dc.creator | NAHAS, Caio S. R. | |
dc.creator | SILVA FILHO, Edesio V. da | |
dc.creator | SEGURADO, Aluisio A. C. | |
dc.creator | GENEVCIUS, Raphael F. F. | |
dc.creator | GERHARD, Rene | |
dc.creator | GUTIERREZ, Eliana B. | |
dc.creator | MARQUES, Carlos F. S. | |
dc.creator | CECCONELLO, Ivan | |
dc.creator | NAHAS, Sergio C. | |
dc.date.accessioned | 2012-10-19T17:25:25Z | |
dc.date.accessioned | 2018-07-04T15:07:21Z | |
dc.date.available | 2012-10-19T17:25:25Z | |
dc.date.available | 2018-07-04T15:07:21Z | |
dc.date.created | 2012-10-19T17:25:25Z | |
dc.date.issued | 2009 | |
dc.identifier | DISEASES OF THE COLON & RECTUM, v.52, n.11, p.1854-1860, 2009 | |
dc.identifier | 0012-3706 | |
dc.identifier | http://producao.usp.br/handle/BDPI/22107 | |
dc.identifier | 10.1007/DCR.0b013e3181b98f36 | |
dc.identifier | http://dx.doi.org/10.1007/DCR.0b013e3181b98f36 | |
dc.identifier.uri | http://repositorioslatinoamericanos.uchile.cl/handle/2250/1618880 | |
dc.description.abstract | PURPOSE: The purpose of this study was to analyze the agreement between anal Pap smear and high-resolution anoscopy-guided biopsy in diagnosing anal dysplasia in HIV-infected patients. METHODS: We conducted cross-sectional analysis of HIV-infected patients receiving anal dysplasia screening as part of routine care. Agreement between measures was estimated by weighted kappa statistics, using a three-tiered cytologic and histologic grading system (normal, low-grade dysplasia, and high-grade dysplasia). Estimates of sensitivity, specificity, and predictive values were calculated using a two-tiered cytologic and histologic grading system (""without dysplasia"" and ""with dysplasia of any grade""). Estimates were also calculated for the detection of high-grade dysplasia. RESULTS: During a one-year period, 222 patients underwent 330 anal Pap smears followed by high-resolution anoscopy-guided biopsies. There were 311 satisfactory Pap smears with concurrent biopsies. Considering histology the standard, the frequency of anal dysplasia was 46%. Kappa agreement between anal Pap smear and biopsy was 0.20. For detection of anal dysplasia of any grade, anal Pap smear showed sensitivity of 61%, specificity of 60%, positive predictive value of 56%, and negative predictive value of 64%. For high-grade dysplasia, anal Pap smear showed sensitivity of 16% and specificity of 97%. CONCLUSION: Anal Pap smears alone were not sensitive enough to rule out anal dysplasia. We recommend that high-resolution anoscopy-guided biopsy be incorporated as a complementary screening test for anal dysplasia in high-risk patients. Following baseline high-resolution anoscopy, these individuals could be followed with serial anal cytology to dictate the need for future high-resolution anoscopy-guided biopsies. | |
dc.language | eng | |
dc.publisher | LIPPINCOTT WILLIAMS & WILKINS | |
dc.relation | Diseases of the Colon & Rectum | |
dc.rights | Copyright LIPPINCOTT WILLIAMS & WILKINS | |
dc.rights | restrictedAccess | |
dc.subject | Squamous-cell carcinoma | |
dc.subject | Human papillomavirus | |
dc.subject | Screening | |
dc.subject | Anal dysplasia | |
dc.subject | Anal intraepithelial neoplasia | |
dc.subject | HIV | |
dc.subject | High-resolution anoscopy | |
dc.subject | Pap smear | |
dc.title | Screening Anal Dysplasia in HIV-Infected Patients: Is There an Agreement Between Anal Pap Smear and High-Resolution Anoscopy-Guided Biopsy? | |
dc.type | Artículos de revistas | |