Uso de la anoscopia de alta resolución para la detección de displasia anal por papilomavirus en pacientes con enfermedad inflamatoria intestinal

Autores/as

DOI:

https://doi.org/10.22516/25007440.1048

Palabras clave:

Virus del papiloma humano, Enfermedad inflamatoria intestinal, Displasia anal, Cáncer anal, Anoscopia de alta resolución

Resumen

Introducción: el carcinoma anal de células escamosas es raro, pero su incidencia y mortalidad han ido en aumento globalmente. El 90% de los casos están relacionados con la infección por el virus del papiloma humano (VPH)(1,2) y los pacientes con enfermedad inflamatoria intestinal (EII) tienen un mayor riesgo de infección por este virus; se ha identificado una incidencia de 5,5 por 100.000 pacientes en el grupo de EII frente a 1,8 en el grupo sin EII(3).

Metodología: se realizó un estudio descriptivo de serie de casos en el que se incluyó a 21 pacientes con EII, sin síntomas perianales, entre enero y julio de 2022 en el Instituto de Coloproctología de Medellín, a quienes se les realizó citología anal, genotipificación del VPH y anoscopia de alta resolución, previa explicación y aceptación del procedimiento. Si se encontraban lesiones, se realizaba tratamiento ablativo.

Resultados: el 23% de esta cohorte tenía lesiones escamosas de bajo grado, mientras que el 14,2% presentaba lesiones de alto grado con cambios de displasia al momento de la anoscopia. El 90,4% tenían genotipificación positiva para VPH, de los cuales el 76,1% eran de alto grado.

Conclusiones: nuestro estudio sugiere que esta serie de pacientes con EII se comporta como un grupo de alto riesgo para desarrollar lesiones premalignas en asociación con el VPH. La anoscopia de alta resolución es un método rentable, indoloro y asequible que, en manos expertas, puede impactar el diagnóstico y manejo de lesiones premalignas y disminuir la incidencia de cáncer anal en pacientes con EII.

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Biografía del autor/a

Juan Ricardo Márquez Velásquez, Instituto de Coloproctología ICO

Coloproctólogo, Instituto de Coloproctología ICO. Medellín, Colombia.

Paola Stephany González Awique, Instituto de Coloproctología ICO

Cirujana general. Medellín, Colombia. 

Carlos Miranda, Instituto de Coloproctología ICO

Médico general. Medellín, Colombia.

Mario Muñoz Zuluaga, Instituto de Coloproctología ICO

Cirujano general. Medellín, Colombia.

Luis Francisco Miranda-Ruíz, Instituto de Coloproctología ICO

Coloproctólogo. Medellín, Colombia.

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Figura 1. Condilomas anales y perianales. Fuente: archivo de los autores

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Publicado

2023-12-19

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Márquez Velásquez, J. R., González Awique, P. S., Miranda Ruíz, C. A., Muñoz Zuluaga, M., & Miranda Ruíz, L. F. (2023). Uso de la anoscopia de alta resolución para la detección de displasia anal por papilomavirus en pacientes con enfermedad inflamatoria intestinal. Revista Colombiana De Gastroenterología, 38(4), 419–429. https://doi.org/10.22516/25007440.1048

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