title: Anal High-Grade Squamous Intraepithelial Lesions in Human Immunodeficiency Virus-Infected Men: A Study of 100 Cases With Emphasis on Cytohistologic Correlation.
abstract: OBJECTIVE
  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.
authors.affiliation: From the Division of Gynecologic Pathology.
authors.forename: Yuxin
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Division of Cytology, Department of Pathology, University of Massachusetts Medical School, UMass Memorial Medical Center, Worcester.
authors.forename: Xiaofei
authors.initials: X
authors.lastname: Wang
authors.affiliation: From the Division of Gynecologic Pathology.
authors.forename: Tamara
authors.initials: T
authors.lastname: Kalir
authors.affiliation: Division of Cytology, Department of Pathology.
authors.forename: David
authors.initials: D
authors.lastname: Chhieng
authors.affiliation: Division of General Internal Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, NY.
authors.forename: Keith
authors.initials: K
authors.lastname: Sigel
authors.affiliation: Division of General Internal Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, NY.
authors.forename: Michael M
authors.initials: MM
authors.lastname: Gaisa
mesh_terms: D000328:Adult; D000368:Aged; D001005:Anus Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000821:virology; D002278:Carcinoma in Situ / Q000175:diagnosis* / Q000473:pathology / Q000821:virology; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000473:pathology / Q000821:virology; D003581:Cytodiagnosis / Q000379:methods*; D055088:Early Detection of Cancer / Q000379:methods; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D055815:Young Adult
keywords: Anal high-grade squamous intraepithelial lesions; Anorectal cytology; HIV-infected MSM