title: [Effectiveness of human papillomavirus genotyping for detection of high-grade anal intraepithelial neoplasia compared to anal cytology].
abstract: BACKGROUND
  The incidence of high-grade anal intraepithelial neoplasia (HGAIN) -with an aetiological based on high-risk types of human papillomavirus- is increasing in some high-risk groups. Screening for HGAIN includes routine anal cytology and, more recently, HPV genotyping. The main objective of this study was to determine the sensitivity and specificity of anal cytology and HPV genotyping for the detection of HGAIN.
  
  
  METHODS
  This is a study to determine the correlation of cytological and microbiological findings with anal biopsy findings in a cohort of patients at high risk of developing AIN referred to the department of sexually transmitted infections of the Hospital Costa del Sol, Spain, between January 2008 and December 2014.
  
  
  RESULTS
  Of the 151 patients subjected to screening, a total of 92 patients, all of them with the result of three screening test (anal cytology, genotyping and biopsy) were included in the study. Just under two-thirds (62%) of them were HIV-positive. The sensitivity and specificity of anal cytology to detect HGAIN were 52.8 and 85.7%, respectively (k: 0.328), and 78 and 62.8% to detect two or more HPV oncogenic genotypes (k: 0.417). The detection of oncogenic HPV genotypes allowed the identification of 23 new cases of HGAIN that had been underdiagnosed with anal cytology, with 14 cases containing at least three high-risk genotypes.
  
  
  CONCLUSIONS
  Anal cytology did not show enough sensitivity in HGAIN screening. HPV genotyping has shown to be a useful tool to detect HGAIN cases, although it could lead to an over-diagnosis as a solitary screening procedure.
authors.affiliation: Dermatología, Hospital Costa del Sol , Marbella, España. Electronic address: laura.padilla.espana@gmail.com.
authors.forename: Laura
authors.initials: L
authors.lastname: Padilla-España
authors.affiliation: Dermatología, Hospital Costa del Sol , Marbella, España.
authors.forename: Juan Bosco
authors.initials: JB
authors.lastname: Repiso-Jiménez
authors.affiliation: Microbiología, Hospital Costa del Sol, Marbella, España.
authors.forename: Fernando
authors.initials: F
authors.lastname: Fernández-Sánchez
authors.affiliation: Anatomía Patológica, Hospital Costa del Sol , Marbella, España.
authors.forename: Teresa
authors.initials: T
authors.lastname: Pereda
authors.affiliation: Unidad de Apoyo a la Investigación, Hospital Costa del Sol , Marbella, España.
authors.forename: Francisco
authors.initials: F
authors.lastname: Rivas-Ruiz
authors.affiliation: Dermatología, Hospital Costa del Sol , Marbella, España.
authors.forename: Teresa
authors.initials: T
authors.lastname: Fernández-Morano
authors.affiliation: Medicina Interna, Hospital Costa del Sol , Marbella, España.
authors.forename: Javier
authors.initials: J
authors.lastname: de la Torre-Lima
authors.affiliation: Cirugía General, Hospital Costa del Sol, Marbella, España.
authors.forename: Fermín
authors.initials: F
authors.lastname: Palma
authors.affiliation: Universidad de Málaga, Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Málaga, España.
authors.forename: Maximino
authors.initials: M
authors.lastname: Redondo
authors.affiliation: Dermatología, Hospital Costa del Sol , Marbella, España.
authors.forename: Magdalena
authors.initials: M
authors.lastname: de Troya-Martín
mesh_terms: D000328:Adult; D001005:Anus Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000821:virology*; D002278:Carcinoma in Situ / Q000175:diagnosis* / Q000473:pathology / Q000821:virology*; D003430:Cross-Sectional Studies; D005260:Female; D005838:Genotype; D060005:Genotyping Techniques; D006801:Humans; D008297:Male; D027383:Papillomaviridae / Q000235:genetics*; D030361:Papillomavirus Infections / Q000175:diagnosis*; D012680:Sensitivity and Specificity; D013030:Spain
keywords: Biopsia; Biopsy; Citología; Cytology; Despistaje; Genotipo; Genotype; Human papillomavirus; Screening; Virus papiloma humano