TY - JOUR
T1 - The value of a transformation zone component in anal cytology to detect HSIL
AU - Roberts, Jennifer M.
AU - Jin, Fengyi
AU - Thurloe, Julia K.
AU - Ekman, Deborah
AU - Adams, Marjorie K.
AU - McDonald, Ross L.
AU - Biro, Clare
AU - Poynten, I. Mary
AU - Grulich, Andrew E.
AU - Farnsworth, Annabelle
AU - The Study of the Prevention of Anal Cancer (SPANC) Study Team
AU - Acraman, Brian
AU - Adams, Marjorie K.
AU - Biro, Clare
AU - Carr, Andrew
AU - Carroll, Susan
AU - Cooper, David
AU - Cornall, Alyssa
AU - Crampton, Leonie
AU - Ekman, Deborah
AU - Fairley, Christopher
AU - Farnsworth, Annabelle
AU - Feeney, Lance
AU - Garcia, Marko
AU - Garland, Suzanne
AU - Gluyas, Russ
AU - Grulich, Andrew E.
AU - Hillman, Richard
AU - Howard, Kirsten
AU - Jin, Fengyi
AU - Law, Carmella
AU - Law, Matthew
AU - Machalek, Dorothy
AU - McCaffery, Kirsten
AU - McDonald, Ross L.
AU - McGrath, Patrick
AU - Mellor, Robert
AU - Pendlebury, Susan
AU - Petoumenos, Kathy
AU - Pezzopane, Piero
AU - Phillips, Samuel
AU - Mary Poynten, I.
AU - Prestage, Garrett
AU - Richards, Adele
AU - Roberts, Jennifer M.
AU - Seeds, Daniel
AU - Segelov, Eva
AU - Tabrizi, Sepehr
AU - Templeton, Dave
AU - Thurloe, Julia K.
AU - Tong, Winnie
AU - Varma, Rick
PY - 2016/8/1
Y1 - 2016/8/1
N2 - Background: In a cytology-based screening program intended to prevent anal cancer, the anal transformation zone (TZ) should be adequately sampled because it is the site most susceptible to the development of the cancer precursor, high-grade squamous intraepithelial lesion (HSIL). An adequate TZ component is defined as comprising at least 10 rectal columnar or squamous metaplastic cells. In the current study, the authors examined whether the presence of a TZ component in anal cytology correlated with the detection of histological HSIL. Methods: In a natural history study of anal human papillomavirus infection in homosexual men, all participants underwent liquid-based cytology and high-resolution anoscopy (HRA) with or without biopsy at each visit. True-negative cytology (negative cytology with non-HSIL biopsy or negative HRA), false-negative cytology (negative cytology with HSIL biopsy), and true-positive cytology (abnormal cytology with HSIL biopsy) were compared with regard to the presence or absence of a TZ component. Results: Of 617 participants, baseline results included 155 true-positive results, 191 true-negative results, and 31 false-negative results. The absence of an adequate TZ component was found to be significantly higher for false-negative (32.3%) than for either true-positive (11.0%; P =.0034) or true-negative (13.1%; P =.0089) results. Conclusions: Significantly more false-negative cases lacked a TZ component compared with either true-positive or true-negative cases. TZ cells may be an important indicator of sample quality for anal cytology because, unlike cervical sampling, the anal canal is not visualized during cytology sampling.
AB - Background: In a cytology-based screening program intended to prevent anal cancer, the anal transformation zone (TZ) should be adequately sampled because it is the site most susceptible to the development of the cancer precursor, high-grade squamous intraepithelial lesion (HSIL). An adequate TZ component is defined as comprising at least 10 rectal columnar or squamous metaplastic cells. In the current study, the authors examined whether the presence of a TZ component in anal cytology correlated with the detection of histological HSIL. Methods: In a natural history study of anal human papillomavirus infection in homosexual men, all participants underwent liquid-based cytology and high-resolution anoscopy (HRA) with or without biopsy at each visit. True-negative cytology (negative cytology with non-HSIL biopsy or negative HRA), false-negative cytology (negative cytology with HSIL biopsy), and true-positive cytology (abnormal cytology with HSIL biopsy) were compared with regard to the presence or absence of a TZ component. Results: Of 617 participants, baseline results included 155 true-positive results, 191 true-negative results, and 31 false-negative results. The absence of an adequate TZ component was found to be significantly higher for false-negative (32.3%) than for either true-positive (11.0%; P =.0034) or true-negative (13.1%; P =.0089) results. Conclusions: Significantly more false-negative cases lacked a TZ component compared with either true-positive or true-negative cases. TZ cells may be an important indicator of sample quality for anal cytology because, unlike cervical sampling, the anal canal is not visualized during cytology sampling.
KW - anal cytology
KW - high-grade squamous intraepithelial lesion (HSIL)
KW - human papillomavirus
KW - transformation zone
UR - http://www.scopus.com/inward/record.url?scp=84982135117&partnerID=8YFLogxK
U2 - 10.1002/cncy.21730
DO - 10.1002/cncy.21730
M3 - Article
C2 - 27176896
AN - SCOPUS:84982135117
SN - 1934-662X
VL - 124
SP - 596
EP - 601
JO - Cancer Cytopathology
JF - Cancer Cytopathology
IS - 8
ER -