P521 Infection of the anal canal by human papillomavirus in Crohn’s disease
V. Guzela1, C. Sobrado Júnior1, S. Nadal2, C.R. Nadal2, L.L. Villa3, A.P. Gonçalves1, L.R. Boarini1, S.C. Nahas1, I. Cecconello1
1Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Gastroenterologia - Divisão de Coloproctologia, São Paulo, Brazil, 2Instituto de Infectologia Emílio Ribas, Departamento de Coloproctologia, São Paulo, Brazil, 3Faculdade de Medicina da Universidade de São Paulo, Laboratório de Inovação em Câncer do Centro de Investigação Translacional em Oncologia, São Paulo, Brazil
Background
Compare the frequency of subclinical papillomavirus (HPV) in the anal canal os Crohn′s disease (DC) patients to a control group by smear cytology and polymerase chain reaction (PCR) and hybridisation and to assess whether there is correlation with the presence of immunosuppression and anal manifestations of the disease, besides establishing the agreement between the two diagnostic methods used.
Methods
Two groups were selected, one with DC and others to be the control population. All the individuals were submitted to smear cytology (two brushes inserted in sequence in the anal canal) and a third one preserved for molecular analysis (PCR and hybridisation). The cytology was classified according to Bethesda criteria as normal, atypical squamous cells of undetermined significance (ASCUS), low-grade squamous intraepithelial lesion (LSIL), high-grade squamous intraepithelial lesion (HSIL). The molecular analysis was considered with HPV present or absent and types 16 and high-risk HPV group identified.
Results
During sixteen months, 104 patients underwent anal cytology collection for smear preparation and HPV molecular method detection. The control group consisted of 41 individuals and the DC of 63 patients (32 immunocompetent and 31 immunosuppressed). ASCUS and LSIL represented respectively 26.8% and 22.0% of the control patients and 28.6% and 39.7% of the Crohn′s patients, with no statistically significant difference between the groups. HPV was identified in 17.1% of patients in the control group and 27% of patients with CD by the molecular method, being predominantly high risk in both groups. In a subanalysis considering Crohn’s disease patients with and without immunosuppression and the control group, there was no statistical difference between the frequencies detected by PCR and hybridisation (
Conclusion
In this study, is possible to conclude that in the sample studied there was no difference between subclinical HPV anal infection between control patients and Crohn’s disease group evaluated by both cytology and hybridisation and immunosuppression and anal impairment did not influence these results either. Anal cytology and hybridisation did not show agreement represented by the Kappa coefficient in this population.