Annals of Surgical Oncology Sign the Guestbook
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
10.1245/s10434-007-9750-8
Annals of Surgical Oncology 15:1470-1475 (2008)
© 2008 Society of Surgical Oncology
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Google Scholar
Right arrow Articles by da Costa e Silva, I. T.
Right arrow Articles by de Souza Atala, L.
PubMed
Right arrow PubMed Citation
Right arrow Articles by da Costa e Silva, I. T.
Right arrow Articles by de Souza Atala, L.

Original Article

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

Ivan Tramujas da Costa e Silva, MD, MSc1, Luiz Carlos de Lima Ferreira, MD, PhD2, Felicidad Santos Gimenez, MD3, Ricardo Alexandre Gonçalves Guimarães, MD, MSc2, Luciana Botinelly Fujimoto, MD, MSc2, Celso Rômulo Barbosa Cabral, PhD4, Renzo Venturim Mozzer, MD5 and Larissa de Souza Atala, MD5

1 Department of Surgery, School of Medicine, Federal University of Amazonas, Rua Afonso Pena, 1053, Manaus, Amazonas 69020-160, Brazil
2 Department of Pathology and Forensic Medicine, School of Medicine, Federal University of Amazonas, Manaus, Amazonas 69020-160, Brazil
3 Getulio Vargas University Hospital, Federal University of Amazonas, Manaus, Amazonas 69020-160, Brazil
4 Department of Statistics, Federal University of Amazonas, Manaus, Amazonas 69020-160, Brazil
5 School of Medicine, Federal University of Amazonas, Manaus, Amazonas 69020-160, Brazil

Correspondence: Address correspondence and reprint requests to: Ivan Tramujas da Costa e Silva, MD, MSc; E-mail: itramujas{at}ufam.edu.br

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.

Key Words: Renal transplantation • Anus neoplasms • Early diagnosis • Colposcopy






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2008 by the Society of Surgical Oncology.