Chilou Camille, Espirito Santo Iolanda, Faes Seraina, St-Amour Pénélope, Jacot-Guillarmod Martine, Pache Basile, Hübner Martin, Hahnloser Dieter, Grass Fabian
Department of Visceral Surgery, Lausanne University Hospital (CHUV), University of Lausanne (UNIL), 1011 Lausanne, Switzerland.
Stadtspital Triemli Zürich, 8063 Zürich, Switzerland.
Cancers (Basel). 2024 Oct 19;16(20):3534. doi: 10.3390/cancers16203534.
This study represents a follow-up analysis of the (ANGY) study.
This prospective, cross-sectional, single-center study recruited women for concomitant cervical and anal screening of HPV genotypes and cytology during a single appointment. All women with findings of either HPV or any type of dysplastic lesions on anal smears were offered follow-up in a specialized high-resolution anoscopy (HRA) outpatient clinic, representing the study cohort for this follow-up study.
Overall, 275 patients (mean age 42 ± 12) were included. Among them, 102 (37%) had cervical high-risk (HR) HPV. In total, HPV was (incidentally) revealed in 91 patients (33%) on anal smears, while any degree of anal squamous intraepithelial lesion (SIL) was found in 30 patients (11%), 6 if which were high-grade SIL (H-SIL). Furthermore, 10 out of 19 biopsies were positive (3 H-SIL lesions). Only half (48/91, 53%) of the women agreed to undergo the recommended specialized follow-up evaluation. Of them, 18 (38%) were diagnosed with dysplastic lesions (9 low grade (L-SIL) and 9 H-SIL, respectively) on biopsies, while the remaining visits revealed no abnormalities. Multivariable analysis revealed cervical HR-HPV infection (OR 4, 95% CI 2.2-7.5) and anal intercourse (OR 3.1, 95% CI 1.7-5.9) as independent risk factors for anal HR-HPV infection.
Close follow-up of these women is hence strongly recommended.
本研究是对（ANGY）研究的一项随访分析。
这项前瞻性、横断面、单中心研究招募女性在一次就诊时同时进行宫颈和肛门的HPV基因型及细胞学筛查。所有在肛门涂片检查中发现HPV或任何类型发育异常病变的女性都被安排在专门的高分辨率肛门镜检查（HRA）门诊进行随访，这些女性构成了本随访研究的队列。
总共纳入了275例患者（平均年龄42±12岁）。其中，102例（37%）患有宫颈高危（HR）HPV。总体而言，在肛门涂片检查中（偶然）发现91例患者（33%）感染了HPV，30例患者（11%）发现有任何程度的肛门鳞状上皮内病变（SIL），其中6例为高级别SIL（H-SIL）。此外，19例活检中有10例呈阳性（3例H-SIL病变）。只有一半（48/91，53%）的女性同意接受推荐的专门随访评估。在这些女性中，18例（38%）活检诊断为发育异常病变（分别为9例低级别（L-SIL）和9例H-SIL），其余检查未发现异常。多变量分析显示，宫颈HR-HPV感染（比值比4，95%置信区间2.2-7.5）和肛交（比值比3.1，95%置信区间1.7-5.9）是肛门HR-HPV感染的独立危险因素。
因此，强烈建议对这些女性进行密切随访。
