RESUMO
BACKGROUND: Anal canal carcinoma is relevant because it commonly occurs in high-risk groups, and its incidence has been increasing. OBJECTIVE: This study evaluated the accuracy of anal cytology in the screening of precursor lesions of anal cancer, compared with histopathologic examination as the reference, in all subjects and in men who have sex with men, HIV-infected men and women, and men who have sex with men and HIV-infected subgroups. DATA SOURCES: The data included studies identified in the MEDLINE, Latin American and Caribbean Health Sciences, Cochrane Library, and Embase electronic databases, as well as in the grey literature. The search terms included anal cancer, anal dysplasia, anal intraepithelial neoplasia, screening, and anal cytology. STUDY SELECTION: After excluding studies with no histopathological data and those with duplicate and missing data, 34 primary studies were included. INTERVENTION: Cytology of anal smears was studied. MAIN OUTCOME MEASURES: Sensitivity, specificity, diagnostic OR, and area under the curve were measured. RESULTS: A total of 5093 patients were included. The pooled sensitivity of anal cytology was 85.0% (95% CI, 82.0%-87.0%) and pooled specificity was 43.2% (95% CI, 41.4%-45.1%) for the detection of anal intraepithelial neoplasia grade 2 or worse versus anal intraepithelial neoplasia grade 1 and normal when measuring all subjects. The accuracy of anal cytology was higher in the men who have sex with men and HIV-infected and men who have sex with men only subgroups. LIMITATIONS: This study was limited by its specificity. CONCLUSIONS: The study results support the hypothesis that cytology is a good test for the screening of anal cancer.
Assuntos
Canal Anal/patologia , Neoplasias do Ânus/diagnóstico , Neoplasias do Ânus/patologia , Lesões Pré-Cancerosas/diagnóstico , Lesões Pré-Cancerosas/patologia , Neoplasias do Ânus/etiologia , Citodiagnóstico , Feminino , Infecções por HIV/complicações , Homossexualidade Masculina , Humanos , Masculino , Lesões Pré-Cancerosas/etiologia , Fatores de Risco , Sensibilidade e EspecificidadeRESUMO
Information on autochthonous ticks and their hosts is scarce in South America, especially in Argentina. To contribute to tick knowledge in the region, 2094 ticks were collected from the vegetation, humans, domestic and wild animals at a host-and-tick rich area of northern Argentina during six field trips conducted in 1999 (January and August), 2000 (March and November), and 2001 (March and June). The ticks were identified as Amblyomma cajennense (Fabricius), Amblyomma coelebs Neumann, Amblyomma sp., Haemaphysalis juxtakochi Cooley, H. leporispalustris (Packard), Ixodes pararicinus Keirans & Clifford, I. loricatus Neumann, I. longiscutatum Boero and Ixodes sp. Small mammals were mainly parasitized by immature stages of Ixodes; humans and domestic animals, predominantly by Amblyomma spp., and birds, mainly by nymphs and larvae of Haemaphysalis spp.
Informações sobre carrapatos autóctones e seus hospedeiros são escassas na América do Sul, especialmente para a Argentina. Com o objetivo de contribuir para o conhecimento dos carrapatos na região, 2094 carrapatos foram coletados da vegetação, de humanos e de animais domésticos e selvagens numa área no norte da Argentina rica em carrapatos e hospedeiros, durante seis viagens de campo conduzidas em 1999 (janeiro e agosto), 2000 (março e novembro) e 2001 (março e junho). Os carrapatos foram identificados como Amblyomma cajennense (Fabricius), A. coelebs Neumann, Amblyomma sp., Haemaphysalis juxtakochi Cooley, H. leporispalustris (Packard), Ixodes pararicinus Keirans & Clifford, I. loricatus Neumann, I. longiscutatum Boero e Ixodes sp. Pequenos mamíferos foram principalmente parasitados por estágios imaturos de Ixodes; humanos e animais domésticos, predominantemente por Amblyomma spp., e pássaros, principalmente por ninfas e larvas de Haemaphysalis spp.
