title: Comparison of 2 anal cytology protocols to predict high-grade anal intraepithelial neoplasia.
abstract: OBJECTIVE
  Nylon-flocked and Dacron swab anal cytology collection procedures were evaluated for detecting high-grade anal intraepithelial neoplasia.
  
  
  METHODS
  Cross-sectional data for 42 HIV-infected and 16 uninfected men who have sex with men have been used. Sequentially collected anal cytology specimens, high-resolution anoscopy, and medical biopsy evaluated the sensitivity and specificity of cytology for predicting high-grade anal intraepithelial neoplasia. Men showing atypical squamous cells (ASC) or more severe findings by cytology were compared with those showing negative for intraepithelial lesions.
  
  
  RESULTS
  The prevalence of high-grade anal intraepithelial neoplasia was 35% (21/58), and findings were approximately 1.5 times higher among HIV-infected compared with uninfected men. Unsatisfactory cytology was twice as common among Dacron compared with nylon-flocked swab protocol specimens (14% [8/58] vs 7% [4/58]). Sensitivity and specificity for the nylon-flocked protocol cytology showing ASC or more severe findings were 81% (58%-95%) and 73% (50%-89%), respectively. Dacron protocol specimens showed 52% (30%-74%) and 58% (34%-80%) sensitivity and specificity, respectively. Men showing ASC or more severe findings using the nylon-flocked protocol cytology showed 3-fold higher odds for high-grade anal intraepithelial neoplasia compared with men with negative results (p < .05), but no statistically significantly higher odds of high-grade anal intraepithelial neoplasia for men showing ASC or more severe findings compared with those with negative results for Dacron protocol cytology (p > .05).
  
  
  CONCLUSIONS
  The nylon-flocked protocol better detects high-grade anal intraepithelial neoplasia than does the Dacron protocol, yields more interpretable results, and classifies men with high-grade anal intraepithelial neoplasia as cytologically abnormal 2.5 times more often, even in this small clinical trial.
  
  
  BACKGROUND
  NCT00955591.
authors.affiliation: 1Translational Science Section, School of Nursing, University of California at Los Angeles, Los Angeles; 2Los Angeles Gay and Lesbian Center, Jeffrey Goodman Clinic, Hollywood; 3Center for Clinical AIDS Research and Education (University of California at Los Angeles-CARE Center); 4Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles; and 5Jonsson Comprehensive Cancer Center, Los Angeles, CA; 6Tricore Diagnostic Laboratories, University of New Mexico, Albuquerque, NM; and 7University of California at Los Angeles AIDS Institute; and 8Department of Obstetrics and Gynecology, David Geffen School of Medicine, and 9Jonathan & Karin Fielding School of Public Health, University of California at Los Angeles, Los Angeles, CA.
authors.forename: Dorothy JoAnn
authors.initials: DJ
authors.lastname: Wiley
authors.forename: Hilary
authors.initials: H
authors.lastname: Hsu
authors.forename: Robert
authors.initials: R
authors.lastname: Bolan
authors.forename: Alen
authors.initials: A
authors.lastname: Voskanian
authors.forename: David
authors.initials: D
authors.lastname: Elashoff
authors.forename: Stephen
authors.initials: S
authors.lastname: Young
authors.forename: Ruvy
authors.initials: R
authors.lastname: Dayrit
authors.forename: Provaboti
authors.initials: P
authors.lastname: Barman
authors.forename: Katherine
authors.initials: K
authors.lastname: DeAzambuja
authors.forename: Emmanuel V
authors.initials: EV
authors.lastname: Masongsong
authors.forename: Otoniel
authors.initials: O
authors.lastname: Martínez-Maza
authors.forename: Roger
authors.initials: R
authors.lastname: Detels
mesh_terms: D000328:Adult; D000368:Aged; D001005:Anus Neoplasms / Q000175:diagnosis*; D002278:Carcinoma in Situ / Q000175:diagnosis*; D003584:Cytological Techniques / Q000379:methods*; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D013048:Specimen Handling / Q000379:methods*