Analysis of the Prevalence of Anal Human Papillomavirus and Abnormal Cytology in High-Risk Women.

Objectives: Anal human papillomavirus (HPV) and abnormal anal cytology may precede anal intraepithelial neoplasia (AIN). Our aim is to analyse the association of anal HPV infection and abnormal cytology in women with high-grade cervical intraepithelial neoplasia (CIN2+). Methods: We carried out a prevalence study from April 2015 to March 2017 at La Paz hospital. Women diagnosed with histological CIN2+ were considered at high risk for developing anomalous anal results. Genotyping of HPV, anal cytology and high resolution anoscopy were performed. Results: Of 171 patients recruited, 53 cases (31%) were diagnosed as CIN2+: there were no statistically significant differences in the prevalence of anal HPV (OR 0.8); nor in abnormal cytology (OR 2.15, 95%CI 0.8-5.7). The prevalence of anal HPV in the immunocompromised patients was higher (OR 2.51, 95%CI 1-6.3, P<0.05). Cervical HPV increased the risk of anal HPV (OR 3.9, 95%CI 1.9-8.0, P<0.01). The average age of the women with altered anal cytology was 41.3 ±8.8 SD (P<0.05). Conclusions: CIN2+ of recent diagnosis does not appear to be an independent risk factor for the detection of anal HPV and abnormal cytology. Suffering immunosuppression, cervical HPV and women over 40 years old; irrespective of their cervical dysplasia, were associated with anomalous anal results. Keywords: HPV, anal cytology, cervical intraepithelial neoplasia. Data acquired: Cytologies in liquid medium: Thin PrepTM (Cytyc Corporation Boxborough, MA). HPV genotyping in automated viral DNA amplification test (method based on the polymerase chain reaction) Clart® Human Papillomavirus 2 (Genomica, Madrid). Population: New patients referred to the Unit of Cervical Pathology and Lower Genital Tract Value of the Data: The data could improve the evidence of anal HPV infection and altered anal cytology of the less-studied high-risk population: women with high-grade cervical dysplasia.研究目标：肛门人类乳头瘤病毒（human papillomavirus, HPV）感染与肛门细胞学异常可能先于肛门上皮内瘤变（anal intraepithelial neoplasia, AIN）发生。本研究旨在分析高级别宫颈上皮内瘤变（high-grade cervical intraepithelial neoplasia, CIN2+）女性人群中肛门HPV感染与肛门细胞学异常的关联。 研究方法：本研究为2015年4月至2017年3月于拉巴斯医院开展的现况研究。纳入经组织学确诊为CIN2+的女性作为肛门检查结果异常的高危人群。所有受试者均接受HPV基因分型、肛门细胞学检查及高分辨率肛门镜检查。 研究结果：本研究共纳入171例受试者，其中53例（31%）确诊为CIN2+；肛门HPV感染率未呈现统计学显著差异（比值比OR=0.8），肛门细胞学异常率亦无统计学意义（OR=2.15，95%置信区间CI：0.8~5.7）。免疫功能低下患者的肛门HPV感染率更高（OR=2.51，95%CI：1.0~6.3，P<0.05）。宫颈HPV感染可升高肛门HPV感染风险（OR=3.9，95%CI：1.9~8.0，P<0.01）。肛门细胞学异常受试者的平均年龄为41.3±8.8（标准差SD）岁（P<0.05）。 研究结论：近期确诊的CIN2+并非检测出肛门HPV感染与肛门细胞学异常的独立危险因素。存在免疫抑制状态、宫颈HPV感染以及年龄超过40岁的女性，无论其宫颈上皮内瘤变情况如何，均与肛门检查结果异常相关。 关键词：HPV、肛门细胞学、宫颈上皮内瘤变。 数据采集：液基细胞学标本采用Thin Prep™液基细胞学检测试剂盒（美国马萨诸塞州博斯博罗市Cytyc公司）。HPV基因分型采用基于聚合酶链反应的自动化病毒DNA扩增检测：Clart®人乳头瘤病毒2型检测试剂盒（西班牙马德里Genomica公司）。 研究人群：转诊至宫颈病理与下生殖道专科的初诊患者。 数据价值：本数据集可完善针对研究较少的高危人群——即伴高级别宫颈上皮内瘤变女性的肛门HPV感染与肛门细胞学异常相关证据。