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Oncogenic human papillomavirus is not helpful for cytology screening of the precursor lesions of anal cancers in Taiwanese men who are infected with human immunodeficiency virus

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Abstract

Background

Homosexual men infected with human immunodeficiency virus (HIV) are at increased risk of developing anal cancer. The aim of this study was to assess the clinical sensitivity of anal cytology analysis and oncogenic human papillomavirus (HPV) detection for predicting histological anal intraepithelial neoplasia.

Methods

Between March 2011 and December 2013, we enrolled 196 HIV-positive men in Taoyuan General Hospital, Taiwan. We analyzed the results of thin-preparation anal Pap smears, HPV genotyping, and histology of anoscopic biopsy samples.

Results

The mean age (±standard deviation) was 31.43 (±8.74) years. The proportion (95 % confidence interval) with abnormal thin-preparation anal cytology was 36.2 % (29.8–43.2 %): 16.8 % (12.2–22.7 %) atypical squamous cells of undetermined significance, 14.8 % (10.5–20.4 %) low-grade squamous intraepithelial lesions, and 4.6 % (2.4–8.5 %) high-grade squamous intraepithelial lesions. At least one HPV genotype was detected in 90.8 % of subjects, and the mean number of HPV infection types was 4.41 (±3.24).The frequency of histological high-grade anal intraepithelial lesions was 7.14 % (95 % confidence interval 4.3–11.6 %). Anal cytology yielding atypical squamous cells of undetermined significance or higher grades resulted in a sensitivity of 64.3 %, specificity of 65.9 %, positive predictive value of 12.7 %, and negative predictive value of 96 %. Using both oncogenic HPV and cytology did not provide better performance.

Conclusions

Anal cytology yielding atypical squamous cells of undetermined significance or higher grades could detect two-thirds of high-grade anal intraepithelial neoplasias in HIV-infected men and should be promoted for anal cancer prevention.

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Acknowledgments

This study was supported by grants PTH-10019, 10105, and 10203 from the Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan. We thank the participants for their time.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standard

The study was approved by the institutional review boards of this hospital (IRB No: TYGH99034, 10020, and 101042) and all participants were enrolled with informed consent.

Author information

Authors and Affiliations

  1. School of Public Health, College of Public Health and Nutrition, Taipei Medical University, No. 250 Wu-Hsing St, Taipei, Taiwan

    Shu-Hsing Cheng & Yu-Mei Hsueh

  2. Department of Infectious Diseases, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan

    Shu-Hsing Cheng

  3. Department of Surgery, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan

    Chi-Chao Wang

  4. Department of Pathology, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan

    Shih-Lung Chang

  5. School of Medical Laboratory Science and Biotechnology, Taipei Medical University, Taipei, Taiwan

    Fang-Yeh Chu

  6. Department of Clinical Pathology, Far Eastern Memorial Hospital, New Taipei City, Taiwan

    Fang-Yeh Chu

  7. Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan

    Yu-Mei Hsueh

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  1. Shu-Hsing Cheng
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  2. Chi-Chao Wang
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Correspondence to Yu-Mei Hsueh.

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Cheng, SH., Wang, CC., Chang, SL. et al. Oncogenic human papillomavirus is not helpful for cytology screening of the precursor lesions of anal cancers in Taiwanese men who are infected with human immunodeficiency virus. Int J Clin Oncol 20, 943–951 (2015). https://doi.org/10.1007/s10147-015-0804-9

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  • DOI: https://doi.org/10.1007/s10147-015-0804-9

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