visual screening for cervical neoplasia .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • OBJECTIVE: To investigate the diagnostic value of AgNOR counts in cervical smears in the process of cervical carcinogenesis and in discriminating the different grades of squamous intraepithelial lesion (SIL).
  • STUDY DESIGN: Silver nitrate staining for AgNOR counts was performed in 50 cervical smears of cytologically diagnosed normal, inflammatory, low grade SIL (LSIL) (mild dysplasia), high grade SIL (HSIL) (moderate and severe dysplasia) and squamous cell carcinoma.

  • MedlinePlus Health Information. consumer health - Cervical Cancer.
  • International Agency for Research on Cancer - Screening Group. diagnostics - Histopathology and cytopathology of the uterine cervix - digital atlas .
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  • (PMID = 16450790.001).
  • [ISSN] 0884-6812
  • [Journal-full-title] Analytical and quantitative cytology and histology
  • [ISO-abbreviation] Anal. Quant. Cytol. Histol.
  • [Language] ENG
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor
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