Anal High-Grade Squamous Intraepithelial Lesions in Human Immunodeficiency Virus-Infected Men

作者：Liu Yuxin^*; Wang Xiaofei; Kalir Tamara; Chhieng David; Sigel Keith; Gaisa Michael M

来源：American Journal of Clinical Pathology, 2017, 147(3): 315-321.

DOI：10.1093/AJCP/AQW229

• Anorectal cytology
• HIV-infected MSM
• Anal high-grade squamous intraepithelial lesions

Objectives: Anorectal cytology (ARC) is a widely used screening tool for anal cancer in human immunodeficiency virus (HIV)-infected men who have sex with men (MSM). Its diagnostic accuracy needs to be improved, especially for high-grade squamous intraepithelial lesions (HSILs).
Methods: Using 100 HIV+MSM with biopsy-proven anal HSILs, we correlated histologic/cytologic findings.
Results: Upon review, HSIL cells were present in 58 cytology samples and absent in 42. Positive samples were higher in cellularity and contained transformation zones (P<.05). Cytology was able to predict HSILs in 36%, 48%, 68%, and 78% of patients with one, two, three, and four or more high-grade lesions. HSIL cells were identified in all cytology samples initially reported as HSILs or atypical squamous cells, cannot exclude HSIL and in 34 samples reported as low-grade squamous intraepithelial lesions or less. Notably, among this last category, 15 (44%) were keratinized-type HSILs.
Conclusions: Our findings should improve the ARC detection rate for anal HSILs, helping to implement ARC as the primary screening tool for anal cancer.