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Open AccessArticle10.1016/j.pvr.2015.06.004

Colposcopic characteristics and Lugol׳s staining differentiate anal high-grade and low-grade squamous intraepithelial lesions during high resolution anoscopy

Naomi Jay,J. Michael Berry,Christine Miaskowski,M B Cohen,Elizabeth A. Holly,Teresa M. Darragh+1 more-2015-07-05-Papillomavirus Research
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TL;DRAbstract

Anal squamous intraepithelial lesions (SIL) and cancers are increased in immunocompromised populations. Based upon anatomic and histologic similarities, the cervix is used as the model for anal screening. During cervical colposcopy, acetic acid (AA) and Lugol׳s staining (LS) result in characteristic changes that help distinguish low-grade (L)SIL from high-grade (H)SIL. Lesion characteristics were evaluated for their ability to distinguish anal (a)LSIL from anal (a)HSIL during high-resolution anoscopy after application of AA and LS. AA-stained lesions were described using standard cervical colposcopic criteria. LS was then applied and lesions were characterized as Lugol׳s-negative (L−), Lugol׳s-partial (L+/−), or Lugol׳s positive (L+) and then biopsied. Biopsies were characterized as benign, squamous atypia, LSIL or HSIL. 835 anal lesions were analyzed. Sensitivity and positive predictive value (PPV) for aHSIL were highest for characteristics associated with cervical (c)HSIL. L− was ind

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Anal squamous intraepithelial lesions (SIL) and cancers are increased in immunocompromised populations. Based upon anatomic and histologic similarities, the cervix is used as the model for anal screening. During cervical colposcopy, acetic acid (AA) and Lugol׳s staining (LS) result in characteristic changes that help distinguish low-grade (L)SIL from high-grade (H)SIL. Lesion characteristics were evaluated for their ability to distinguish anal (a)LSIL from anal (a)HSIL during high-resolution anoscopy after application of AA and LS. AA-stained lesions were described using standard cervical colposcopic criteria. LS was then applied and lesions were characterized as Lugol׳s-negative (L−), Lugol׳s-partial (L+/−), or Lugol׳s positive (L+) and then biopsied. Biopsies were characterized as benign, squamous atypia, LSIL or HSIL. 835 anal lesions were analyzed. Sensitivity and positive predictive value (PPV) for aHSIL were highest for characteristics associated with cervical (c)HSIL. L− was ind

Keywords

MedicineColposcopySquamous intraepithelial lesionCervixStainingCervical intraepithelial neoplasiaLesionAtypia

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