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01-05-2008 | Gastrointestinal Oncology

High-Resolution Anoscopy in the Diagnosis of Anal Cancer Precursor Lesions in Renal Graft Recipients

Authors: Ivan Tramujas da Costa e Silva, MD, MSc, Luiz Carlos de Lima Ferreira, MD, PhD, Felicidad Santos Gimenez, MD, Ricardo Alexandre Gonçalves Guimarães, MD, MSc, Luciana Botinelly Fujimoto, MD, MSc, Celso Rômulo Barbosa Cabral, PhD, Renzo Venturim Mozzer, MD, Larissa de Souza Atala, MD

Published in: Annals of Surgical Oncology | Issue 5/2008

Abstract

Background

Renal graft recipients are one of the population groups known to be at high risk of developing anal cancer. This study investigated the presence of subclinical anal squamous intraepithelial lesions and the diagnostic ability of high-resolution anoscopy in detecting these lesions in renal graft recipients followed-up in Manaus.

Methods

In a cross-sectional study, 50 renal graft recipients were interviewed and submitted to high-resolution anoscopy with biopsies of acetowhite lesions or of the anal transition zone mucosa when acetowhitening was absent. Considering the histopathological reports of the examined anal specimens as the gold standard, the diagnostic validation and precision measures of high-resolution anoscopy were calculated as well as the prevalence of anal squamous intraepithelial lesions in the studied population.

Results

In 42 renal graft recipients with satisfactory histopathological readings, prevalence of anal squamous intraepithelial lesions or condyloma acuminatum (ASIL-ACU) was 23.81%. Sensitivity of high-resolution anoscopy was 100%; specificity, 65.63%; positive predictive value, 47.62%; negative predictive value, 100%; and kappa coefficient, 0.48.

Conclusions

With a prevalence of 23.81% of subclinical ASIL-ACU lesions, the studied renal graft recipients had all these lesions detected by high-resolution anoscopy, notwithstanding most anal transition zone acetowhitened biopsied areas did not reveal histopathological aspects of anal cancer precursor lesions or condyloma acuminatum. Therefore, greater experience with the diagnostic tool was felt necessary to enhance its positive predictive value, specificity and diagnostic precision.

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Title: High-Resolution Anoscopy in the Diagnosis of Anal Cancer Precursor Lesions in Renal Graft Recipients
Authors: Ivan Tramujas da Costa e Silva, MD, MSc
Luiz Carlos de Lima Ferreira, MD, PhD
Felicidad Santos Gimenez, MD
Ricardo Alexandre Gonçalves Guimarães, MD, MSc
Luciana Botinelly Fujimoto, MD, MSc
Celso Rômulo Barbosa Cabral, PhD
Renzo Venturim Mozzer, MD
Larissa de Souza Atala, MD
Publication date: 01-05-2008
Publisher: Springer-Verlag
Published in: Annals of Surgical Oncology / Issue 5/2008
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-007-9750-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

High-Resolution Anoscopy in the Diagnosis of Anal Cancer Precursor Lesions in Renal Graft Recipients

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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