Research Article

Anal cytology in immunocompetent patients with high-grade intraepithelial neoplasia (CIN II and CIN III)

Marcio Erik Franco Ribeiro*, Lyliana Coutinho Resende Barbosa and Taylor Brandão Schnaider

Published: 13 February, 2020 | Volume 3 - Issue 1 | Pages: 007-012

Introduction: Anal cancer is directly related to the presence of high-grade HPV. Immunocompromised patients have defined conducts, something which is not observed in immunocompetent patients.

Objective: To study the anal cytology of patients with high-grade intraepithelial neoplasia (CINII and III) in order to propose a protocol to be followed by the Oncology Gynaecology Service at the Samuel Libânio Clinical Hospital (HCSL).

Methods: Clinical, prospective, transversal and single-centered study. Sampling was by convenience within one year. A total of 150 patients were studied. Out of these, 76 were patients with high-grade cervical intraepithelial lesions diagnosed through histopathological examination of the uterine cervix (Study Group) and 74 without high-grade intraepithelial lesions and with cervical cytology negative for neoplasia (Control Group). The following variables were analyzed: age, sexarc, tobacco use, alcohol consumption, STD history (not HPV), menopause, Hormone Replacement Therapy, anal sex practice, parity, number of sexual partners and contraceptive use.

Results: There was no significant difference between the number of cases in altered anal cancer oncology in the study group, in comparison with the control group.

Conclusion: There were changes in the anal cytology of the study group and these should be evaluated due to the risk of dealing with pre-neoplastic anal lesion. Clinical Trials: NCT03241680.

Read Full Article HTML DOI: 10.29328/journal.cjog.1001041 Cite this Article Read Full Article PDF


Papillomaviridae; Anus neoplasms; Uterine cervical neoplasms; Cytodiagnosis


  1. Instituto Nacional de Câncer (INCA). Colo do útero. Disponível em: http://www2.inca.gov.br/wps/wcm/connect/tiposdecancer/site/home/colo_utero/definicao. Acesso em 06 mar. 2017.
  2. Wright J. Cervical intraepithelial neoplasia: treatment and follow-up. UptoDate; 2016. Disponível em.
  3. Palefsky JM, Cranston RD. Virology of human papillomavirus infections and the link to cancer. 2010.
  4. Feldman S, Crum CP. Cervical cancer screening tests: techniques for cervical cytology and human papillomavirus testing. 2017.
  5. Ryan DP, Mamon H. Treatment for potentially resectable exocrine pancreatic cancer. 2017.
  6. Palefsky JM, Cranston RD. Anal squamous intraepithelial lesions: diagnosis, screening, prevention, and treatment. 2017.
  7. Leeds IL, Fang SH. Anal cancer and intraepithelial neoplasia screening: a review. World J Gastrointest Surg. 2016; 8: 41–51. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/26843912
  8. Bosman FT, Carneiro F, Hruban RH, Theise ND. WHO classification of tumours of the digestive system. 4thed. Geneva: WHO; 2010.
  9. Palefsky JM, Giuliano AR, Goldstone S, Moreira Junior ED, Aranda C, et al. HPV vaccine against anal HPV infection and anal intraepithelial neoplasia. N Engl J Med. 2011; 365: 1576-1585. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/22029979
  10. Capobiango A, Silva Filho AL, Nunes TA. Diagnóstico de HPV anal em mulheres com NIC: prevenção de câncer do ânus? Rev Bras Coloproctol. 2009; 29: 443-450.
  11. Heráclio SA, Araujo TA, Souza ASR, Cahen K, Lima Junior SF, et al. Prevalência da lesão HVP induzida em canal anal de mulheres com neoplasia intraepitelial cervical 2 e 3: um estudo de corte transversal. Rev Bras Ginecol Obstet. 2015; 37: 480-485.
  12. Giraldo P, Jacyntho C, Costa C, Iglesias M, Gondim C, et al. Prevalence of anal squamous intra-epithelial lesion in women presenting genital squamous intra-epithelial lesion. Eur J Obstet Gynecol Reprod Biol. 2009; 142: 73-75. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/19019529
  13. Park IU, Ogilvie JW, Anderson KE, LI Z, Darrah L, et al. Anal human papillomavirus infection and abnormal anal cytology in women with genital neoplasia. Gynecol Oncol. 2009; 114: 399-403. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/19501896
  14. Koppe DC, Bandeira CB, Rosa MR, Cambruzzi E, Meurer L, et al. Prevalence of anal intraepithelial neoplasia in women with genital neoplasia. Dis Colon Tectum. 2011; 54: 442-445. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/20733438
  15. Vasconcelos Filho FE, Eleutério Junio J, Dias BHM, Siulva AMHP, Andrade ACR. Is screening of or anal squamous intraepithelial lesions in women with genital human papillomavirus intraepithelial lesions necessary? DST – J Bras Doenças Sex Transm. 2013; 25: 145-149.
  16. Dermen KH, Thomas SN. Randomized controlled trial of brief interventions to reduce college students’ drinking and risk sex. Psychol Addict Behav. 2011; 25: 583-594. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/21928866
  17. Roura E, Castellsagué X, Pawlita M, Travier N, Waterboer T, et al. Smoking as a major risk factor for cervical cancer and pre-cancer: results from EPIC cohort. Int J Cancer. 2014; 135: 453-466. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/24338632
  18. Bezerra SSJ, Gonçalves PC, Franco ES, Pinheiro AKB. Perfil de mulheres portadoras de lesões cervicais por HPV quanto aos fatores de risco para câncer de colo uterino. DST – J Bras Doenças Sex Trams. 2005; 17: 143-148.
  19. Carvalho MCMP, Paula CL, Queiroz ABA. Lesões precursosras do câncer cervicouterino associado ao tabagismo: um estudo sobre o conhecimento entre as mulheres que fumam. Revista Brasileira de Cancerologia. 2011; 57: 387-394.
  20. Fonseca FV, Tomasich FDS, Jung JE. Neoplasa intraepitelial cervical: da etiopatogenia ao desempenho da tecnologia no rastreio e no seguimento. DST – J Bras Doenças Sex Transm. 2012; 24: 53-61.
  21. Fritsch H, Aigner F, Ludwikowski B, Reinstadler-Zankl S, Illig R, et al. Epithelial and muscular regionalization of the human developing anorectum. Anat Rec (Hoboken). 2007; 290: 1449-1458. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/17853405
  22. Jacyntho C. HPV X Hormônios: especulações sobre o vírus gerar duas doenças. 2004.

Similar Articles

Recently Viewed

Read More

Most Viewed

Read More