Self-collected versus clinician-collected anal cytology specimens to diagnose anal intraepithelial neoplasia in HIV-positive men
Self-collected versus clinician-collected anal cytology specimens to diagnose anal intraepithelial neoplasia in HIV-positive men
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DOI：
10.1097/00126334-200408010-00004
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发表时间：
2004-08-01
影响因子：
3.6
通讯作者：
Palefsky, JM
中科院分区：
文献类型：
--
作者：
Cranston, RD;Darragh, TM;Palefsky, JM
背景：肛门上皮内瘤变（AIN）常见于男男性行为者（MSM），可通过肛门细胞学筛查诊断。方法：对加州大学旧金山分校AIN的一项队列研究中收集的102例MSM患者的肛门细胞学和组织病理学标本进行评估。给这些男性一个带有书面使用说明的细胞学自我收集试剂盒，并要求在诊所就诊1个月后收集样本。结果：91%的自行收集的肛门细胞学样本和99%的临床收集的肛门细胞学样本足以解释。肛门异常细胞学对自己采集标本的组织学检测AIN的敏感性为68%，对临床采集标本的敏感性为70%，对AIN 2和AIN 3的敏感性分别为71%和74%。细胞学结果在自行收集和临床收集的样本之间没有等级差异。在活检诊断为AIN 2或3的男男性行为者中，33%的自己收集的细胞学样本和39%的临床收集的细胞学样本是高级别的。hiv阳性男男性接触者中自行采集和临床采集的样本检测AIN 2或3的敏感性高于hiv阴性男男性接触者。结论：活检证实AIN的男男性接触者可以自行收集肛门细胞学样本，其敏感性与经验丰富的临床医生相当。这可能有助于筛选AIN。
Background: Anal intraepithelial neoplasia (AIN) is common in men who have sex with men (MSM) and may be diagnosed by anal cytology screening.Methods: One hundred two MSM with clinician-collected anal cytology and histopathology specimens were assessed from a cohort study of AIN at the University of California at San Francisco. The men were given a cytology self-collection kit with written instructions for use and requested to collect the sample I month after the clinic visit.Results: Ninety-one percent of self-collected and 99% of clinician-collected anal cytology samples were adequate for interpretation. The sensitivity of abnormal anal cytology to detect AIN by histology was 68% in self-collected samples and 70% in clinician-collected samples, and the sensitivity to detect AIN 2 or AIN 3 was 71% and 74%, respectively. Cytologic results did not differ by grade between self-collected and clinician-collected samples. Among MSM diagnosed with AIN 2 or 3 by biopsy, 33% of self-collected and 39% of clinician-collected cytology samples were high-grade. The sensitivity of both self-collected and clinician-collected samples to detect AIN 2 or 3 was higher among HIV-positive MSM than among HIV-negative MSM.Conclusions: MSM with biopsy-proven AIN can self-collect anal cytology samples with sensitivity comparable with that of experienced clinicians. This may facilitate screening for AIN.