title: Liquid-based cytology and HPV DNA testing using intra-anal specimens from HIV-negative women with and without genital HPV-induced lesions.
abstract: BACKGROUND
  Screening for anal cancer using cytology has not been considered in immunocompetent women. The aim of this study was to identify cytological atypia and human papillomavirus (HPV) DNA in intra-anal specimens from human immunodeficiency virus (HIV)-negative women with and without genital HPV lesions.
  
  
  METHODS
  This study was a cross-sectional analysis of 142 women who were negative for the HIV: 80 with genital lesions that were associated with HPV and 62 without HPV-induced lesions. The women were evaluated at the Federal University of Ceará from October 2011 to June 2012. The statistical analysis included the Fisher exact test and the odds ratio (CI 95%).
  
  
  RESULTS
  Atypical anal cytology was observed in 24 (29.3%) patients in the study group and in 11 (17.8%) patients in the control group. In cases with at least two sites of HPV-associated lesions, 12 (41.4%) presented atypical cytology (P = 0.0220; OR = 2.7621, 1.1579-6.5889). When the practice of anal sex was evaluated, atypical cytology was observed in 22/43 (34%) [P = 0.0214; OR = 2.519, 1.146-5.534]. HPV DNA was detected in 17/27 (63%) cases with at least two sites of lesions (P = 0.0293, OR = 2.4855, 1.0960-5.6367). In the 33 cases who presented positive HPV DNA test results, the liquid-based cytology results were atypical (P = 0.0212, OR = 2.8, 1.1665-6.7208).
  
  
  CONCLUSIONS
  Based on the results, liquid-based cytology may be used to detect intra-anal lesions, especially among women who have a history of anal intercourse or who have genital HPV-associated lesions at multiple sites.
authors.affiliation: Department of Maternal and Child Health, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil; Department of Pathology, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil.
authors.forename: José
authors.initials: J
authors.lastname: Eleutério
authors.forename: Givanildo Carneiro
authors.initials: GC
authors.lastname: Benício
authors.forename: Paulo César
authors.initials: PC
authors.lastname: Giraldo
authors.forename: Ana Katherine Silveira
authors.initials: AK
authors.lastname: Gonçalves
authors.forename: Renata Mírian Nunes
authors.initials: RM
authors.lastname: Eleutério
authors.forename: Denise Nunes
authors.initials: DN
authors.lastname: Oliveira
authors.forename: Cláudia
authors.initials: C
authors.lastname: Jacyntho
mesh_terms: D000328:Adult; D001003:Anal Canal / Q000473:pathology* / Q000821:virology; D001005:Anus Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000821:virology; D065309:Atypical Squamous Cells of the Cervix / Q000473:pathology* / Q000821:virology; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003581:Cytodiagnosis / Q000379:methods; D004279:DNA, Viral / Q000302:isolation & purification*; D005260:Female; D015658:HIV Infections; D006651:Histocytochemistry / Q000379:methods; D061809:Human Papillomavirus DNA Tests; D006801:Humans; D008875:Middle Aged; D027383:Papillomaviridae / Q000472:pathogenicity / Q000502:physiology; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000473:pathology / Q000821:virology; D012725:Sexual Behavior / Q000706:statistics & numerical data; D065310:Squamous Intraepithelial Lesions of the Cervix / Q000473:pathology* / Q000821:virology
chemical_list: D004279:DNA, Viral
keywords: anal cytology; human papillomavirus; human papillomavirus DNA tests; screening; women