Pisano Luigi, Giachini Claudia, Turco Martina, Farini Jacopo, Caminati Filippo, Giani Iacopo, Elbetti Claudio, Bisanzi Simonetta, Cannistrà Stefania, Pompeo Giampaolo, Sani Cristina, Pimpinelli Nicola
Section of Dermatology, Health Sciences Department, University of Florence, 50121 Florence, Italy.
Regional Laboratory of Cancer Prevention, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), 50121 Florence, Italy.
J Clin Med. 2025 Mar 23;14(7):2186. doi: 10.3390/jcm14072186.
: Squamous cell carcinoma of the anus (SCCA) remains a relatively rare form of cancer linked to high-risk human papillomavirus (HR-HPV) infection; however, its incidence has been increasing globally. Anal cytology and HR-HPV testing can identify precursors, though standardized screening guidelines are still lacking. This study aimed to assess the correlation between high-resolution anoscopy (HRA) findings and primary screening results through PAP-HPV co-testing in high-risk patients. : A retrospective, single-center study was conducted collecting data from the joint multidisciplinary anal cancer clinic of Piero Palagi Hospital in Florence (Italy), between August 2019 and September 2022. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of anal cytology, HR-HPV testing, and PAP-HPV co-testing were assessed. : In 577 HRAs, histology revealed 31 AIN2+ lesions (5.4%) and 220 AIN1 lesions (38.1%), while 326 (56.5%) were negative. Cytology alone showed a sensitivity of 74.2% and specificity of 63.3% for AIN2+ lesions, while HR-HPV testing alone had a sensitivity of 96.8% and specificity of 38.1%. Co-testing demonstrated 100% sensitivity and a 100% NPV for AIN2+ lesions. Among men who have sex with men (MSM), no significant differences in outcomes were observed between HIV-positive and HIV-negative patients, likely reflecting similar high-risk behaviors and effective HIV treatments. : Co-testing with anal cytology and HR-HPV testing provides the most reliable screening for high-grade lesions (AIN2+), surpassing the reliability of individual methods. Tailored co-testing strategies are crucial for early detection and effective prevention in high-risk groups.
肛门鳞状细胞癌（SCCA）仍然是一种与高危型人乳头瘤病毒（HR-HPV）感染相关的相对罕见的癌症形式；然而，其全球发病率一直在上升。肛门细胞学检查和HR-HPV检测可以识别癌前病变，尽管仍缺乏标准化的筛查指南。本研究旨在评估高危患者通过PAP-HPV联合检测得出的高分辨率肛门镜检查（HRA）结果与初次筛查结果之间的相关性。：进行了一项回顾性单中心研究，收集了2019年8月至2022年9月期间意大利佛罗伦萨皮耶罗·帕拉吉医院联合多学科肛门癌诊所的数据。评估了肛门细胞学检查、HR-HPV检测和PAP-HPV联合检测的敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）和准确性。：在577例HRA中，组织学检查发现31例高级别上皮内瘤变（AIN2+）病变（5.4%）和220例低级别上皮内瘤变（AIN1）病变（38.1%），而326例（56.5%）为阴性。单独的细胞学检查对AIN2+病变的敏感性为74.2%，特异性为63.3%，而单独的HR-HPV检测的敏感性为96.8%，特异性为38.1%。联合检测对AIN2+病变的敏感性和NPV均为100%。在男男性行为者（MSM）中，HIV阳性和HIV阴性患者的结果没有显著差异，这可能反映了相似的高危行为和有效的HIV治疗。：肛门细胞学检查和HR-HPV检测联合检测为高级别病变（AIN2+）提供了最可靠的筛查，超过了单独方法的可靠性。量身定制的联合检测策略对于高危人群的早期检测和有效预防至关重要。
