Cervical Disease Center, Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
Department of Pathology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
J Med Virol. 2024 Jun;96(6):e29747. doi: 10.1002/jmv.29747.
This study aimed to provide comprehensive clinical screening data for anal intraepithelial neoplasia (AIN). This study included 312 patients who underwent high-resolution anoscopy (HRA) examinations between January 1, 2020 and April 15, 2024. Clinical data, including demographic information, clinical history, cytology/high-risk human papilloma virus (hrHPV) results, and HRA records, were analyzed. The median age of all patients was 42 years (interquartile range: 33-52 years). Approximately 26.3% reported a history of VIN2/3+, 13.5% had a history of VaIN2/3+, 29.8% had a history of CIN2/3+, 44.6% had persistent cervical HPV16 infection, and 12.5% had immune suppression. Among the 312 patients, 14.4% were diagnosed with AIN2/3, 25.0% with AIN1 and 60.6% were normal. Anal cytological abnormalities were found in 41.3% of all patients, with a significantly higher rate in AIN2/3 patients than in ≤AIN1, 71.1% versus 36.3%, p < 0.001. The hrHPV positivity rate was 89.7%, with HPV16 being the most prevalent. The complete agreement rate for HRA impressions was 79.5%. Multi-variable analysis revealed immune suppression (odds ratio [OR]: 3.47, 95% confidence interval [CI]: 1.42-8.5) and VIN2/3+ (OR: 2.82, 95% CI: 1.27-6.28) were independent risk factors for AIN2/3. Abnormal cytology results (OR: 3.3, 95% CI: 1.52-7.17) and anal HPV16 infection (OR: 3.2, 95% CI: 1.26-8.12) demonstrated similar ORs for AIN2/3. Early screening for AIN2/3+ is crucial in Chinese women with lower genital tract precancerous and cancerous lesions, particularly in those with VIN2/3+ and immune suppression.
本研究旨在为肛门上皮内瘤变（AIN）提供全面的临床筛查数据。该研究纳入了 2020 年 1 月 1 日至 2024 年 4 月 15 日期间接受高分辨率肛门镜检查（HRA）的 312 例患者。分析了包括人口统计学信息、临床病史、细胞学/高危型人乳头瘤病毒（hrHPV）结果和 HRA 记录在内的临床数据。所有患者的中位年龄为 42 岁（四分位距：33-52 岁）。约 26.3%的患者报告有 VIN2/3+病史，13.5%有 VaIN2/3+病史，29.8%有 CIN2/3+病史，44.6%有持续性宫颈 HPV16 感染，12.5%有免疫抑制。312 例患者中，14.4%诊断为 AIN2/3，25.0%诊断为 AIN1，60.6%为正常。所有患者中，41.3%存在肛门细胞学异常，AIN2/3 患者的异常率明显高于≤AIN1 患者（71.1% vs. 36.3%，p<0.001）。hrHPV 阳性率为 89.7%，其中 HPV16 最为常见。HRA 印象的完全一致性率为 79.5%。多变量分析显示，免疫抑制（比值比[OR]：3.47，95%置信区间[CI]：1.42-8.5）和 VIN2/3+（OR：2.82，95%CI：1.27-6.28）是 AIN2/3 的独立危险因素。细胞学异常结果（OR：3.3，95%CI：1.52-7.17）和肛门 HPV16 感染（OR：3.2，95%CI：1.26-8.12）对 AIN2/3 也具有相似的 OR。在中国有下生殖道癌前病变和癌症病史的女性中，早期筛查 AIN2/3+至关重要，尤其是 VIN2/3+和免疫抑制的患者。
