Padilla-España Laura, Repiso-Jiménez Bosco, Fernández-Sánchez Fernando, Frieyro-Elicegui Marta, Fernández-Morano Teresa, Pereda Teresa, Rivas-Ruiz Francisco, Redondo Maximino, de-Troya Martín Magdalena
Servicio de Dermatología, Hospital Costa del Sol, Marbella, Málaga, España.
Servicio de Dermatología, Hospital Costa del Sol, Marbella, Málaga, España.
Enferm Infecc Microbiol Clin. 2014 Nov;32(9):560-4. doi: 10.1016/j.eimc.2014.03.008. Epub 2014 Jun 5.
The incidence of intraepithelial anal neoplasia is increasing in certain risk behaviour groups, and human papillomavirus (HPV) infection is involved in its pathogenesis. The systematic use of anal cytology, and more recently HPV detection by hybrid capture and genotyping, have been introduced into screening programs in recent decades.
A retrospective cohort study was carried out on individuals with risk behaviours of developing intraepithelial anal neoplasia and who attended Sexually Transmitted Infections clinics in the Dermatology area of the Hospital Costa del Sol from January 2010 to December 2012. The intraepithelial anal neoplasia screening was performed using anal cytology and HPV genotyping.
Half (50%) of the study population were HIV positive. A high frequency of anal dysplasia and presence of HPV in cytology (82.1%) and genotype (79%) was found. A statistically significant association (P<.005) was obtained between the presence of high-risk HPV genotypes and the presence of high-grade dysplasia in the second directed cytology. HPV genotyping enabled 17 cases (22%) of severe dysplasia to be identified that were under-diagnosed in the first cytology.
Cases of high-grade dysplasia can be under-diagnosed by a first anal cytology. Detection of HPV can supplement this procedure, leading to the identification of those patients most at risk of developing high-grade anal dysplasia.
在某些具有特定风险行为的人群中，肛管上皮内瘤变的发病率呈上升趋势，人乳头瘤病毒（HPV）感染参与其发病机制。近几十年来，肛管细胞学检查以及最近通过杂交捕获和基因分型进行HPV检测已被纳入筛查项目。
对2010年1月至2012年12月期间在科斯塔德尔索尔医院皮肤科性传播感染门诊就诊、具有发生肛管上皮内瘤变风险行为的个体进行了一项回顾性队列研究。采用肛管细胞学检查和HPV基因分型进行肛管上皮内瘤变筛查。
研究人群中有一半（50%）为HIV阳性。在细胞学检查（82.1%）和基因分型（79%）中发现肛管发育异常和HPV存在的频率较高。在第二次定向细胞学检查中，高危HPV基因型的存在与高级别发育异常的存在之间存在统计学显著关联（P<0.005）。HPV基因分型能够识别出17例（22%）在首次细胞学检查中漏诊的重度发育异常病例。
首次肛管细胞学检查可能漏诊高级别发育异常病例。HPV检测可以补充这一检查方法，从而识别出那些最有可能发生高级别肛管发育异常的患者。
