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HPV in anal squamous cell carcinoma and anal intraepithelial neoplasia (AIN)

Impact of HPV analysis of anal lesions on diagnosis and prognosis

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Background and aims

Majority of cases of anal squamous cell carcinoma are human papilloma virus (HPV)-induced and result from anal intraepithelial neoplasia (AIN). This study was conducted to examine methods which may enable the routine diagnosis of HPV-induced changes in the anal rim and the consequences of such detection especially in view of a more sensitive diagnosis of AIN. Results were clinically correlated.

Methods

The study included biopsy samples from 87 patients who had been diagnosed with the following disease patterns: 47 invasive anal carcinoma, 33 AIN of varying severity and seven condylomatous lesions. In 52 of these cases, a tumour was clinically suspected. All biopsies were retrospectively examined for microscopic indications of HPV infection. After microdissection, additional HPV analysis via PCR was carried out.

Results

In 38 of 47 cases of anal carcinoma, HPV DNA could be detected via PCR (80.9%), the majority of which were HPV 16 (33/38=86.8%). In 29 of the 33 cases of AIN, HPV DNA was detected (87.9%), most of these in AIN III (15/16=93.8%). Histological markers of HPV infection were detected in all 87 cases.

Discussion

In our series, the clinical diagnosis of the invasive anal carcinoma had a high sensitivity of 93.6%, with a specificity of 80%. The positive predictive value was 84.6%, and the negative predictive value 91.4%. In contrast, AIN had been detected clinically in none of the cases. In this situation, especially with high-risk patients, our findings recommend anal HPV screening in combination with anal cytology and anoscopy.

Conclusion

Based on our results, we urgently recommend for any histological report on excision of anal lesions to include a statement whether histological markers of HPV infection were detected. In individual cases, validation via HPV PCR must be considered.

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Authors and Affiliations

  1. Institut of Pathology, Bonn Duisdorf, Germany

    A. D. Varnai, M. Bollmann, H. Griefingholt & R. Bollmann

  2. IMOGen (Institute for Molecular Pathology and Gene Diagnostic) GmbH, Bonn Duisdorf, Germany

    N. Speich & C. Schmitt

  3. Department of General, Visceral, Thoracic and Vascular Surgery, University of Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Germany

    Dorothee Decker

Authors
  1. A. D. Varnai
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  2. M. Bollmann
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  3. H. Griefingholt
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  4. N. Speich
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  7. Dorothee Decker
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Correspondence to Dorothee Decker.

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Varnai, A.D., Bollmann, M., Griefingholt, H. et al. HPV in anal squamous cell carcinoma and anal intraepithelial neoplasia (AIN). Int J Colorectal Dis 21, 135–142 (2006). https://doi.org/10.1007/s00384-005-0777-7

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  • DOI: https://doi.org/10.1007/s00384-005-0777-7

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