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Uruguayan Medical Journal

ISSN: 1688-0390

Vol.31 - Nº 2 - Jun. 2015

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HPV Rectal lesions, diagnosis with anal PAP and high resolution anoscopy with biopsies. First series in Uruguay

Rev Med Urug 2015; 31: 97-102
Full text (spanish) |  Full text (spanish) (New windows, pdf) | Abstract


Introduction: the incidence of anal cáncer has doubled in the last decades. The HPV is the cause for the most frequent sexually transmitted disease in the world, and causes 90% of anal cancers.

This is the first time a protocol for screening rectoanal neoplasias is followed in Uruguay, using PAPs and high resolution anoscopies with biopsies.

Objetives: to describe rectoanal lesions associated with HPV in a population of patients belonging to risk groups with anal PAP (citology) and biopsies with high resolution anoscopy with aceto-whitening. To compare the diagnostic yield of anal PAP with histology in high resolution anoscopy with aceto-whitening guided biopsy samples (golden standard).

Method: we conducted a statistical description of the population studied. We conducted the agreement test (Kappa coefficient). Internal validity coefficients were calculated (sensitivity and specificity). The Epi-Info version 3.5.1 statistics package was used to process the information.

Results: 60 patients were considered for the study, average age was 33 years old, 78% were female. The Kappa coefficient for agreement between histology and the cell classification with PAP was 0.403, IC 95% (0.17-0.63). PAPA sensitivity was 92%, specificity was 46%.

Conclusion: the sensitivity of anal PAP we have found suggests it could be considered as a screening technique for the diagnosis of these lesions. Its scarce specificity suggests the need for confirmation with high resolution anoscopy with aceto-whitening guided biopsy in the future in the cases when PAP cytology is positive.