Translational Biomedicine Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina, Criciúma, Santa Catarina, Brazil.
Department of Medicine, Centro Universitário do Espírito Santo, University of Southern Santa Catarina, Colatina, Espírito Santo, Brazil.
Dis Colon Rectum. 2019 Jan;62(1):112-120. doi: 10.1097/DCR.0000000000001231.
Anal canal carcinoma is relevant because it commonly occurs in high-risk groups, and its incidence has been increasing.
This study evaluated the accuracy of anal cytology in the screening of precursor lesions of anal cancer, compared with histopathologic examination as the reference, in all subjects and in men who have sex with men, HIV-infected men and women, and men who have sex with men and HIV-infected subgroups.
The data included studies identified in the MEDLINE, Latin American and Caribbean Health Sciences, Cochrane Library, and Embase electronic databases, as well as in the grey literature. The search terms included anal cancer, anal dysplasia, anal intraepithelial neoplasia, screening, and anal cytology.
After excluding studies with no histopathological data and those with duplicate and missing data, 34 primary studies were included.
Cytology of anal smears was studied.
Sensitivity, specificity, diagnostic OR, and area under the curve were measured.
A total of 5093 patients were included. The pooled sensitivity of anal cytology was 85.0% (95% CI, 82.0%-87.0%) and pooled specificity was 43.2% (95% CI, 41.4%-45.1%) for the detection of anal intraepithelial neoplasia grade 2 or worse versus anal intraepithelial neoplasia grade 1 and normal when measuring all subjects. The accuracy of anal cytology was higher in the men who have sex with men and HIV-infected and men who have sex with men only subgroups.
This study was limited by its specificity.
The study results support the hypothesis that cytology is a good test for the screening of anal cancer.
肛门腺癌相关，因为它常见于高危人群，且其发病率一直在增加。
本研究通过与组织病理学检查作为参考标准进行比较，评估肛门细胞学检查在肛门癌前病变筛查中的准确性，所有研究对象以及男男性行为者、HIV 感染者、男男性行为者和 HIV 感染者亚组中。
数据来源于 MEDLINE、拉丁美洲和加勒比健康科学、考科蓝图书馆和 Embase 电子数据库以及灰色文献中确定的研究。检索词包括肛门癌、肛门发育不良、肛门上皮内瘤变、筛查和肛门细胞学。
排除无组织病理学数据以及重复和缺失数据的研究后，共纳入 34 项主要研究。
分析肛门拭子细胞学检查。
灵敏度、特异性、诊断 OR 和曲线下面积。
共纳入 5093 例患者。分析所有研究对象时，肛门细胞学检查对 2 级或更高级别肛门上皮内瘤变与 1 级和正常的检测的合并灵敏度为 85.0%（95%CI，82.0%-87.0%），合并特异性为 43.2%（95%CI，41.4%-45.1%）。在男男性行为者和 HIV 感染者以及仅男男性行为者亚组中，肛门细胞学检查的准确性更高。
本研究受特异性限制。
研究结果支持细胞检查是肛门癌筛查的良好检测方法的假说。
