Análise da ocorrência de alterações citopatológicas no canal anal em mulheres com lúpus e lesões citopatológicas cervicais

Abstract

Anal cancer is rare and accounts for only approximately 0.5% of all malignancies, with squamous cell carcinoma being the most common histopathological type. It shares several characteristics with cervical cancer, the main one being HPV infection as a necessary factor for its development. Certain risk groups have a higher incidence of anal cancer, such as patients with HIV, a history of genital neoplasms, smoking habit, and diagnosis of autoimmune diseases or those using immunosuppressive medications. Patients with lupus are more likely to develop cervical cytopathological changes than the general population, but whether this is also applicable to anal canal remains unclear. This study evaluated the occurrence of anal cytopathological alterations in patients with lupus and cervical cytopathological alterations. This observational study was conducted at the Lupus Clinic of the Department of Rheumatology, HUPE/UERJ, where 1222 patients are routinely followed up. Other hospitals were encouraged to refer women who met the inclusion criteria for this research. Of the 239 SLE patients interviewed, 13 were referred for anal cytology sample collection. Three patients were referred from other services, increasing the sample size to 16, among these, 9 (56.25%) had anal cytopathological alterations, 5 (31.25%) undergone cytopathological examination without alterations, and 2 (12.5%) had no results, presenting insufficient cytology assessment for analysis. It was possible to observe an occurrence of 56,25% of anal cytopathological alterations in patients with lupus and cervical cytopathological alterations. Of the 9 patients who developed anal cytopathological alterations, two (22.22%) were ASCUS, three (33.33%) were ASC-H and four (44.44%) were LSIL. None had HSIL. New studies need to be encouraged for potential development of screening methods to be adopted for patients in the risk group once increased incidence of these changes has been confirmed, thereby preventing the progression of these lesions to invasive anal cancer.