Comparison of nylon-flocked swab and Dacron swab cytology for anal HSIL detection in transgender women and gay, bisexual, and other men who have sex with men

Comparison of nylon-flocked swabs and cotton swabs in the detection of human papillomavirus infection in men

BACKGROUND

Human papillomavirus (HPV) is an oncogenic virus and the commonest sexually transmitted pathogen worldwide. Appropriate sampling is an important factor in infection management. This study aimed to compare the efficacy of cotton swabs (CS) and nylon-flocked swabs (NFS) in sampling for HPV-DNA PCR testing in male patients with genital warts.

METHODS

The study included men with genital warts who presented to the urology outpatient clinic of Antalya Medical Park Hospital. Before wart treatment, multisite sampling of the penis and genital area was performed separately with CS and NFS. The samples were analyzed for HPV-DNA using real-time PCR.

RESULTS

The study included 45 men with a mean age of 32.1 ± 8.6 years. At least one HPV type was detected in all 45 patients with NFS sampling and 44 patients with CS sampling (total HPV types detected: 106 and 84, respectively). NFS sampling detected 52 high-risk HPV types in 37 of the 45 patients, while CS sampling detected 37 high-risk types in 19 patients (p = 0.029). NFS sampling also detected a total of 54 low-risk HPV types in all 45 patients, versus 47 low-risk HPV types in 41 patients with CS sampling. Multiple HPV types were detected in 30 patients with NFS and 17 patients with CS (p = 0.001).

CONCLUSION

NFS were more effective than CS for HPV-DNA testing in men with genital warts. NFS were superior to CS in detecting multiple-type HPV infection and high-risk HPV types. The use of NFS should be recommended for HPV-DNA PCR testing in men.

A comprehensive review of anal cancer-with a special focus on anal cytology

The diagnosis of anal cancer is relatively uncommon, but its incidence has been steadily increasing in high-risk populations. In the 2001 Bethesda System for Reporting Cervical Cytology, anal cytology was introduced as a component. Since then, it has been recognized as a potential tool for screening anal cancer, often in conjunction with high-resolution anoscopy. There are notable similarities between anal cancer and cervical cancer, including the causative role of human papillomavirus. However, there are also significant differences, particularly in terms of disease prevalence. Anal cytology may be used as a primary screening test, and in the event of abnormalities, patients are subsequently directed for high-resolution anoscopy. However, the best approach for anal cancer screening is yet to be determined and uniformly implemented. This comprehensive review article provides an in-depth analysis of the epidemiology and incidence of anal precursor and malignant lesions. It explores the various methods of sample procurement, preparation, interpretation (including sensitivity and specificity), and reporting terminology in anal cytology. The article also addresses the significance of concurrent high-risk human papillomavirus screening in anal cytology and its role in screening programs. Furthermore, it discusses the follow-up, prevention, and subsequent management strategies for anal cancers. By synthesizing current knowledge in these areas, this review aims to provide a comprehensive understanding of anal cytology and its implications in the early detection, prevention, and management of anal neoplasia and cancer.

A systematic review and meta-analysis of cytology and HPV-related biomarkers for anal cancer screening among different risk groups

To inform optimal approaches for detecting anal precancers, we performed a systematic review and meta-analysis of the diagnostic accuracy of anal cancer screening tests in different populations with elevated risk for anal cancer. We conducted a literature search of studies evaluating tests for anal precancer and cancer (anal intraepithelial neoplasia grade 2 or worse, AIN2+) published between January 1, 1997 to September 30, 2021 in PubMed and Embase. Titles and abstracts were screened for inclusion and included articles underwent full-text review, data abstraction and quality assessment. We estimated the prevalence of AIN2+ and calculated summary estimates and 95% confidence intervals (CI) of test positivity, sensitivity and specificity and predictive values of various testing strategies, overall and among population subgroups. A total of 39 articles were included. The prevalence of AIN2+ was 20% (95% CI, 17-29%), and ranged from 22% in men who have sex with men (MSM) living with HIV to 13% in women and 12% in MSM without HIV. The sensitivity and specificity of cytology and HPV testing were 81% and 62% and 92% and 42%, respectively, and 93% and 33%, respectively for cytology and HPV co-testing. AIN2+ risks were similar among those testing positive for cytology, HPV, or co-testing. Limited data on other biomarkers (HPV E6/E7 mRNA and p16/Ki-67 dual stain), suggested higher specificity, but lower sensitivity compared with anal cytology and HPV. Our findings provide important evidence for the development of clinical guidelines using anal cytology and HPV testing for anal cancer screening.

Understanding and utilizing textile-based electrostatic flocking for biomedical applications

Electrostatic flocking immobilizes electrical charges to the surface of microfibers from a high voltage-connected electrode and utilizes Coulombic forces to propel microfibers toward an adhesive-coated substrate, leaving a forest of aligned fibers. This traditional textile engineering technique has been used to modify surfaces or to create standalone anisotropic structures. Notably, a small body of evidence validating the use of electrostatic flocking for biomedical applications has emerged over the past several years. Noting the growing interest in utilizing electrostatic flocking in biomedical research, we aim to provide an overview of electrostatic flocking, including the principle, setups, and general and biomedical considerations, and propose a variety of biomedical applications. We begin with an introduction to the development and general applications of electrostatic flocking. Additionally, we introduce and review some of the flocking physics and mathematical considerations. We then discuss how to select, synthesize, and tune the main components (flocking fibers, adhesives, substrates) of electrostatic flocking for biomedical applications. After reviewing the considerations necessary for applying flocking toward biomedical research, we introduce a variety of proposed use cases including bone and skin tissue engineering, wound healing and wound management, and specimen swabbing. Finally, we presented the industrial comments followed by conclusions and future directions. We hope this review article inspires a broad audience of biomedical, material, and physics researchers to apply electrostatic flocking technology to solve a variety of biomedical and materials science problems.

Cytology in Anal Cancer Screening: Practical Review for Clinicians

The incidence and mortality of anal squamous cell carcinoma (SCC) are expected to continue to increase in the next 20 years. High-risk groups for anal SCC, i.e., human immunodeficiency virus (HIV)-positive patients, men who have sex with men (MSM), women with previous genital neoplasia, and solid-organ transplant recipients, have been identified. HIV-positive MSM have the highest risk, and some societies have advocated for anal cancer screening to be done in this population. Screening for anal SCC follows the same principles as that for cervical cancer since there are similarities between the two types of cancers. Anal cytology has been recommended as an initial screening method for high-risk groups, e.g., HIV-positive MSM. Normally, the cytology is liquid based and collected blindly by a clinician using a Dacron swab and it is especially used for internal lesions detection. The sensitivity to predict anal high-grade squamous intraepithelial lesions is higher in immunosuppressed patients with a high burden of the disease. The report should include the classification, normally according to the Bethesda terminology and the sample adequacy, in a manner similar to that for cervical cytology. In cases involving unsatisfactory samples, it is important to repeat the procedure given the prevalence of anal squamous cytological abnormalities in follow-up cytology procedures. The absence of transformation zone cells in anal cytology seems to increase the risk of false-negative results.