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1. Hessol NA, Holly EA, Efird JT, Minkoff H, Schowalter K, Darragh TM, Burk RD, Strickler HD, Greenblatt RM, Palefsky JM: Anal intraepithelial neoplasia in a multisite study of HIV-infected and high-risk HIV-uninfected women. AIDS; 2009 Jan 2;23(1):59-70
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  • [Title] Anal intraepithelial neoplasia in a multisite study of HIV-infected and high-risk HIV-uninfected women.
  • OBJECTIVES: To study anal intraepithelial neoplasia and its associations with anal and cervical human papillomavirus (HPV), cervical neoplasia, host immune status, and demographic and behavioral risk factors in women with and at risk for HIV infection.
  • METHODS: In 2001-2003 participants were interviewed, received a gynecological examination, anal and cervical cytology testing and, if abnormal, colposcopy-guided or anoscopy-guided biopsy of visible lesions.
  • Exfoliated cervical and anal specimens were assessed for HPV using PCR and type-specific HPV probing.
  • Logistic regression analyses were performed, and odds ratios (ORs) estimated risks for anal intraepithelial neoplasia.
  • Low-grade anal intraepithelial neoplasia was present in 12% of HIV-infected and 5% of HIV-uninfected women.
  • High-grade anal intraepithelial neoplasia was present in 9% of HIV-infected and 1% of HIV-uninfected women.
  • In adjusted analyses among HIV-infected women, the risk factors for low-grade anal intraepithelial neoplasia were younger age [OR = 0.59, 95% confidence interval (CI) = 0.36-0.97], history of receptive anal intercourse (OR = 3.2, 95% CI = 1.5-6.8), anal HPV (oncogenic types only OR = 11, 95% CI = 1.2-103; oncogenic and nononcogenic types OR = 11, 95% CI = 1.3-96), and cervical HPV (oncogenic and nononcogenic types OR = 3.5, 95% CI = 1.1-11).
  • In multivariable analyses among HIV-infected women, the only significant risk factor for high-grade anal intraepithelial neoplasia was anal HPV infection (oncogenic and nononcogenic types OR = 7.6, 95% CI = 1.5-38).
  • CONCLUSION: Even in the era of highly active antiviral therapy, the prevalence of anal intraepithelial neoplasia was 16% in HIV-infected women.
  • After controlling for potential confounders, several risk factors for low-grade anal intraepithelial neoplasia differed from risk factors for high-grade anal intraepithelial neoplasia.

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  • (PMID = 19050387.001).
  • [ISSN] 1473-5571
  • [Journal-full-title] AIDS (London, England)
  • [ISO-abbreviation] AIDS
  • [Language] ENG
  • [Grant] United States / NIAID NIH HHS / AI / U01-AI-42590; United States / NIAID NIH HHS / AI / U01 AI031834; United States / NCI NIH HHS / CA / R01 CA 88739; United States / NIAID NIH HHS / AI / U01 AI035004; United States / NICHD NIH HHS / HD / U01-HD-32632; United States / NCI NIH HHS / CA / R01 CA088739; United States / NCRR NIH HHS / RR / UL1 RR024131; United States / NIAID NIH HHS / AI / U01 AI034989; United States / NIAID NIH HHS / AI / U01-AI-34994; United States / NIAID NIH HHS / AI / U01-AI-35004; United States / NCI NIH HHS / CA / CA088739-05S1; United States / NIAID NIH HHS / AI / U01-AI-31834; United States / NIAID NIH HHS / AI / U01 AI034994; United States / NIAID NIH HHS / AI / U01 AI034989-15; United States / NCI NIH HHS / CA / R01 CA088739-05S1; United States / NIAID NIH HHS / AI / U01-AI-34993; United States / NCI NIH HHS / CA / R01 CA085178; United States / NIAID NIH HHS / AI / U01 AI034993; United States / NIAID NIH HHS / AI / U01-AI-34989; United States / NICHD NIH HHS / HD / U01 HD032632; United States / NIAID NIH HHS / AI / U01 AI042590
  • [Publication-type] Journal Article; Multicenter Study; Research Support, N.I.H., Extramural
  • [Publication-country] England
  • [Other-IDs] NLM/ NIHMS84186; NLM/ PMC2614220
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2. Park IU, Palefsky JM: Evaluation and Management of Anal Intraepithelial Neoplasia in HIV-Negative and HIV-Positive Men Who Have Sex with Men. Curr Infect Dis Rep; 2010 Mar;12(2):126-33
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  • [Title] Evaluation and Management of Anal Intraepithelial Neoplasia in HIV-Negative and HIV-Positive Men Who Have Sex with Men.
  • The incidence of human papillomavirus (HPV)-associated anal cancer in men who have sex with men (MSM) is striking and has not been mitigated by the use of highly active antiretroviral therapy.
  • Detection and treatment of high-grade anal intraepithelial neoplasia (HGAIN) may reduce the incidence of anal cancer.
  • Anal cytology is a useful tool to detect HGAIN; annual screening of HIV-positive MSM and biennial screening of HIV-negative MSM appears to be cost-effective.
  • Large prospective studies are needed to document the efficacy of screening and treatment of HGAIN on anal cancer incidence.
  • The HPV vaccine holds promise for primary prevention of anal cancer in MSM, but significant implementation challenges remain.

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  • (PMID = 20461117.001).
  • [ISSN] 1534-3146
  • [Journal-full-title] Current infectious disease reports
  • [ISO-abbreviation] Curr Infect Dis Rep
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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3. 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


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4. Vajdic CM, Anderson JS, Hillman RJ, Medley G, Grulich AE: Blind sampling is superior to anoscope guided sampling for screening for anal intraepithelial neoplasia. Sex Transm Infect; 2005 Oct;81(5):415-8
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  • [Title] Blind sampling is superior to anoscope guided sampling for screening for anal intraepithelial neoplasia.
  • OBJECTIVES: Anal cytology smears are either collected "blind" (swab inserted 4 cm into anal canal and rotated) or guided through an anoscope (transformation zone visualised and then sampled).
  • The outcome measures were cytological specimen adequacy, cytological classification, presence of rectal columnar, squamous and metaplastic cells, contamination, patient comfort and acceptability, and volume of fluid that remained after the ThinPrep procedure.
  • Controlling for smear order, guided smears were more likely to be assessed as "unsatisfactory" for cytological assessment (OR 6.93, 95% CI 1.92 to 24.94), and contain fewer squamous (OR 0.20, 95% CI 0.04 to 0.94) and metaplastic cells (OR 0.12, 95% CI 0.03 to 0.54) than blind smears; there were no other statistically significant differences between techniques.
  • CONCLUSIONS: Blind cytology smears are superior to anoscope guided smears for screening for anal neoplasia in homosexual men.
  • [MeSH-major] Anus Neoplasms / pathology. Homosexuality, Male. Proctoscopy / methods. Specimen Handling / methods

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  • (PMID = 16199742.001).
  • [ISSN] 1368-4973
  • [Journal-full-title] Sexually transmitted infections
  • [ISO-abbreviation] Sex Transm Infect
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Randomized Controlled Trial
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC1745038
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5. Baudet JS, Castro V, Díaz-Bethencourt D, Morales S, Avilés J: [Bowenoide papulosis. An anal intraepithelial neoplasia]. Rev Esp Enferm Dig; 2009 Jun;101(6):440-1
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  • [Title] [Bowenoide papulosis. An anal intraepithelial neoplasia].
  • [Transliterated title] Papulomatosis bowenoide. Una neoplasia intraepitelial anal.
  • [MeSH-major] Anus Neoplasms / pathology. Carcinoma in Situ / pathology

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  • (PMID = 19630470.001).
  • [ISSN] 1130-0108
  • [Journal-full-title] Revista española de enfermedades digestivas : organo oficial de la Sociedad Española de Patología Digestiva
  • [ISO-abbreviation] Rev Esp Enferm Dig
  • [Language] spa
  • [Publication-type] Case Reports; Letter
  • [Publication-country] Spain
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6. 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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7. Palefsky J: Human papillomavirus-related disease in people with HIV. Curr Opin HIV AIDS; 2009 Jan;4(1):52-6
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  • This review will describe recent findings in HPV-associated cancer incidence since the introduction of antiretroviral therapy, HPV/disease prevalence at sites other than cervix and anus, and recent data on screening and treatment of anal intraepithelial neoplasia.
  • RECENT FINDINGS: Consistent with high prevalence of anogenital HPV infection, new data on cervical intraepithelial neoplasia and anal intraepithelial neoplasia in HIV-positive men and women show that the incidence of cervical cancer has not declined since the introduction of antiretroviral therapy and that the incidence of anal cancer is rising.
  • Several studies also highlight high rates of HPV infection and HPV-associated disease at sites other than the cervix and anus, including the penis and the mouth.
  • Treatment methods for anal intraepithelial neoplasia have been described and show reasonable efficacy.
  • SUMMARY: New data imply that the problem of HPV-related cancers will not decline among HIV-positive men and women in the antiretroviral therapy era, highlighting the need to perform studies to determine if screening and treatment of anal intraepithelial neoplasia will prevent development of anal cancer.

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  • (PMID = 19339939.001).
  • [ISSN] 1746-6318
  • [Journal-full-title] Current opinion in HIV and AIDS
  • [ISO-abbreviation] Curr Opin HIV AIDS
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / CA054053-08; United States / NCI NIH HHS / CA / R01 CA054053; United States / NCI NIH HHS / CA / R01 CA088739; United States / NCI NIH HHS / CA / R01 CA054053-08; United States / NCI NIH HHS / CA / R01 CA088739-03; United States / NCI NIH HHS / CA / CA088739-03
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Anti-Retroviral Agents
  • [Number-of-references] 36
  • [Other-IDs] NLM/ NIHMS94538; NLM/ PMC2756707
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8. Kreuter A, Brockmeyer NH, Pfister H, Altmeyer P, Wieland U, Competence Network HIV/AIDS: Human papillomavirus type 26-associated periungual squamous cell carcinoma in situ in a HIV-infected patient with concomitant penile and anal intraepithelial neoplasia. J Am Acad Dermatol; 2005 Oct;53(4):737-9
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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 type 26-associated periungual squamous cell carcinoma in situ in a HIV-infected patient with concomitant penile and anal intraepithelial neoplasia.
  • [MeSH-major] Anus Neoplasms / epidemiology. Carcinoma in Situ / epidemiology. Carcinoma, Squamous Cell / virology. HIV Infections / epidemiology. HIV-1. Nail Diseases / epidemiology. Papillomaviridae. Papillomavirus Infections / epidemiology. Penile Neoplasms / epidemiology. Skin Neoplasms / epidemiology


9. Kreuter A, Wieland U, Brockmeyer N: [Anal carcinoma and anal intraepithelial neoplasia in HIV-infections]. J Dtsch Dermatol Ges; 2006 Jul;4(7):611-2
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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 and anal intraepithelial neoplasia in HIV-infections].
  • [Transliterated title] Analkarzinom und anale intraepitheliale Neoplasie bei HIV-Infektion.
  • [MeSH-major] Anus Neoplasms / diagnosis. Carcinoma in Situ / diagnosis. HIV Infections / diagnosis. Skin Neoplasms / diagnosis

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  • (PMID = 16883662.001).
  • [ISSN] 1610-0379
  • [Journal-full-title] Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG
  • [ISO-abbreviation] J Dtsch Dermatol Ges
  • [Language] ger
  • [Publication-type] Journal Article
  • [Publication-country] Germany
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10. Jongen J: Letter to the editor concerning "HPV in anal squamous cell carcinoma and anal intraepithelial neoplasia (AIN)" by Varnai et al. (Int J Colorectal Dis 21:135-142, 2006). Int J Colorectal Dis; 2007 Oct;22(10):1289
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Letter to the editor concerning "HPV in anal squamous cell carcinoma and anal intraepithelial neoplasia (AIN)" by Varnai et al. (Int J Colorectal Dis 21:135-142, 2006).
  • [MeSH-major] Alphapapillomavirus / isolation & purification. Anus Neoplasms / virology. Carcinoma in Situ / virology. Carcinoma, Squamous Cell / virology

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  • [CommentOn] Int J Colorectal Dis. 2006 Mar;21(2):135-42 [15864603.001]
  • (PMID = 16703315.001).
  • [ISSN] 0179-1958
  • [Journal-full-title] International journal of colorectal disease
  • [ISO-abbreviation] Int J Colorectal Dis
  • [Language] eng
  • [Publication-type] Comment; Letter
  • [Publication-country] Germany
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11. 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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12. Shepherd NA: Anal intraepithelial neoplasia and other neoplastic precursor lesions of the anal canal and perianal region. Gastroenterol Clin North Am; 2007 Dec;36(4):969-87, ix
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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 and other neoplastic precursor lesions of the anal canal and perianal region.
  • Anal cancer is rare and this helps to explain why anal pre-neoplastic conditions are poorly understood, especially with regard to their natural history and management.
  • Anal intraepithelial neoplasia is closely linked to human papillomavirus infection and is particularly common in homosexuals and in immunosuppressed patients, especially those with HIV/AIDS.
  • The high regression rates of low-grade anal intraepithelial neoplasia may simply reflect inconsistent pathologic reporting.
  • Higher grades of anal intraepithelial neoplasia may remain static for long periods of time in immunocompetent patients, but those with HIV/AIDS show early and rapid malignant transformation.
  • In general, most anal pre-neoplastic conditions are best diagnosed by biopsy and treated by surgical excision, although local recurrence is a problem.
  • In anal Paget's disease, it is important to ascertain, at the time of diagnosis, whether it is due to a primary in-situ apocrine-type of neoplasia of the anus or if the disease is secondary to an invasive primary carcinoma of the rectum.
  • [MeSH-minor] Anal Canal. Diagnosis, Differential. Humans

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  • (PMID = 17996800.001).
  • [ISSN] 0889-8553
  • [Journal-full-title] Gastroenterology clinics of North America
  • [ISO-abbreviation] Gastroenterol. Clin. North Am.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 119
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13. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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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14. Alvarez J, de Pokomandy A, Rouleau D, Ghattas G, Vézina S, Coté P, Allaire G, Hadjeres R, Franco EL, Coutlée F, HIPVIRG Study Group: Episomal and integrated human papillomavirus type 16 loads and anal intraepithelial neoplasia in HIV-seropositive men. AIDS; 2010 Sep 24;24(15):2355-63
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Episomal and integrated human papillomavirus type 16 loads and anal intraepithelial neoplasia in HIV-seropositive men.
  • OBJECTIVES: To assess levels of episomal and integrated human papillomavirus type 16 (HPV-16) loads in HIV-seropositive men who have sex with men (MSM) in anal infection and to study the association between episomal and integrated HPV-16 loads and anal intraepithelial neoplasia (AIN).
  • Overall, 135 (54.7%) men provided 665 HPV-16-positive anal samples.
  • RESULTS: The HPV-16 DNA forms in anal samples were characterized as episomal only in 627 samples (94.3%), mixed in 22 samples (3.3%) and integrated only in nine samples (1.4%).
  • HPV-16 episomal load [odds ratio (OR) = 1.5, 95% confidence interval (CI) 1.1-2.1], number of HPV types (OR = 1.4, 95% CI 1.1-1.8) and current smoking (OR = 4.8, 95% CI 1.3-18.6) were associated with high-grade AIN (AIN-2,3) after adjusting for age and CD4 cell counts.
  • Integrated HPV-16 load was not associated with AIN-2,3 (OR = 0.7, 95% CI 0.4-1.1).
  • Considering men with AIN-1 at baseline, four (16.7%) of the 24 men who progressed to AIN-2,3 had at least one sample with integrated HPV-16 DNA compared with three (23.1%) of 13 men who did not progress (OR = 0.7, 95% CI 0.2-3.8; P = 0.64).
  • Integration was detected in similar proportions in samples from men without AIN, with AIN-1 or AIN-2,3.
  • CONCLUSION: High episomal HPV-16 load but not HPV-16 integration load measured by real-time PCR was associated with AIN-2,3.
  • [MeSH-major] Anus Neoplasms / immunology. Carcinoma, Squamous Cell / immunology. HIV Seropositivity / immunology. Human papillomavirus 16 / immunology. Papillomavirus Infections / immunology. Plasmids / immunology

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  • (PMID = 20706109.001).
  • [ISSN] 1473-5571
  • [Journal-full-title] AIDS (London, England)
  • [ISO-abbreviation] AIDS
  • [Language] eng
  • [Grant] Canada / Canadian Institutes of Health Research / /
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / DNA, Viral
  • [Investigator] Allaire G; Baril JG; Boissonnault M; Charest L; Charron MA; Coté S; Coté P; Coutlée F; de Pokomandy A; Dion H; Dufresne S; Falutz J; Fortin C; Franco EL; Ghattas G; Gilmore N; Gorska I; Hadjeres R; Junod P; Klein M; Lalonde R; Laplante F; Leblanc R; Legault D; Lessard B; Longpré 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; Trépanier JM; Trottier B; Tsoukas C; Turner H; Vezina S
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15. Berry JM, Palefsky JM, Jay N, Cheng SC, Darragh TM, Chin-Hong PV: Performance characteristics of anal cytology and human papillomavirus testing in patients with high-resolution anoscopy-guided biopsy of high-grade anal intraepithelial neoplasia. Dis Colon Rectum; 2009 Feb;52(2):239-47
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Performance characteristics of anal cytology and human papillomavirus testing in patients with high-resolution anoscopy-guided biopsy of high-grade anal intraepithelial neoplasia.
  • PURPOSE: High-resolution anoscopy is colposcopy of the anus after applying 3 percent acetic acid.
  • High-resolution anoscopy with biopsy was used as the standard for detecting high-grade anal neoplasia and was compared to detection of high-grade anal neoplasia by anal cytology, human papillomavirus testing, or the combination.
  • A specimen was taken for anal cytology and human papillomavirus testing, followed by high-resolution anoscopy with biopsy of any lesions.
  • RESULTS: Ninety-one percent of HIV-positive and 57 percent of HIV-negative MSM had anal human papillomavirus infection.
  • In HIV-positive men the sensitivity of abnormal cytology to detect high-grade anal neoplasia was 87 percent, and in HIV-negative MSM it was 55 percent.
  • Among HIV-negative men, 9 of 20 cases of high-grade anal neoplasia would have been missed because cytology was negative, but the addition of human papillomavirus positivity increased sensitivity for the combination to 90 percent.
  • CONCLUSIONS: Sensitivity and specificity of anal cytology and human papillomavirus testing are different in HIV-positive and HIV-negative MSM for detecting high-grade anal neoplasia when patients have high-resolution anoscopy-guided biopsy of lesions.
  • High-resolution anoscopy is an effective tool for diagnosing high-grade anal neoplasia.
  • [MeSH-major] Anal Canal / pathology. Anus Neoplasms / diagnosis. Carcinoma in Situ / diagnosis. Endoscopy, Gastrointestinal. Papillomaviridae / isolation & purification. Papillomavirus Infections / diagnosis
  • [MeSH-minor] Adult. Aged. Anus Diseases / diagnosis. Anus Diseases / virology. Biopsy. Cytodiagnosis. HIV Seronegativity. HIV Seropositivity / complications. Homosexuality. Humans. Male. Middle Aged. Polymerase Chain Reaction. Precancerous Conditions / diagnosis. Predictive Value of Tests. Sensitivity and Specificity

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  • (PMID = 19279418.001).
  • [ISSN] 1530-0358
  • [Journal-full-title] Diseases of the colon and rectum
  • [ISO-abbreviation] Dis. Colon Rectum
  • [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 / NCRR NIH HHS / RR / UL1 RR024131-01
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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16. 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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17. Abbasakoor F, Boulos PB: Anal intraepithelial neoplasia. Br J Surg; 2005 Mar;92(3):277-90
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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.
  • 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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18. 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).
  • 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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19. Herat A, Whitfeld M, Hillman R: Anal intraepithelial neoplasia and anal cancer in dermatological practice. Australas J Dermatol; 2007 Aug;48(3):143-53; quiz 154-5
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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 and anal cancer in dermatological practice.
  • Anal intraepithelial neoplasia is considered to be a precursor lesion of invasive anal cancer.
  • Human papillomaviruses are considered to be an important aetiological agent in both anal intraepithelial neoplasia and anal cancer.
  • Dermatologists are likely to encounter these conditions among the differential diagnoses to be considered in high-risk patients presenting with perianal and anal lesions.
  • Anal cancer rates are also increasing among the HIV-infected and HIV-non-infected population.
  • The successful treatment of anal intraepithelial neoplasia may reduce the risk of subsequent development of anal cancer.
  • However, current therapies for anal intraepithelial neoplasia may be associated with treatment-related morbidity and are not well validated.
  • It is currently not proven that they reduce the likelihood of the development of anal cancer.
  • Nevertheless, screening for anal intraepithelial neoplasia is being advocated for high-risk groups and may become standard dermatological care for these patients.
  • In view of recent developments in the understanding of this condition, this article reviews the current understanding of anal intraepithelial neoplasia and its treatment from a dermatological perspective.
  • [MeSH-major] Anus Neoplasms. Carcinoma in Situ. Carcinoma, Squamous Cell. Papillomavirus Infections
  • [MeSH-minor] Diagnosis, Differential. HIV Infections / complications. Humans. Papillomaviridae / pathogenicity

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  • (PMID = 17680964.001).
  • [ISSN] 0004-8380
  • [Journal-full-title] The Australasian journal of dermatology
  • [ISO-abbreviation] Australas. J. Dermatol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Australia
  • [Number-of-references] 115
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20. Kreuter A, Brockmeyer NH, Wieland U, German Competence Network HIV/AIDS: Irregularly shaped leucoplakic lesion of the anus. Diagnosis: anal intraepithelial neoplasia (AIN). Clin Exp Dermatol; 2007 Sep;32(5):621-3
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Irregularly shaped leucoplakic lesion of the anus. Diagnosis: anal intraepithelial neoplasia (AIN).
  • [MeSH-major] Anus Neoplasms / pathology. Carcinoma in Situ / pathology. Leukoplakia / pathology. Papillomavirus Infections / complications
  • [MeSH-minor] Adult. Antiretroviral Therapy, Highly Active. Diagnosis, Differential. Homosexuality, Male. Humans. Male. Papillomaviridae / isolation & purification. Precancerous Conditions / pathology. Risk Factors

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  • (PMID = 17425644.001).
  • [ISSN] 0307-6938
  • [Journal-full-title] Clinical and experimental dermatology
  • [ISO-abbreviation] Clin. Exp. Dermatol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
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21. Kruijt B, van der Snoek EM, Sterenborg HJ, Amelink A, Robinson DJ: A dedicated applicator for light delivery and monitoring of PDT of intra-anal intraepithelial neoplasia. Photodiagnosis Photodyn Ther; 2010 Mar;7(1):3-9
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  • [Title] A dedicated applicator for light delivery and monitoring of PDT of intra-anal intraepithelial neoplasia.
  • The objective of this study was to develop an applicator for delivery of light and monitoring of photodynamic therapy (PDT) in the anal cavity for treatment of anal intraepithelial neoplasia grade III (AIN III), which can progress to invasive anal cancer.
  • [MeSH-major] Anus Neoplasms / diagnosis. Anus Neoplasms / drug therapy. Carcinoma in Situ / diagnosis. Carcinoma in Situ / drug therapy. Lighting / instrumentation. Photochemotherapy / instrumentation. Photosensitizing Agents / administration & dosage

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  • [Copyright] 2010 Elsevier B.V. All rights reserved.
  • (PMID = 20230986.001).
  • [ISSN] 1873-1597
  • [Journal-full-title] Photodiagnosis and photodynamic therapy
  • [ISO-abbreviation] Photodiagnosis Photodyn Ther
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Netherlands
  • [Chemical-registry-number] 0 / Photosensitizing Agents
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22. Richel O, Wieland U, de Vries HJ, Brockmeyer NH, van Noesel C, Potthoff A, Prins JM, Kreuter A: Topical 5-fluorouracil treatment of anal intraepithelial neoplasia in human immunodeficiency virus-positive men. Br J Dermatol; 2010 Dec;163(6):1301-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Topical 5-fluorouracil treatment of anal intraepithelial neoplasia in human immunodeficiency virus-positive men.
  • BACKGROUND: Anal intraepithelial neoplasia (AIN), a human papillomavirus (HPV)-induced potential precursor lesion of anal cancer, is frequent among human immunodeficiency virus (HIV)-positive men who have sex with men (MSM).
  • So far, only a few prospective studies have been performed on the topical treatment of AIN, especially at the intra-anal location.
  • OBJECTIVES: To evaluate the efficacy and safety of self-administered topical 5-fluorouracil (5-FU) treatment of AIN in HIV-positive MSM.
  • METHODS: High-resolution anoscopy (HRA) was performed and patients with AIN (grade 1-3) were treated with 5-FU twice weekly for a total of 16 weeks.
  • RESULTS: A total of 46 patients with AIN were included in this open prospective pilot study; 76% had multifocal disease and 74% had high-grade lesions (AIN 2 or 3).
  • Eighteen patients (39%) had a complete clearance of AIN and eight patients (17%) had a partial response.
  • Seventeen patients (37%) did not respond (unchanged grade of AIN in 16 patients and progression from low- to high-grade AIN in one patient).
  • CONCLUSIONS: A substantial proportion of HIV-positive MSM with AIN completely cleared their lesions with topical 5-FU treatment.
  • [MeSH-major] Antimetabolites, Antineoplastic / therapeutic use. Anus Neoplasms / drug therapy. Fluorouracil / therapeutic use. HIV Infections / complications

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  • [Copyright] © 2010 The Authors. BJD © 2010 British Association of Dermatologists.
  • (PMID = 20716208.001).
  • [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 / Antimetabolites, Antineoplastic; U3P01618RT / Fluorouracil
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23. Palefsky JM, Holly EA, Efirdc JT, Da Costa M, Jay N, Berry JM, Darragh TM: Anal intraepithelial neoplasia in the highly active antiretroviral therapy era among HIV-positive men who have sex with men. AIDS; 2005 Sep 2;19(13):1407-14
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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 the highly active antiretroviral therapy era among HIV-positive men who have sex with men.
  • OBJECTIVES: The incidence of anal cancer among men who have sex with men (MSM) has continued to increase since the introduction of highly active antiretroviral therapy (HAART).
  • The prevalence of the putative anal cancer precursor, anal intraepithelial neoplasia (AIN) was high among HIV-positive MSM prior to the availability of HAART but little is known about AIN since HAART was introduced.
  • We characterized the prevalence of AIN among HIV-positive MSM and examined the association between AIN and various factors including use of HAART.
  • DESIGN AND METHODS: A baseline point-prevalence analyses in a prospective cohort study of AIN was performed at a university-based research clinic.
  • A total of 357 HIV-positive MSM with no history of anal cancer completed a questionnaire detailing behaviors and medical history, anal cytology and human papillomavirus (HPV) testing, and high-resolution anoscopy with biopsy for detection of AIN.
  • RESULTS: Eighty-one percent of participants with available CD4+ cell counts at baseline had AIN of any grade; 52% had AIN 2 or 3; and 95% had anal HPV infection.
  • In multivariate analysis, detection of > or = 6 HPV types [odds ratio (OR), 36; 95% confidence interval (CI), 7.4-171) and use of HAART (OR, 10; 95% CI, 2.6-38) were associated with AIN after adjustment for length of time participants were HIV-positive, CD4+ cell count and HIV viral load.
  • CONCLUSIONS: The prevalence of AIN has remained high among HIV-positive MSM after the introduction of HAART.
  • Our data indicate that HAART is not associated with a reduced prevalence of AIN and support measures to prevent anal cancer among HIV-positive MSM whether or not they are using HAART.
  • [MeSH-major] Anus Neoplasms / virology. Carcinoma in Situ / virology. HIV Infections / complications. Homosexuality, Male

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  • (PMID = 16103772.001).
  • [ISSN] 0269-9370
  • [Journal-full-title] AIDS (London, England)
  • [ISO-abbreviation] AIDS
  • [Language] eng
  • [Grant] United States / NCRR NIH HHS / RR / 5 M01-RR-00079; United States / NCI NIH HHS / CA / R01CA54053
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Anti-HIV Agents
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24. Palefsky JM, Berry JM, Jay N, Krogstad M, Da Costa M, Darragh TM, Lee JY: A trial of SGN-00101 (HspE7) to treat high-grade anal intraepithelial neoplasia in HIV-positive individuals. AIDS; 2006 May 12;20(8):1151-5
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  • [Title] A trial of SGN-00101 (HspE7) to treat high-grade anal intraepithelial neoplasia in HIV-positive individuals.
  • OBJECTIVES: To test a therapeutic vaccine consisting of a fusion of the human papillomavirus (HPV) 16 E7 protein and the Mycobacterium bovis heat shock protein 65 (SGN-00101) to treat high-grade anal intraepithelial neoplasia (HG-AIN) in HIV-positive individuals.
  • Anal disease was assessed at baseline, 8, 12, 24 and 48 weeks and was classified as the more severe of anal cytology and anal biopsy.
  • Anal HPV DNA was detected using L1 consensus primer-based PCR followed by type-specific probing and dot-blot hybridization (DBH).
  • PARTICIPANTS: Thirteen HIV-positive men and two HIV-positive women with HG-AIN.
  • At 48 weeks, two of five participants in both the 100 and 500 microg cohorts regressed to AIN 1 and one of five participants in the 1000 microg cohort regressed to atypical squamous cells of undetermined significance (ASC-US).
  • Three of five (60%) participants who regressed to AIN 1 or ASC-US became HPV-negative using DBH and real-time PCR, compared with none of 10 participants with no clinical response (P = 0.02).
  • [MeSH-major] Anus Neoplasms / therapy. Cancer Vaccines / therapeutic use. Carcinoma in Situ / therapy. HIV Seropositivity / complications

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  • (PMID = 16691066.001).
  • [ISSN] 0269-9370
  • [Journal-full-title] AIDS (London, England)
  • [ISO-abbreviation] AIDS
  • [Language] eng
  • [Grant] United States / NCRR NIH HHS / RR / M01 RR 00079; United States / NCI NIH HHS / CA / U01 CA 70019; United States / NCI NIH HHS / CA / U01 CA 70047
  • [Publication-type] Clinical Trial, Phase I; Clinical Trial, Phase II; Journal Article; Research Support, N.I.H., Extramural
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Bacterial Proteins; 0 / Cancer Vaccines; 0 / Chaperonin 60; 0 / Papillomavirus E7 Proteins; 0 / Recombinant Fusion Proteins; 0 / Viral Vaccines; 0 / heat-shock protein 65, Mycobacterium; EC 3.6.1.- / Chaperonins
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25. 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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26. 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.
  • 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.
  • [MeSH-major] Anus Neoplasms / epidemiology. Carcinoma in Situ / epidemiology. Genital Neoplasms, Female / epidemiology

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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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27. 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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28. de Góis NM, Costa RR, Kesselring F, de Freitas VG, Ribalta JC, Kobata MP, Taha NS: Grade 3 vulvar and anal intraepithelial neoplasia in a HIV seropositive child--therapeutic result: case report. Clin Exp Obstet Gynecol; 2005;32(2):138-40
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  • [Title] Grade 3 vulvar and anal intraepithelial neoplasia in a HIV seropositive child--therapeutic result: case report.
  • A case report of a HIV seropositive 8-year-old child with vulvar and anal border neoplasia, both grade 3, and the adopted therapeutic management are presented.
  • On physical examination a pigmented and elevated lesion was observed in the whole vulvar region extending to the anal region and intergluteal sulcus.
  • [MeSH-major] Anus Neoplasms / therapy. Carcinoma / therapy. HIV Infections / diagnosis. HIV Infections / drug therapy. Vulvar Neoplasms / therapy


29. 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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30. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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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31. 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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32. 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.
  • A 54-year-old HIV-positive homosexual man presented with erythematous and pigmented plaques on background erythema in the perianal region, histologically consistent with Bowen's disease.
  • 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


33. 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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  • [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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34. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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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35. 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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  • [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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36. 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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  • [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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37. 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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38. 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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  • [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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39. 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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  • [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


40. Schlecht HP, Fugelso DK, Murphy RK, Wagner KT, Doweiko JP, Proper J, Dezube BJ, Panther LA: Frequency of occult high-grade squamous intraepithelial neoplasia and invasive cancer within anal condylomata in men who have sex with men. Clin Infect Dis; 2010 Jul 1;51(1):107-10
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  • [Title] Frequency of occult high-grade squamous intraepithelial neoplasia and invasive cancer within anal condylomata in men who have sex with men.
  • Human papillomavirus causes anal condylomata, high-grade anal intraepithelial neoplasia, and anal squamous cell cancer.
  • We found high-grade intraepithelial neoplasia or squamous cell cancer in 75 (47%) of 159 HIV-seropositive men who have sex with men (MSM) and in 42 (26%) of 160 HIV-seronegative MSM with anal condylomata meriting surgery (P<.001, determined by use of the chi(2) test).
  • Anal condylomata in MSM often harbor high-grade intraepithelial neoplasia and squamous cell cancer.
  • [MeSH-major] Anus Diseases / complications. Anus Neoplasms / epidemiology. Carcinoma, Squamous Cell / epidemiology. Condylomata Acuminata / complications. Homosexuality, Male. Papillomavirus Infections / complications


41. Lee PK, Wilkins KB: Condyloma and other infections including human immunodeficiency virus. Surg Clin North Am; 2010 Feb;90(1):99-112, Table of Contents
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  • This article reviews the presentation and management of the more common perianal STDs including human immunodeficiency virus, as well as the pathogenesis and management of anal intraepithelial neoplasia.
  • [MeSH-minor] Aminoquinolines / administration & dosage. Anti-Bacterial Agents / administration & dosage. Antineoplastic Agents / administration & dosage. Anus Neoplasms / virology. Chancroid. Female. HIV Infections. Herpes Genitalis / diagnosis. Herpesvirus 1, Human. Herpesvirus 2, Human. Humans. Male. Penicillin G / administration & dosage. Proctitis / virology. Rectal Diseases / virology. Sexually Transmitted Diseases / virology. Syphilis / drug therapy. Ulcer

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  • [Copyright] Copyright 2010 Elsevier Inc. All rights reserved.
  • (PMID = 20109635.001).
  • [ISSN] 1558-3171
  • [Journal-full-title] The Surgical clinics of North America
  • [ISO-abbreviation] Surg. Clin. North Am.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Aminoquinolines; 0 / Anti-Bacterial Agents; 0 / Antineoplastic Agents; 99011-02-6 / imiquimod; Q42T66VG0C / Penicillin G
  • [Number-of-references] 42
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42. Palefsky JM: Anal cancer prevention in HIV-positive men and women. Curr Opin Oncol; 2009 Sep;21(5):433-8
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  • [Title] Anal cancer prevention in HIV-positive men and women.
  • PURPOSE OF REVIEW: The incidence of human papillomavirus-associated anal cancer is unacceptably high among HIV-positive men who have sex with men, and possibly in HIV-positive women.
  • Unlike most other malignancies occurring in the HIV-positive population, anal cancer is potentially preventable, using methods similar to those used to prevent cervical cancer in women.
  • This review discusses the issues around screening to prevent anal cancer.
  • RECENT FINDINGS: Recent studies show that the incidence of anal cancer has increased since the introduction of highly active antiretroviral therapy in this population and now exceeds the highest incidence of cervical cancer among women reported anywhere in the world.
  • SUMMARY: The high incidence of anal cancer among HIV-positive individuals must not be ignored, since it may be preventable.
  • Given the current evidence and analogy with the cervical cancer prevention model, many clinicians believe that identification and treatment of high-grade anal intraepithelial neoplasia to prevent anal cancer are warranted.
  • When the expertise to do so exists, this is a reasonable approach, particularly if coupled with efforts to optimize further screening and treatment approaches, as well as efforts to document the efficacy of high-grade anal intraepithelial neoplasia treatment to reduce the incidence of anal cancer.

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  • (PMID = 19587592.001).
  • [ISSN] 1531-703X
  • [Journal-full-title] Current opinion in oncology
  • [ISO-abbreviation] Curr Opin Oncol
  • [Language] ENG
  • [Grant] United States / NCRR NIH HHS / RR / M01 RR000079; United States / NCI NIH HHS / CA / CA088739-04S2; United States / NCI NIH HHS / CA / CA054053-10; United States / NCI NIH HHS / CA / R01 CA054053; United States / NCI NIH HHS / CA / U01 CA121947; United States / NCI NIH HHS / CA / R01 CA088739; United States / NCI NIH HHS / CA / R01 CA088739-04S2; United States / NCRR NIH HHS / RR / M01 RR00079; United States / NCI NIH HHS / CA / R01CA 88739; United States / NCI NIH HHS / CA / R01 CA054053-10
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] United States
  • [Number-of-references] 17
  • [Other-IDs] NLM/ NIHMS202771; NLM/ PMC3415247
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43. 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


44. Franceschi S, De Vuyst H: Human papillomavirus vaccines and anal carcinoma. Curr Opin HIV AIDS; 2009 Jan;4(1):57-63
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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 vaccines and anal carcinoma.
  • PURPOSE OF REVIEW: To explore the possible role of current prophylactic vaccines against human papillomavirus (HPV) in the prevention of anal intraepithelial neoplasia and squamous cell carcinoma of the anus (SCCA).
  • In addition, more than 90% prevalence of HPV was found in anal intraepithelial neoplasia.
  • Answers to some still open questions, notably vaccine efficacy in men and HIV-infected individuals and willingness to expand vaccination programmes to both sexes, are essential to predict the ultimate impact of HPV vaccines on the prevention of cancerous and precancerous anal lesions.
  • [MeSH-major] Anus Neoplasms / prevention & control. Carcinoma in Situ / prevention & control. Carcinoma, Squamous Cell / prevention & control. HIV Infections / complications. Papillomavirus Infections / prevention & control. Papillomavirus Vaccines / therapeutic use

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  • (PMID = 19339940.001).
  • [ISSN] 1746-6318
  • [Journal-full-title] Current opinion in HIV and AIDS
  • [ISO-abbreviation] Curr Opin HIV AIDS
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Anti-Retroviral Agents; 0 / Papillomavirus Vaccines
  • [Number-of-references] 56
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45. Palefsky JM, Rubin M: The epidemiology of anal human papillomavirus and related neoplasia. Obstet Gynecol Clin North Am; 2009 Mar;36(1):187-200
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The epidemiology of anal human papillomavirus and related neoplasia.
  • Like cervical cancer, anal cancer is preceded by a series of precancerous changes, raising the possibility that like cervical cancer, anal cancer can be prevented.
  • Further, given the known risk factors for anal cancer, prevention efforts could be targeted to high-risk groups, providing a unique example of a screening program targeted to high-risk individuals.
  • This article describes the epidemiology of anal HPV infection, anal intraepithelial neoplasia, and anal cancer among men and women, as well as current efforts to prevent anal cancers.
  • [MeSH-major] Anal Canal / pathology. Anus Neoplasms / epidemiology. Colonoscopy / methods. Human papillomavirus 11. Papillomavirus Infections / epidemiology. Sexually Transmitted Diseases, Viral / epidemiology
  • [MeSH-minor] Diagnosis, Differential. Female. Humans. Incidence. Male. Risk Factors. United States / epidemiology

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  • (PMID = 19344856.001).
  • [ISSN] 1558-0474
  • [Journal-full-title] Obstetrics and gynecology clinics of North America
  • [ISO-abbreviation] Obstet. Gynecol. Clin. North Am.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / R01 CA 085178; United States / NCI NIH HHS / CA / R01 CA 88739; United States / NCRR NIH HHS / RR / UL1 RR02413,1
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] United States
  • [Number-of-references] 49
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46. Lillo FB: Human papillomavirus infection and its role in the genesis of dysplastic and neoplastic lesions of the squamous epithelia. New Microbiol; 2005 Apr;28(2):111-8
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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 infection and its role in the genesis of dysplastic and neoplastic lesions of the squamous epithelia.
  • Extensive laboratory and epidemiological evidence demonstrate that human papillomavirus (HPV) is the major cause of squamous cervical carcinoma (SCC), its precursor lesions (cervical intraepithelial neoplasia - CIN) and several other benign and malign clinical manifestations including genital warts, condylomata acuminata, Bowenoid papulosis, vaginal, vulvar and anal intraepithelial neoplasia (VIN and AIN) and carcinoma, penile carcinoma and other squamous neoplasias of the head and neck districts.
  • [MeSH-major] Carcinoma, Squamous Cell. Cervical Intraepithelial Neoplasia. Papillomaviridae / pathogenicity. Papillomavirus Infections / virology

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  • (PMID = 16035255.001).
  • [ISSN] 1121-7138
  • [Journal-full-title] The new microbiologica
  • [ISO-abbreviation] New Microbiol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Italy
  • [Number-of-references] 40
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47. Anderson JS, Hoy J, Hillman R, Barnden M, Eu B, McKenzie A, Gittleson C: A randomized, placebo-controlled, dose-escalation study to determine the safety, tolerability, and immunogenicity of an HPV-16 therapeutic vaccine in HIV-positive participants with oncogenic HPV infection of the anus. J Acquir Immune Defic Syndr; 2009 Nov 1;52(3):371-81
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] A randomized, placebo-controlled, dose-escalation study to determine the safety, tolerability, and immunogenicity of an HPV-16 therapeutic vaccine in HIV-positive participants with oncogenic HPV infection of the anus.
  • OBJECTIVE: Study aimed to assess safety, tolerability, and immunogenicity of novel therapeutic HPV-16 E6E7 ISCOMATRIX vaccine for treatment of human papilloma virus (HPV)-related anal intraepithelial neoplasia in HIV-infected men who have sex with men with moderate immunosuppression.
  • RESULTS: Thirty-five men who have sex with men enrolled; median age 47 years; current CD4 count 627 cells per milliliter; nadir CD4 count 154 cells per milliliter; 94% current antiretrovirals; 100% high-risk HPV types; 69% abnormal anal cytology; and 34% anal intraepithelial neoplasia 1-3 on high-resolution anoscopy.
  • [MeSH-major] Anus Neoplasms / therapy. HIV Infections / complications. Human papillomavirus 16. Papillomavirus Infections / therapy. Papillomavirus Vaccines / therapeutic use

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  • (PMID = 19661810.001).
  • [ISSN] 1944-7884
  • [Journal-full-title] Journal of acquired immune deficiency syndromes (1999)
  • [ISO-abbreviation] J. Acquir. Immune Defic. Syndr.
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase I; Journal Article; Multicenter Study; Randomized Controlled Trial
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Adjuvants, Immunologic; 0 / Antibodies, Viral; 0 / Drug Combinations; 0 / ISCOMATRIX; 0 / Papillomavirus Vaccines; 0 / Phospholipids; 0 / Saponins; 97C5T2UQ7J / Cholesterol
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48. Newsom-Davis T, Bower M: HIV-associated anal cancer. F1000 Med Rep; 2010;2:85

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] HIV-associated anal cancer.
  • HIV-associated anal carcinoma, a non-AIDS-defining cancer, is a human papillomavirus-associated malignancy with a spectrum of preinvasive changes.
  • The standardized incidence ratio for anal cancer in patients with HIV/AIDS is 20-50.
  • Algorithms for anal cancer screening include anal cytology followed by high-resolution anoscopy for those with abnormal findings.
  • Outpatient topical treatments for anal intraepithelial neoplasia include infrared coagulation therapy, trichloroacetic acid, and imiquimod.
  • The development of cost-effective national screening programs for HIV-associated anal cancer remains a challenge.

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  • (PMID = 21283597.001).
  • [ISSN] 1757-5931
  • [Journal-full-title] F1000 medicine reports
  • [ISO-abbreviation] F1000 Med Rep
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC3026623
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49. Gormley RH, Kovarik CL: Dermatologic manifestations of HPV in HIV-infected individuals. Curr HIV/AIDS Rep; 2009 Aug;6(3):130-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Anogenital HPV-related disease includes benign condyloma acuminata, the most common cutaneous manifestation of genital HPV infection; intermediate malignancy or premalignant conditions including giant condyloma acuminata (also called Buschke-Loewenstein tumor), anal intraepithelial neoplasia, penile intraepithelial neoplasia, and vaginal or vulvar intraepithelial neoplasia; and frankly malignant disease including Bowen's disease and invasive anal, penile, or vulvar carcinoma.

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  • (PMID = 19589298.001).
  • [ISSN] 1548-3576
  • [Journal-full-title] Current HIV/AIDS reports
  • [ISO-abbreviation] Curr HIV/AIDS Rep
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Papillomavirus Vaccines
  • [Number-of-references] 69
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50. 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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51. 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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52. van der Snoek EM, Amelink A, van der Ende ME, den Hollander JC, den Hollander JG, Kroon FP, Vriesendorp R, Neumann HA, Robinson DJ: Photodynamic therapy with topical metatetrahydroxychlorin (Fosgel) is ineffective for the treatment of anal intraepithelial neoplasia, grade III. J Acquir Immune Defic Syndr; 2009 Sep 1;52(1):141-3
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Photodynamic therapy with topical metatetrahydroxychlorin (Fosgel) is ineffective for the treatment of anal intraepithelial neoplasia, grade III.
  • [MeSH-major] Anus Neoplasms / drug therapy. Anus Neoplasms / virology. HIV Infections / complications. Mesoporphyrins / administration & dosage. Photochemotherapy / methods. Photosensitizing Agents / administration & dosage

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  • (PMID = 19704267.001).
  • [ISSN] 1525-4135
  • [Journal-full-title] Journal of acquired immune deficiency syndromes (1999)
  • [ISO-abbreviation] J. Acquir. Immune Defic. Syndr.
  • [Language] eng
  • [Publication-type] Letter; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Liposomes; 0 / Mesoporphyrins; 0 / Photosensitizing Agents; FU21S769PF / temoporfin
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53. 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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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [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.
  • 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


54. 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


55. Park IU, Ogilvie JW Jr, Anderson KE, Li ZZ, Darrah L, Madoff R, Downs L Jr: Anal human papillomavirus infection and abnormal anal cytology in women with genital neoplasia. Gynecol Oncol; 2009 Sep;114(3):399-403
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Anal human papillomavirus infection and abnormal anal cytology in women with genital neoplasia.
  • OBJECTIVES: Describe the type-specific prevalence of anal HPV infection in women with lower genital tract intraepithelial neoplasia and cancer.
  • Describe the prevalence of abnormal anal cytology and identify risk factors for anal HPV infection and abnormal anal cytology in this population.
  • METHODS: We performed a cross-sectional study of women attending 2 university-based colposcopy clinics with high-grade lower genital tract intraepithelial neoplasia or cancer.
  • Participants received anal HPV testing/typing, anal cytology and completed a questionnaire detailing medical history and sexual behavior.
  • RESULTS: Of the 102 women enrolled, 92 (90%) had adequate beta-globin for analysis of HPV DNA status, and 47/92 women (51%) had detectable anal HPV.
  • Overall, 9 women (9%) had abnormal anal cytology, and 7 of those had corresponding anal intraepithelial neoplasia grade I (AIN I).
  • Women with vulvar disease had the highest proportion of abnormal anal cytology (21%) compared to women with cervical disease alone (7%), but this difference was not statistically significant (p=0.10).
  • Neither anal HPV infection nor abnormal cytology was significantly associated with anal sex practices, smoking or number of sexual partners.
  • CONCLUSIONS: Anal infection with high-risk HPV types is common in women with high-grade genital neoplasia, but was not associated with known risk factors for genital HPV infection.
  • Other unidentified risk factors may play a role in the anal HPV infection in this population.
  • Abnormal anal cytology was rare and larger studies are needed to identify risk factors associated with abnormal cytology and anal intraepithelial neoplasia in this population.
  • [MeSH-major] Anus Diseases / virology. Cervical Intraepithelial Neoplasia / virology. Genital Neoplasms, Female / pathology. Papillomavirus Infections / pathology

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  • (PMID = 19501896.001).
  • [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
  • [Publication-country] United States
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56. 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
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  • [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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57. 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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58. Siekas LL, Aboulafia DM: Establishing an anal dysplasia clinic for HIV-infected men: initial experience. AIDS Read; 2009 May;19(5):178-86
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] Establishing an anal dysplasia clinic for HIV-infected men: initial experience.
  • Anal dysplasia caused by human papillomavirus (HPV) infection is common in the HIV-infected population and is a precursor to squamous cell carcinoma of the anus (SCCA).
  • Herein, we describe our initial experience in assessing the frequency and severity of anal intraepithelial neoplasia (AIN) in a newly formed anal dysplasia clinic in Seattle.
  • Forty-seven patients of the 122 patients who underwent biopsy (39%) had biopsy-identified low-grade AIN, and 47 (39%) had high-grade AIN (HGAIN).
  • Patient tolerance and acceptance of AIN screening was good, and the majority of those who underwent screening have been adherent to recommended follow-up examinations and treatment.
  • We anticipate that the anal dysplasia clinic will enable our institution to participate in emerging HIV- and HPV-related AIN clinical trials.
  • [MeSH-major] Anus Neoplasms / etiology. Carcinoma in Situ / etiology. Carcinoma, Squamous Cell / etiology. HIV Infections / epidemiology. Precancerous Conditions / etiology

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  • [CommentIn] AIDS Read. 2009 May;19(5):182-3 [19554737.001]
  • (PMID = 19554736.001).
  • [ISSN] 1053-0894
  • [Journal-full-title] The AIDS reader
  • [ISO-abbreviation] AIDS Read
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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59. 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+).
  • 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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60. Oon SF, Hanly A, Winter DC: Pap smears for men: a vision of the future? Ir J Med Sci; 2010 Sep;179(3):459-62
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • BACKGROUND: Anal intraepithelial neoplasia (AIN) rarely receives as much publicity as its neighbouring orifice, the cervix.
  • As in the cervix, intraepithelial neoplasias are precursors to cancer in the anal canal.
  • AIN and cervical interstitial neoplasia (CIN) undergo dysplasia as a consequence of human papillomavirus (HPV) infection.
  • Anal cancer, however, has been rising, with a predilection for human immunodeficiency virus-infected men.
  • HPV causes a squamous epithelial dysplasia and converts healthy tissue into AINs of increasing severity until anal cancer manifests.
  • CONCLUSIONS: The paper concludes by briefly discussing the implications of a national screening programme against AIN in the future.
  • [MeSH-major] Anus Neoplasms / virology. Carcinoma in Situ / virology
  • [MeSH-minor] Adult. Anus Diseases / surgery. Anus Diseases / therapy. Anus Diseases / virology. Cervical Intraepithelial Neoplasia / virology. Condylomata Acuminata / surgery. Condylomata Acuminata / therapy. Condylomata Acuminata / virology. Cytodiagnosis. Female. Humans. Male. Papillomavirus Infections. Recurrence. Uterine Cervical Neoplasms / virology

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  • [CommentIn] Ir J Med Sci. 2010 Jun;179(2):319 [19921312.001]
  • (PMID = 19763675.001).
  • [ISSN] 1863-4362
  • [Journal-full-title] Irish journal of medical science
  • [ISO-abbreviation] Ir J Med Sci
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Ireland
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61. Palefsky J: Human papillomavirus-related tumors in HIV. Curr Opin Oncol; 2006 Sep;18(5):463-8
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  • Many HIV-infected women do not undergo routine cervical cytology screening, however, and there are currently no routine anal cytology screening programs.
  • RECENT FINDINGS: Highly active antiretroviral therapy has limited benefit to reduce the incidence of cervical intraepithelial neoplasia 3 and no benefit to reduce the incidence of anal intraepithelial neoplasia 3.
  • Consistent with these findings, there has been no reduction in the incidence of cervical and anal cancer since the introduction of highly active antiretroviral therapy.
  • [MeSH-major] Anti-Retroviral Agents / therapeutic use. Anus Neoplasms / drug therapy. HIV Infections / complications. Papillomavirus Infections / complications. Tumor Virus Infections / complications. Uterine Cervical Neoplasms / drug therapy

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  • (PMID = 16894294.001).
  • [ISSN] 1040-8746
  • [Journal-full-title] Current opinion in oncology
  • [ISO-abbreviation] Curr Opin Oncol
  • [Language] eng
  • [Grant] United States / NCRR NIH HHS / RR / M01 RR00079; United States / NCI NIH HHS / CA / R01CA 88739
  • [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 / Anti-Retroviral Agents
  • [Number-of-references] 36
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62. Walts AE, Bose S: BD ProEx C immunostaining in extramammary Paget's disease and perineal melanoma. Mod Pathol; 2009 Feb;22(2):246-51
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • The differential diagnosis of perineal biopsies can include squamous intraepithelial lesions, extramammary Paget's disease, and melanoma.
  • Immunostaining for ProEx C has been validated in cervical cytology and positive staining has also been shown to be strongly associated with human papilloma virus (HPV)-induced cervical and anal intraepithelial neoplasia in biopsies.
  • [MeSH-major] Antigens, Neoplasm / analysis. Anus Neoplasms / enzymology. Cell Cycle Proteins / analysis. DNA Topoisomerases, Type II / analysis. DNA-Binding Proteins / analysis. Melanoma / enzymology. Nuclear Proteins / analysis. Paget Disease, Extramammary / enzymology. Perineum / pathology. Reagent Kits, Diagnostic. Vaginal Neoplasms / enzymology. Vulvar Neoplasms / enzymology
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Alphapapillomavirus / genetics. Alphapapillomavirus / isolation & purification. Biopsy. DNA, Viral / isolation & purification. Diagnosis, Differential. Female. Humans. Immunoassay. In Situ Hybridization. Male. Middle Aged. Minichromosome Maintenance Complex Component 2. Mucous Membrane / enzymology. Mucous Membrane / pathology. Mucous Membrane / virology. Predictive Value of Tests

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  • (PMID = 18931649.001).
  • [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 / Antigens, Neoplasm; 0 / Cell Cycle Proteins; 0 / DNA, Viral; 0 / DNA-Binding Proteins; 0 / Nuclear Proteins; 0 / Reagent Kits, Diagnostic; EC 3.6.4.12 / MCM2 protein, human; EC 3.6.4.12 / Minichromosome Maintenance Complex Component 2; EC 5.99.1.3 / DNA Topoisomerases, Type II; EC 5.99.1.3 / DNA topoisomerase II alpha
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63. Villa LL: Prophylactic HPV vaccines: reducing the burden of HPV-related diseases. Vaccine; 2006 Mar 30;24 Suppl 1:S23-8
International Agency for Research on Cancer - Screening Group. diagnostics - Planning and Implementing Cervical Cancer Prevention and Control Programs: A Manual for Managers .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • HPV-associated diseases, such as cervical and other anogenital cancers, cervical and anal intraepithelial neoplasia, genital warts, and recurrent respiratory papillomatosis confer considerable morbidity and mortality, and are significant health care concerns.

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  • (PMID = 16194583.001).
  • [ISSN] 0264-410X
  • [Journal-full-title] Vaccine
  • [ISO-abbreviation] Vaccine
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Netherlands
  • [Chemical-registry-number] 0 / Capsid Proteins; 0 / HPV L1 protein, Human papillomavirus; 0 / Oncogene Proteins, Viral; 0 / Papillomavirus Vaccines; 0 / Viral Vaccines; 0 / Virosomes
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64. 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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65. Palefsky J: Human papillomavirus and anal neoplasia. Curr HIV/AIDS Rep; 2008 May;5(2):78-85
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] Human papillomavirus and anal neoplasia.
  • Anal cancer is a rare disease in the general population, but the incidence of anal cancer is higher in certain at-risk groups, such as men who have sex with men (MSM), and immunosuppressed individuals, including those with HIV infection.
  • Among HIV-positive MSM, the incidence of anal cancer may be as high as 10 times greater than current rates of cervical cancer in the general population of women.
  • Anal cancer is associated with human papillomavirus (HPV) infection and may be preceded by high-grade anal intraepithelial neoplasia (HGAIN).
  • HGAIN and anal HPV infection are both highly prevalent in groups at risk for anal cancer.
  • Current issues include determining the effect of antiretroviral therapy on the natural history of HGAIN and the incidence of anal cancer, optimizing diagnostic and therapeutic approaches to HGAIN, and determining the potential for prophylactic HPV vaccines to prevent anal HPV infection and anal cancer in at-risk groups.
  • [MeSH-major] Anus Neoplasms. Carcinoma in Situ. Papillomavirus Infections
  • [MeSH-minor] Anus Diseases / epidemiology. Anus Diseases / virology. Female. HIV Infections / complications. Homosexuality, Male. Humans. Male. Papillomaviridae / isolation & purification

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  • (PMID = 18510893.001).
  • [ISSN] 1548-3568
  • [Journal-full-title] Current HIV/AIDS reports
  • [ISO-abbreviation] Curr HIV/AIDS Rep
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] United States
  • [Number-of-references] 57
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66. 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.
  • 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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67. 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
MedlinePlus Health Information. consumer health - Skin Cancer.

  • [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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68. Singh JC, Kuohung V, Palefsky JM: Efficacy of trichloroacetic acid in the treatment of anal intraepithelial neoplasia in HIV-positive and HIV-negative men who have sex with men. J Acquir Immune Defic Syndr; 2009 Dec 1;52(4):474-9
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  • [Title] Efficacy of trichloroacetic acid in the treatment of anal intraepithelial neoplasia in HIV-positive and HIV-negative men who have sex with men.
  • BACKGROUND: Anal intraepithelial neoplasia (AIN), particularly AIN 3 is a precursor to anal cancer.
  • Most cases of AIN are intraanal, but few treatments for intraanal AIN are currently available.
  • Topical 85% trichloroacetic acid (TCA) is an inexpensive method used to treat perianal condyloma, a form of AIN 1, but its efficacy to treat intraanal AIN as first-line therapy is unknown.
  • METHODS: Retrospective review of medical records was performed for all patients with AIN treated at the University of California San Francisco Anal Neoplasia Clinic with TCA as the first-line therapy from January 2000 to December 2004.
  • Clearance was defined as the absence of AIN confirmed by high-resolution anoscopy and cytology after up to 4 TCA treatments.
  • 32% of patients with AIN 2/3 cleared to no lesions.
  • On a per lesion basis, 73% of AIN 1 and 71% AIN 2/3 cleared to no lesion or AIN 1 or less, respectively.
  • A high proportion of AIN 2/3 lesions responded to TCA treatment.

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  • [Cites] Semin Oncol. 2000 Aug;27(4):471-9 [10950374.001]
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  • (PMID = 19779306.001).
  • [ISSN] 1944-7884
  • [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 / M01 RR000079; United States / NCRR NIH HHS / RR / RR000079-420472; United States / NCRR NIH HHS / RR / UL1 RR024131; United States / NCRR NIH HHS / RR / M01 RR000079-420472
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 5V2JDO056X / Trichloroacetic Acid
  • [Other-IDs] NLM/ NIHMS149443; NLM/ PMC2871540
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69. Kreuter A, Brockmeyer NH, Weissenborn SJ, Gambichler T, Stücker M, Altmeyer P, Pfister H, Wieland U, German Competence Network HIV/AIDS: Penile intraepithelial neoplasia is frequent in HIV-positive men with anal dysplasia. J Invest Dermatol; 2008 Sep;128(9):2316-24
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Penile intraepithelial neoplasia is frequent in HIV-positive men with anal dysplasia.
  • These patients have a strongly increased risk of HPV-induced anal cancer and its precursor lesion, anal intraepithelial neoplasia (AIN), and a moderately increased risk for penile cancer.
  • Only limited data exist on penile intraepithelial neoplasia (PIN) in HIV+MSM.
  • We determined the prevalence and evaluated the virologic characteristics of PIN and AIN in 263 HIV+MSM.
  • In case of histologically confirmed PIN (and AIN), HPV-typing, HPV-DNA load determination, and immunohistochemical staining for p16(INK4a) were performed.
  • PIN was detected in 11 (4.2%) and AIN in 156 (59.3%) patients.
  • Ten PIN patients also had AIN within the observation period.
  • Cutaneous beta-HPVs were found in PIN and AIN, but beta-HPV-DNA loads were very low, irrespective of the histological grade. p16(INK4a) Expression was detectable in all PIN lesions and correlated both with the histological grade and with high-risk HPV-DNA loads.
  • In view of the PIN prevalence found in our study, all HIV+MSM should be screened for PIN in addition to AIN screening.
  • [MeSH-major] Anus Diseases / epidemiology. Anus Neoplasms / epidemiology. Carcinoma in Situ / epidemiology. HIV Infections. Homosexuality, Male. Penile Neoplasms / epidemiology

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  • (PMID = 18385760.001).
  • [ISSN] 1523-1747
  • [Journal-full-title] The Journal of investigative dermatology
  • [ISO-abbreviation] J. Invest. Dermatol.
  • [Language] eng
  • [Databank-accession-numbers] ClinicalTrials.gov/ NCT00365729
  • [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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70. De Vuyst H, Clifford GM, Nascimento MC, Madeleine MM, Franceschi S: Prevalence and type distribution of human papillomavirus in carcinoma and intraepithelial neoplasia of the vulva, vagina and anus: a meta-analysis. Int J Cancer; 2009 Apr 1;124(7):1626-36
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Prevalence and type distribution of human papillomavirus in carcinoma and intraepithelial neoplasia of the vulva, vagina and anus: a meta-analysis.
  • This meta-analysis investigated human papillomavirus (HPV) prevalence in vulvar, vaginal and anal intraepithelial neoplasia (VIN, VAIN, AIN) grades 1-3 and carcinoma from 93 studies conducted in 4 continents and using PCR assays.
  • Overall HPV prevalence was 67.8%, 85.3% and 40.4% among 90 VIN1, 1,061 VIN2/3 and 1,873 vulvar carcinomas; 100%, 90.1% and 69.9% among 107 VAIN1, 191 VAIN2/3 and 136 vaginal carcinomas; and 91.5%, 93.9% and 84.3% among 671 AIN1, 609 AIN2/3 and 955 anal carcinomas, respectively.
  • HPV16 was found more frequently (>75%) and HPV18 less frequently (<10%) in HPV-positive vulvar, vaginal and anal carcinomas than in cervical carcinoma.
  • HPV prevalence in anal carcinoma was higher among women (90.8%) than men (74.9%), but no difference by gender emerged in North America.
  • In conclusion, approximately 40% of vulvar, 60% of vaginal and 80% of anal carcinoma may be avoided by prophylactic vaccines against HPV16/18.
  • This proportion would be similar for the corresponding high-grade lesions of the vagina and anus, but higher for VIN2/3 (75%) than for vulvar carcinoma.
  • [MeSH-major] Anus Neoplasms / virology. Papillomavirus Infections / epidemiology. Vaginal Neoplasms / virology. Vulvar Neoplasms / virology

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  • (PMID = 19115209.001).
  • [ISSN] 1097-0215
  • [Journal-full-title] International journal of cancer
  • [ISO-abbreviation] Int. J. Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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71. Czoski-Murray C, Karnon J, Jones R, Smith K, Kinghorn G: Cost-effectiveness of screening high-risk HIV-positive men who have sex with men (MSM) and HIV-positive women for anal cancer. Health Technol Assess; 2010 Nov;14(53):iii-iv, ix-x, 1-101
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Cost-effectiveness of screening high-risk HIV-positive men who have sex with men (MSM) and HIV-positive women for anal cancer.
  • BACKGROUND: Anal cancer is uncommon and predominantly a disease of the elderly.
  • Individuals who are human immunodeficiency virus (HIV)-positive are particularly vulnerable to HPV infections, and increasing numbers from this population present with anal cancer.
  • OBJECTIVE: To estimate the cost-effectiveness of screening for anal cancer in the high-risk HIV-positive population [in particular, men who have sex with men (MSM), who have been identified as being at greater risk of the disease] by developing a model that incorporates the national screening guidelines criteria.
  • Papers that met the inclusion criteria contained the following: data on population incidence, effectiveness of screening, health outcomes or screening and/or treatment costs; defined suitable screening technologies; prospectively evaluated tests to detect anal cancer.
  • RESULTS: The reference case cost-effectiveness model for MSM found that screening for anal cancer is very unlikely to be cost-effective.
  • The negative aspects of screening included utility decrements associated with false-positive results and with treatment for high-grade anal intraepithelial neoplasia (HG-AIN).
  • However, combined with higher regression rates from low-grade anal intraepithelial neoplasia (LG-AIN), the lowest expected incremental cost-effectiveness ratio remained at over 44,000 pounds per quality-adjusted life-year (QALY) gained.
  • LIMITATIONS: Limited knowledge is available about the epidemiology and natural history of anal cancer, along with a paucity of good-quality evidence concerning the effectiveness of screening.
  • Further studies could assess whether the screening model has underestimated the impact of anal cancer, the results of which may justify an evaluative study of the effects of treatment for HG-AIN.
  • [MeSH-major] Anus Neoplasms / diagnosis. Anus Neoplasms / economics. HIV Infections / complications. Homosexuality, Male / statistics & numerical data. Mass Screening / economics


72. Patel HS, Silver AR, Northover JM: Anal cancer in renal transplant patients. Int J Colorectal Dis; 2007 Jan;22(1):1-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Anal cancer in renal transplant patients.
  • PURPOSE: A comprehensive literature review was performed to examine the prevalence of anal cancer, anal intraepithelial neoplasia (AIN) and anal human papillomavirus (HPV) infection in renal transplant recipients who are at risk of anal cancer due to iatrogenic immunosuppression.
  • METHODS: Pertinent articles were identified from searches performed on the National Center for Biotechnology Information database using the following keywords: anal cancer, AIN, screening, renal transplant (or kidney transplant), organ transplant recipients and post-transplant malignancies.
  • RESULTS: The prevalence of AIN is 20% in renal transplant patients.
  • The prevalence of anal HPV infection in established transplant patients is 47%, and the prevalence of anal HPV infection in new transplant patients is 23%.
  • The relative risk for anal cancer in renal transplant patients is 10.
  • CONCLUSIONS: As compared to HIV-positive male patients who practise anal intercourse, renal transplant patients showed a modest rise in relative risk for anal cancer.
  • Screening programmes to detect AIN in HIV-positive patients who practise anal intercourse have been introduced on a preliminary basis in sexual health clinics in the US and may become standard practise in this population.
  • The case for screening in renal transplant patients is unclear and would merit further investigation, especially with reference to the prevalence of anal HPV infection in this population.
  • It may transpire that renal transplant patients would benefit more from HPV prophylaxis rather than screening for AIN.
  • [MeSH-major] Anus Neoplasms / etiology. Carcinoma in Situ / etiology. Graft Rejection / prevention & control. Immunosuppression / adverse effects. Immunosuppressive Agents / adverse effects. Kidney Failure, Chronic / surgery. Kidney Transplantation
  • [MeSH-minor] Anus Diseases / epidemiology. Anus Diseases / virology. Humans. Papillomavirus Infections / epidemiology. Papillomavirus Infections / etiology. Prevalence. Risk Factors

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  • (PMID = 16133005.001).
  • [ISSN] 0179-1958
  • [Journal-full-title] International journal of colorectal disease
  • [ISO-abbreviation] Int J Colorectal Dis
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Immunosuppressive Agents
  • [Number-of-references] 29
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73. 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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74. Chung AP, Rosenfeld DB: Intraoperative high-resolution anoscopy: a minimally invasive approach in the treatment of patients with Bowen's disease and results in a private practice setting. Am Surg; 2007 Dec;73(12):1279-83
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Anal intraepithelial neoplasia III (AIN III) is a risk factor for anal cancer with poor curative results and high morbidity.
  • High-resolution anoscopy (HRA) is a minimally invasive means of identifying and treating AIN III early.
  • We retrospectively reviewed HRA in the treatment of AIN III in a community setting.
  • From January 2002 through November 2005, 76 patients with AIN III diagnosed by anal Pap smear, colposcopy, or biopsy underwent HRA for diagnosis and treatment.
  • Twenty-one patients with AIN III on initial HRA underwent follow-up HRA for reassessment and treatment at 6 months.
  • Twelve of 21 (57%) had intraanal recurrence/persistence; nine of 21 (43%) had no AIN III.
  • HRA is an alternative tool to treat AIN III and can be performed in a community setting yielding results comparable to the university setting.
  • As the prevalence of AIN III increases, it will be more important for community surgeons to treat AIN III with HRA.
  • [MeSH-minor] Adult. Aged. Anal Canal. Community Health Services. Follow-Up Studies. Humans. Male. Middle Aged. Private Practice. Retrospective Studies. Treatment Outcome

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  • (PMID = 18186390.001).
  • [ISSN] 0003-1348
  • [Journal-full-title] The American surgeon
  • [ISO-abbreviation] Am Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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75. Wiley DJ, Huh J, Rao JY, Chang C, Goetz M, Poulter M, Masongsong E, Chang CI, Bernard HU: Methylation of human papillomavirus genomes in cells of anal epithelia of HIV-infected men. J Acquir Immune Defic Syndr; 2005 Jun 1;39(2):143-51
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Methylation of human papillomavirus genomes in cells of anal epithelia of HIV-infected men.
  • Intra-anal malignancies disproportionately affect individuals who engage in anal intercourse because of infection with human papillomaviruses (HPVs), with an increased risk attributed to infection with HIV because of a declining immunity against HPvs. Long-term persistence of HPVs suggests yet other mechanisms that determine the clinical outcome, however.
  • Because methylation of HPV DNA represses oncogene expression in cervical samples, we investigated whether this mechanism also occurs in HIV-positive men and studied the methylation of CpG dinucleotides overlapping with the HPV-16 enhancer and promoter in 16 anal samples.
  • In low-grade anal intraepithelial neoplasia (AIN), methylation was high in CpGs overlapping the viral enhancer but rare in promoter positions, whereas methylation was high in promoter regions in high-grade AIN, especially in samples with a high load of viral genomes.
  • We also detected de novo methylation at methylated (me) CpA, meCpT, and meCpC dinucleotides.
  • Our study expands the observation and mapping of HPV DNA methylation to anal infections and the HIV-positive patient population.
  • [MeSH-minor] Anal Canal / virology. Base Sequence. Biopsy. DNA Primers. DNA, Viral / genetics. DNA, Viral / isolation & purification. Dinucleoside Phosphates / analysis. Enhancer Elements, Genetic. Homosexuality, Male. Humans. Male. Polymerase Chain Reaction. Virus Latency. Virus Replication

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  • (PMID = 15905729.001).
  • [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 / CA-91964; United States / NCI NIH HHS / CA / R01 CA-91964
  • [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
  • [Chemical-registry-number] 0 / DNA Primers; 0 / DNA, Viral; 0 / Dinucleoside Phosphates; 2382-65-2 / cytidylyl-3'-5'-guanosine
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76. Scarpini C, White V, Muralidhar B, Patterson A, Hickey N, Singh N, Mullerat J, Winslet M, Davies RJ, Phillips ML, Stacey P, Laskey RA, Miller R, Nathan M, Coleman N: Improved screening for anal neoplasia by immunocytochemical detection of minichromosome maintenance proteins. Cancer Epidemiol Biomarkers Prev; 2008 Oct;17(10):2855-64
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Improved screening for anal neoplasia by immunocytochemical detection of minichromosome maintenance proteins.
  • PURPOSE: Early detection of anal intraepithelial neoplasia (AIN) and anal squamous cell carcinoma (SCC) by screening will improve clinical outcome.
  • Assessment of anal cytology samples using routine Papanicolaou testing suffers from shortcomings in sensitivity and/or specificity, suggesting that screening tests based on biomarkers may be of value.
  • EXPERIMENTAL DESIGN: We undertook an initial immunohistochemical study of 54 anal tissue samples and validated our findings using an independent prospective cohort study of 235 anal cytology samples from 144 subjects.
  • RESULTS: In the progression from normal anal epithelium through AIN to SCC, there was increasing expression of MCM2 and MCM5, including in the superficial epithelial third, the source of the majority of cells collected by anal swab.
  • By immunocytochemistry using a mixture of anti-MCM2 and anti-MCM5 antibodies, immunopositive cells were readily identified in anal cytology samples, even at low magnification.
  • CONCLUSIONS: MCMs are promising biomarkers for improving detection of AIN and SCC in anal cytology samples.

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  • (PMID = 18843031.001).
  • [ISSN] 1055-9965
  • [Journal-full-title] Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
  • [ISO-abbreviation] Cancer Epidemiol. Biomarkers Prev.
  • [Language] ENG
  • [Grant] United Kingdom / Medical Research Council / / MC/ U105359875; United Kingdom / Medical Research Council / / MC/ U105359878; United Kingdom / Cancer Research UK / / ; United Kingdom / Medical Research Council / /
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Cell Cycle Proteins; 0 / Ki-67 Antigen; 0 / MCM5 protein, human; 0 / Nuclear Proteins; EC 3.6.4.12 / Minichromosome Maintenance Complex Component 2
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77. Owens SR, Greenson JK: Immunohistochemical staining for p63 is useful in the diagnosis of anal squamous cell carcinomas. Am J Surg Pathol; 2007 Feb;31(2):285-90
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Immunohistochemical staining for p63 is useful in the diagnosis of anal squamous cell carcinomas.
  • Anal canal carcinomas account for between 1% and 2% of all gastrointestinal carcinomas in the United States.
  • By far, the most common carcinoma in this site is squamous cell carcinoma, but the differential diagnosis typically includes poorly differentiated adenocarcinoma and well-differentiated neuroendocrine carcinoma or carcinoid tumor.
  • However, accurate diagnosis is imperative, because the treatment differs between squamous carcinoma (chemoradiation) and the other types of carcinoma (surgical therapy).
  • The p63 protein has been previously shown to be involved in epithelial proliferation and differentiation, and is known to be related to squamous carcinomas in many sites.
  • Therefore, we undertook to ascertain its usefulness in the diagnosis of squamous carcinomas in the anal canal.
  • We retrieved 24 anal squamous carcinomas, 68 colorectal adenocarcinomas (including a tissue microarray), and 32 colorectal neuroendocrine carcinomas from the archives at the University of Michigan, and immunostained them for the p63 antigen.
  • As a result, this immunohistochemical stain had a specificity of 98% and a positive predictive value of 92% for squamous cell carcinoma once invasive carcinoma had been established.
  • It also stained the dysplastic epithelial cells in adjacent areas of anal intraepithelial neoplasia.
  • We report that the p63 immunostain is a highly specific and useful tool in the diagnosis of carcinomas of the anal canal.
  • [MeSH-major] Anal Canal / metabolism. Anus Neoplasms / metabolism. Biomarkers, Tumor / metabolism. Carcinoma, Squamous Cell / metabolism. DNA-Binding Proteins / metabolism. Immunoenzyme Techniques / methods. Trans-Activators / metabolism. Tumor Suppressor Proteins / metabolism
  • [MeSH-minor] Carcinoid Tumor / diagnosis. Carcinoid Tumor / metabolism. Carcinoma in Situ / metabolism. Carcinoma in Situ / pathology. Carcinoma, Neuroendocrine / diagnosis. Carcinoma, Neuroendocrine / metabolism. Colorectal Neoplasms / metabolism. Colorectal Neoplasms / pathology. Diagnosis, Differential. Humans. Predictive Value of Tests. Tissue Array Analysis. Transcription Factors

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  • (PMID = 17255774.001).
  • [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 / DNA-Binding Proteins; 0 / TP63 protein, human; 0 / Trans-Activators; 0 / Transcription Factors; 0 / Tumor Suppressor Proteins
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78. Mullerat J, Perrett CW, Deroide F, Winslet MC, Bofill M, Poulters LW: The role of macrophages in angiogenesis. Comparison between HIV+ and HIV- populations with anal dysplasia and anal cancer. Anticancer Res; 2005 Mar-Apr;25(2A):693-9
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  • [Title] The role of macrophages in angiogenesis. Comparison between HIV+ and HIV- populations with anal dysplasia and anal cancer.
  • BACKGROUND: While macrophages (CD68+) have been associated with angiogenesis in some inflammatory and neoplastic processes by increasing the release of vascular endothelial growth factor (VEGF), their role in anal intraepithelial neoplasia (AIN) and anal squamous cell carcinoma has not been established.
  • This study records macrophage infiltration in anal pre-invasive and invasive lesions in HIV+ and HIV- populations, and determines their relationship with angiogenesis.
  • MATERIALS AND METHODS: Sixty patients (31 HIV+) with AIN and anal SCC were studied.
  • [MeSH-major] Anus Neoplasms / blood supply. Anus Neoplasms / virology. Carcinoma, Squamous Cell / blood supply. Carcinoma, Squamous Cell / virology. HIV Infections / pathology. Macrophages / physiology. Neovascularization, Pathologic / virology
  • [MeSH-minor] Anal Canal / blood supply. Anal Canal / pathology. Antigens, CD / biosynthesis. Antigens, Differentiation, Myelomonocytic / biosynthesis. Anus Diseases / pathology. Anus Diseases / virology. Disease Progression. Humans. Immunohistochemistry. Precancerous Conditions / blood supply. Precancerous Conditions / virology. Vascular Endothelial Growth Factor A / biosynthesis. Warts / pathology. Warts / virology

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  • (PMID = 15868898.001).
  • [ISSN] 0250-7005
  • [Journal-full-title] Anticancer research
  • [ISO-abbreviation] Anticancer Res.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Greece
  • [Chemical-registry-number] 0 / Antigens, CD; 0 / Antigens, Differentiation, Myelomonocytic; 0 / CD68 antigen, human; 0 / Vascular Endothelial Growth Factor A
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79. Sarzo G, Del Mistro A, Finco C, Frayle-Salamanca H, Marino F, Franzetti M, Ferrara R, Mistrangelo M, Savastano S, Vecchiato M, Merigliano S: Extensive anal condylomatosis: prognosis in relation to viral and host factors. Colorectal Dis; 2010 Jul;12(7 Online):e128-34
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  • [Title] Extensive anal condylomatosis: prognosis in relation to viral and host factors.
  • OBJECTIVE: To evaluate the clinical course of extensive anal condylomatosis in relation to treatment modalities, patient comorbidity and immune function, and associated papillomavirus (HPV) sequences.
  • RESULTS: Sixteen patients [14 males, median age 41.8 years (range 19-66)] affected by extensive anal condylomatosis [10 Buschke-Lowenstein Tumors (BLT) and 6 condylomatosis] treated in three different Italian institutions were included.
  • There was associated preoperative anal intraepithelial neoplasia grade 3 (AIN3) in one and invasive carcinoma in three patients.
  • Typing of HPV sequences in the management of patients affected by extensive anal condylomatosis may be useful.
  • [MeSH-minor] Adult. Aged. Diagnosis, Differential. Female. Follow-Up Studies. Humans. Male. Middle Aged. Prognosis. Retrospective Studies. Young Adult

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  • [ErratumIn] Colorectal Dis. 2010 Oct;12(10):1072. Mistro, A [corrected to Del Mistro, A]
  • (PMID = 19508521.001).
  • [ISSN] 1463-1318
  • [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] Comparative Study; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / DNA, Viral
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80. Kreuter A, Wieland U, Gambichler T, Altmeyer P, Pfister H, Tenner-Racz K, Racz P, Potthoff A, Brockmeyer NH, German Network of Competence HIV/AIDS: p16ink4a expression decreases during imiquimod treatment of anal intraepithelial neoplasia in human immunodeficiency virus-infected men and correlates with the decline of lesional high-risk human papillomavirus DNA load. Br J Dermatol; 2007 Sep;157(3):523-30
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  • [Title] p16ink4a expression decreases during imiquimod treatment of anal intraepithelial neoplasia in human immunodeficiency virus-infected men and correlates with the decline of lesional high-risk human papillomavirus DNA load.
  • In this context, a drastically increased relative risk for anal intraepithelial neoplasia (AIN) exists in HIV-infected men having sex with men (MSM).
  • In a pilot study, imiquimod, a topical immune response modifier, has been reported to be beneficial in the treatment of AIN.
  • OBJECTIVES: To investigate the role of several biomarkers as potential adjuncts in the course of imiquimod treatment for AIN, and to determine whether these markers correlate with the course of high-risk HPV DNA load during imiquimod therapy.
  • METHODS: Immunohistochemical staining was performed for p16(ink4a), minichromosome maintenance protein (MCM), Ki67, proliferating cell nuclear antigen (PCNA) and p21(waf1) expression before and after 16 weeks of imiquimod treatment for AIN.
  • RESULTS: Histopathological and virological analyses were performed in 21 HIV-infected MSM with histologically confirmed AIN.
  • Eighteen (86%) patients had a complete histological clearance of AIN after imiquimod therapy.
  • A significant correlation between the course of high-risk HPV DNA load and p16(ink4a) expression was observed during imiquimod treatment of AIN, whereas the decline of high-risk HPV DNA load did not significantly correlate with MCM, Ki67, PCNA or p21(waf1) expression.
  • [MeSH-major] Aminoquinolines / therapeutic use. Antineoplastic Agents / therapeutic use. Anus Neoplasms / drug therapy. Carcinoma in Situ / drug therapy. Cyclin-Dependent Kinase Inhibitor p16 / metabolism. Precancerous Conditions / drug therapy

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  • (PMID = 17573882.001).
  • [ISSN] 0007-0963
  • [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 / Aminoquinolines; 0 / Antineoplastic Agents; 0 / Biomarkers, Tumor; 0 / Cyclin-Dependent Kinase Inhibitor p16; 0 / DNA, Viral; 0 / Ki-67 Antigen; 99011-02-6 / imiquimod
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81. 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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82. Scott H, Khoury J, Moore BA, Weissman S: Routine anal cytology screening for anal squamous intraepithelial lesions in an urban HIV clinic. Sex Transm Dis; 2008 Feb;35(2):197-202
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  • [Title] Routine anal cytology screening for anal squamous intraepithelial lesions in an urban HIV clinic.
  • OBJECTIVES: The purpose of this study is to describe our experience with routine anal cancer screening using anal cytology, determine risk factors for abnormal anal cytology, and determine if an association exists between cytology and histology in patients with HIV infection.
  • RESULTS: Overall, 276 of 560 of the clinic patients received a screening anal cytology during the study period.
  • Of these patients, 11 were excluded from the analysis and 74 of 265 (27.9%) patients screened had an abnormal anal cytology.
  • Forty-nine percent were African American, 34% Caucasian, and 17% Hispanic.
  • They were also more likely to have a lower CD4+ nadir (142 cells/mm3 vs. 223 cells/mm3, P = 0.005) and CD4+ at time of anal cytology (353 cells/mm3 vs. 497 cells/mm3, P <0.001).
  • Those with an abnormal anal cytology also had higher occurrence of anal disease on perianal visual inspection (30% vs. 9%, P <0.001) and were more likely to have a history of genital warts (23% vs. 12%, P = 0.02) or herpes (35% vs. 22%, P = 0.02).
  • Two patients had anal intraepithelial neoplasia (AIN) I, 2 AIN II, 3 AIN III, and 2 squamous cell carcinoma in situ on histology.
  • CONCLUSION: Routine anal cytology screening is a feasible tool to incorporate into HIV care for patients regardless of gender and HIV risk factors.
  • [MeSH-major] Anus Neoplasms / diagnosis. HIV Infections / complications. Neoplasms, Squamous Cell / pathology. Urban Health Services / organization & administration
  • [MeSH-minor] Adult. Aged. Anal Canal / pathology. Colonoscopy / methods. Female. Follow-Up Studies. Humans. Logistic Models. Male. Middle Aged. Multivariate Analysis

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  • (PMID = 18216727.001).
  • [ISSN] 0148-5717
  • [Journal-full-title] Sexually transmitted diseases
  • [ISO-abbreviation] Sex Transm Dis
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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83. Fox PA: Human papillomavirus and anal intraepithelial neoplasia. Curr Opin Infect Dis; 2006 Feb;19(1):62-6
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  • [Title] Human papillomavirus and anal intraepithelial neoplasia.
  • PURPOSE OF REVIEW: A review of recent developments in the understanding of the natural history of anal squamous carcinoma arising from areas of high-grade anal intraepithelial neoplasia.
  • RECENT FINDINGS: Anal intraepithelial neoplasia is a consequence of chronic human papillomavirus infection in the anal canal and appears to be driven by high viral loads of human papillomavirus.
  • Anal intraepithelial neoplasia is equally prevalent in different age groups of men who have sex with men, but in other respects what is known of its natural history resembles that of cervical intraepithelial neoplasia.
  • HIV-positives who practise receptive anal intercourse are at highest risk of anal intraepithelial neoplasia.
  • Screening is easy to perform using cytology; the limitations of anal cytology being similar to those of cervical cytology.
  • [MeSH-major] Anus Neoplasms. Carcinoma in Situ. Carcinoma, Squamous Cell. Papillomaviridae / pathogenicity. Papillomavirus Infections

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  • (PMID = 16374220.001).
  • [ISSN] 0951-7375
  • [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] 35
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84. Jamieson DJ, Paramsothy P, Cu-Uvin S, Duerr A, HIV Epidemiology Research Study Group: Vulvar, vaginal, and perianal intraepithelial neoplasia in women with or at risk for human immunodeficiency virus. Obstet Gynecol; 2006 May;107(5):1023-8
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  • [Title] Vulvar, vaginal, and perianal intraepithelial neoplasia in women with or at risk for human immunodeficiency virus.
  • OBJECTIVE: To compare the incidence of vulvar, vaginal, and perianal intraepithelial neoplasia among human immunodeficiency virus (HIV)-infected women with a group of well-matched high-risk HIV-uninfected controls.
  • All women referred for colposcopy underwent a full colposcopic evaluation, including the vulvar, vaginal, and perianal regions.
  • Unadjusted hazard ratios with 95% confidence intervals were calculated for development of vulvar, vaginal, and perianal intraepithelial neoplasia using univariable Cox proportional hazards models.
  • An incidence analysis was performed by calculating Kaplan-Meier survival curves for development of intraepithelial neoplasia.
  • RESULTS: At baseline, 3 (1.6%) of the 192 HIV-infected women and none of the 88 HIV-uninfected women had vulvar, vaginal, and perianal intraepithelial neoplasia.
  • During the study, 16 of 189 (8.5%) HIV-infected women and 1 of 88 (1.1%) HIV-uninfected women developed vulvar, vaginal, and perianal intraepithelial neoplasia.
  • The incidence of vulvar, vaginal, or anal intraepithelial neoplasia was 1.96 per 100 person years for the HIV-infected women and 0.26 per 100 person-years for the HIV-uninfected women (P = .03).
  • CONCLUSION: Human immunodeficiency virus-infected women had more vulvar, vaginal, and perianal intraepithelial lesions compared with HIV-uninfected women.
  • [MeSH-major] Anus Neoplasms / epidemiology. Carcinoma in Situ / epidemiology. HIV Infections / complications. Vaginal Neoplasms / epidemiology. Vulvar Neoplasms / epidemiology


85. 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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86. 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%).
  • The majority of AIN II was preceded by LSIL, 54%; ASC-US, 15%; and HSIL, 8%.
  • 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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87. Nathan M, Singh N, Garrett N, Hickey N, Prevost T, Sheaff M: Performance of anal cytology in a clinical setting when measured against histology and high-resolution anoscopy findings. AIDS; 2010 Jan 28;24(3):373-9
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  • [Title] Performance of anal cytology in a clinical setting when measured against histology and high-resolution anoscopy findings.
  • OBJECTIVES: The success of cervical cytology in screening for cervical neoplasia has led to the concept of anal cytology screening for anal neoplasia.
  • Our objective is to study the performance of anal cytology as a screening tool.
  • DESIGN: We assessed anal cytology against histology and high-resolution anoscopy in a clinical setting.
  • METHODS: Anal pap test was obtained prior to high-resolution anoscopy examinations and biopsies.
  • RESULTS: From 395 individuals (93% men), 584 anal pap tests were obtained.
  • On the basis of 288 histology results, the sensitivity of anal cytology to detect disease was 70% [95% confidence interval (CI) 64-75], whereas the specificity was 67% (95% CI 38-88).
  • For high-grade disease (anal intraepithelial neoplasia 2/3), sensitivity of anal cytology was 81% (95% CI 70-90), and the negative predictive value was 85% (95% CI 76-92).
  • CONCLUSION: Anal cytology performs similar to cervical cytology in a clinical setting.
  • Sensitivity of anal smear is dependent on the area (quadrants) of disease present.
  • Sensitivity of anal cytology is enhanced when CD4 cell count is less than 400 cells/microl in HIV-positive men.
  • [MeSH-major] Anal Canal / pathology. Anus Neoplasms / pathology. Carcinoma in Situ / pathology. HIV Infections / pathology. Papillomaviridae / isolation & purification. Papillomavirus Infections / pathology

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  • [CommentIn] AIDS. 2010 Jan 28;24(3):463-5 [19926960.001]
  • (PMID = 20057313.001).
  • [ISSN] 1473-5571
  • [Journal-full-title] AIDS (London, England)
  • [ISO-abbreviation] AIDS
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
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88. Palefsky JM: Human papillomavirus-related disease in men: not just a women's issue. J Adolesc Health; 2010 Apr;46(4 Suppl):S12-9
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  • HPV is associated with a variety of cancers in men, including anal cancer and a subset of penile and oral cancers.
  • The incidence of anal and oral cancers related to HPV is increasing in the general population and is growing even faster among individuals who are immunocompromised because of human immunodeficiency virus (HIV) infection.
  • Likewise, anal HPV infection and anal intraepithelial neoplasia are very common throughout a wide range of ages in both HIV-negative and HIV-positive men who have sex with men.

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  • (PMID = 20307839.001).
  • [ISSN] 1879-1972
  • [Journal-full-title] The Journal of adolescent health : official publication of the Society for Adolescent Medicine
  • [ISO-abbreviation] J Adolesc Health
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / CA054053-10; United States / NCI NIH HHS / CA / R01 CA054053; United States / NCI NIH HHS / CA / CA088739-05; United States / NCI NIH HHS / CA / R01 CA088739; United States / NCI NIH HHS / CA / R01 CA088739-05; United States / NCI NIH HHS / CA / R01 CA054053-10
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Papillomavirus Vaccines
  • [Number-of-references] 91
  • [Other-IDs] NLM/ NIHMS180665; NLM/ PMC2871537
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89. 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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90. Nathan M, Hickey N, Mayuranathan L, Vowler SL, Singh N: Treatment of anal human papillomavirus-associated disease: a long term outcome study. Int J STD AIDS; 2008 Jul;19(7):445-9
MedlinePlus Health Information. consumer health - Warts.

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Treatment of anal human papillomavirus-associated disease: a long term outcome study.
  • Treatment for human papillomavirus (HPV)-associated anal canal disease has been unsatisfactory.
  • The objective of our study was to determine the treatment outcome in our cohort with anal HPV disease.
  • Eighty-eight patients (48.6%) with high-grade anal intraepithelial neoplasia (AIN) and 82 patients (45.3%) with low-grade AIN underwent treatment.
  • Contrary to the current view that treatment of HPV-related anal disease is difficult, unrewarding due to recurrences and may lead to substantial morbidity, we demonstrate that effective treatment is possible for both low- and high-grade AIN.
  • These findings should help with the general desire to introduce screening for AIN for at-risk groups.
  • [MeSH-major] Anus Diseases / therapy. Anus Neoplasms / therapy. Carcinoma, Squamous Cell / therapy. Laser Therapy / utilization. Papillomavirus Infections / therapy. Warts / therapy

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  • (PMID = 18574114.001).
  • [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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91. Abramowitz L, Rémy V, Vainchtock A: Economic burden of anal cancer management in France. Rev Epidemiol Sante Publique; 2010 Oct;58(5):331-8
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] Economic burden of anal cancer management in France.
  • BACKGROUND: The incidence of anal cancer has increased over the last 25 years.
  • No organized screening exists for the precursors of anal cancer (anal intraepithelial neoplasia and carcinoma in situ) and diagnosis is often delayed.
  • Like cancers of the cervix, most cases of anal cancer are associated with infection with human papillomavirus (HPV).
  • With increases in the incidence of anal cancer, and in light of the availability of prevention strategies such as screening and HPV vaccination, it is important, from a public health perspective, to assess the economic burden of anal cancer in France.
  • METHODS: We performed a retrospective analysis based on data extracted from a French hospital database - the Programme de médicalisation des systèmes d'information (PMSI) - to assess the number and management of patients hospitalized for anal cancer in 2006.
  • Data on radiotherapy sessions performed in private hospitals were obtained from the Statistiques annuelles des établissements de santé (SAE) database.
  • Costs of hospitalization, from the healthcare-payer perspective, were obtained from official diagnosis-related group tariffs for public and private hospitals.
  • RESULTS: In 2006, 3,711 patients with anal cancer were treated in hospitals in France.
  • The annual cost of hospital treatment for anal cancer was estimated at € 20,326,868.
  • CONCLUSION: This study, the first to investigate the economic burden of anal cancer in France, shows that the management costs of anal cancer are high and comparable to cervical cancer management costs (€ 44 million).
  • [MeSH-major] Anus Neoplasms / economics. Health Care Costs

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  • [Copyright] Copyright © 2010 Elsevier Masson SAS. All rights reserved.
  • (PMID = 20869182.001).
  • [ISSN] 0398-7620
  • [Journal-full-title] Revue d'épidémiologie et de santé publique
  • [ISO-abbreviation] Rev Epidemiol Sante Publique
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] France
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92. Wilkin T, Lee JY, Lensing SY, Stier EA, Goldstone SE, Berry JM, Jay N, Aboulafia D, Cohn DL, Einstein MH, Saah A, Mitsuyasu RT, Palefsky JM: Safety and immunogenicity of the quadrivalent human papillomavirus vaccine in HIV-1-infected men. J Infect Dis; 2010 Oct 15;202(8):1246-53
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.
  • BACKGROUND: Human immunodeficiency virus type 1 (HIV-1)-infected men are at increased risk for anal cancer.
  • Human papillomavirus (HPV) vaccination may prevent anal cancer caused by vaccine types.
  • Men with high-grade anal intraepithelial neoplasia or anal cancer by history or by screening cytology or histology were excluded.
  • The primary end points were seroconversion to vaccine types at week 28, in men who were seronegative and without anal infection with the relevant HPV type at entry, and grade 3 or higher adverse events related to vaccination.

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  • (PMID = 20812850.001).
  • [ISSN] 1537-6613
  • [Journal-full-title] The Journal of infectious diseases
  • [ISO-abbreviation] J. Infect. Dis.
  • [Language] ENG
  • [Databank-accession-numbers] ClinicalTrials.gov/ NCT00513526
  • [Grant] United States / NCI NIH HHS / CA / U01CA121947-01; United States / NCRR NIH HHS / RR / UL1 RR024996; United States / NCRR NIH HHS / RR / UL1 RR024996-01; United States / NCRR NIH HHS / RR / M01 RR000865; United States / NCRR NIH HHS / RR / M01 RR000865-26; United States / NCRR NIH HHS / RR / UL1RR024996; United States / NIAID NIH HHS / AI / K23 AI055038; United States / NCRR NIH HHS / RR / UL1 RR024131; United States / NCI NIH HHS / CA / U01 CA121947-01; United States / NIAID NIH HHS / AI / K23 AI 55038; United States / NIAID NIH HHS / AI / K23 AI055038-01; United States / NCI NIH HHS / CA / CA121947-01; United States / NCRR NIH HHS / RR / UL1 RR024131-01; United States / NCRR NIH HHS / RR / M01-RR00865; United States / NCI NIH HHS / CA / U01 CA121947; United States / NIAID NIH HHS / AI / AI055038-01
  • [Publication-type] Clinical Trial; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antibodies, Viral; 0 / Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18; 0 / Papillomavirus Vaccines
  • [Other-IDs] NLM/ NIHMS285476; NLM/ PMC3118428
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93. Salit IE, Tinmouth J, Chong S, Raboud J, Diong C, Su D, Sano M, Lytwyn A, Chapman W, Mahony J: Screening for HIV-associated anal cancer: correlation of HPV genotypes, p16, and E6 transcripts with anal pathology. Cancer Epidemiol Biomarkers Prev; 2009 Jul;18(7):1986-92
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] Screening for HIV-associated anal cancer: correlation of HPV genotypes, p16, and E6 transcripts with anal pathology.
  • BACKGROUND: HIV-positive men with a history of anal-receptive intercourse are at risk for anal cancer.
  • We determined whether human papilloma virus (HPV) biomarkers were correlated with anal pathology in these men.
  • The number of HPV genotypes per anal swab was higher for anal intraepithelial neoplasia (AIN) 2/3 than for normal or AIN 1 histology [median, 5 types (interquartile range) (IQR), 3-7 versus 3.5 (IQR), 2-6; P = 0.0005].
  • HPV 16 viral load was also associated with AIN 2/3 histology.
  • CONCLUSIONS: The presence of high-grade anal pathology (AIN 2/3) in HIV-positive men was associated with multiple HPV genotypes, HPV genotypes 16 and 31, and HPV 16 viral load.
  • [MeSH-major] Alphapapillomavirus / genetics. Anus Neoplasms / epidemiology. Carcinoma in Situ / epidemiology. Genes, p16. HIV Seropositivity / virology. Oncogene Proteins, Viral / genetics. Repressor Proteins / genetics

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  • (PMID = 19567510.001).
  • [ISSN] 1538-7755
  • [Journal-full-title] Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
  • [ISO-abbreviation] Cancer Epidemiol. Biomarkers Prev.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / DNA, Viral; 0 / E6 protein, Human papillomavirus type 16; 0 / Oncogene Proteins, Viral; 0 / Repressor Proteins
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94. 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
ClinicalTrials.gov. clinical trials - ClinicalTrials.gov .

  • [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%.
  • 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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95. Orlando G, Beretta R, Fasolo MM, Amendola A, Bianchi S, Mazza F, Rizzardini G, Tanzi E: Anal HPV genotypes and related displasic lesions in Italian and foreign born high-risk males. Vaccine; 2009 May 29;27 Suppl 1:A24-9
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 HPV genotypes and related displasic lesions in Italian and foreign born high-risk males.
  • Anal intraepithelial neoplasia and anal cancer are closely related to infection from high-risk Human Papilloma Virus (HPV) genotypes.
  • Anal cytology, Digene Hybrid Capture Assay (HC2) and HPV genotyping were evaluated in 226 Italian (IT) and 63 foreign born (FB) subjects, recruited between January 2003 and December 2006.
  • FB people were younger (median 32y-IQR 27-35 vs 36y-IQR 31-43, respectively; Mann-Whitney test p<0.0001) and had a higher rate of abnormal results (>or=atypical squamous cells of undetermined significance (ASCUS)) on anal cytology (95.0% vs 84.04%) (p=0.032; OR 3.61; 95% CI 1.04-1.23).
  • HPV-16 is by far the most common genotype found in anal cytological samples independently from nationality while differences in distribution of other HPV genotypes were observed.
  • The relative contribution of each HPV genotype in the development of pre-neoplastic disease to an early age in the FB group cannot be argued by this study and more extensive epidemiological evaluations are needed to define the influence of each genotype and the association with the most prevalent high-risk HPVs on cytological intraepithelial lesions development.
  • [MeSH-major] Anus Neoplasms / virology. Papillomaviridae / genetics. Papillomavirus Infections / pathology
  • [MeSH-minor] Adult. Anal Canal / virology. Cross-Sectional Studies. DNA, Viral / genetics. Genotype. HIV Infections / complications. HIV Infections / virology. Humans. Italy / epidemiology. Male. Prevalence. Risk Factors

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  • (PMID = 19480957.001).
  • [ISSN] 1873-2518
  • [Journal-full-title] Vaccine
  • [ISO-abbreviation] Vaccine
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Netherlands
  • [Chemical-registry-number] 0 / DNA, Viral
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96. Abbas A, Yang G, Fakih M: Management of anal cancer in 2010. Part 1: Overview, screening, and diagnosis. Oncology (Williston Park); 2010 Apr 15;24(4):364-9
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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 cancer in 2010. Part 1: Overview, screening, and diagnosis.
  • Although anal cancer is a rare disease, its incidence is increasing in men and women worldwide.
  • Anal cancer is generally preceded by high-grade anal intraepithelial neoplasia (HGAIN), which is most prevalent in human immunodeficiency virus (HIV)-positive men who have sex with men.
  • Meta-analysis suggests that 80% of anal cancers could be avoided by vaccination against HPV 16/18.
  • Nearly half of all patients with anal cancer present with rectal bleeding.
  • According to the Surveillance Epidemiology and End Results (SEER) database, 50% of patients with anal cancer have disease localized to the anus, 29% have regional lymph node involvement or direct spread beyond the primary, and 12% have metastatic disease, while 9% have an unknown stage.
  • Clinical staging of anal carcinoma requires a digital rectal exam and a computed tomography scan of the chest, abdomen, and pelvis.
  • The 5-year relative survival rates are 80.1% for localized anal cancer, 60.7% for regional disease, and 29.4% for metastatic disease.
  • Part 2 of this two-part review will address the treatment of anal cancer, highlighting studies of chemoradiation.
  • [MeSH-major] Anus Neoplasms / diagnosis. Anus Neoplasms / prevention & control. Mass Screening

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  • (PMID = 20464850.001).
  • [ISSN] 0890-9091
  • [Journal-full-title] Oncology (Williston Park, N.Y.)
  • [ISO-abbreviation] Oncology (Williston Park, N.Y.)
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 94
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97. 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
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] 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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98. 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
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] 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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99. 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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100. 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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