Letter to the Editor referring to the letter by D'Hauwers KWM and Tjalma WAA on the study by Valari O et al. 2011 titled 'Human papillomavirus DNA and mRNA positivity of the anal canal in women with lower genital tract HPV lesions: Predictors and clinical implications'

摘要

To the Editor:We would like to thank Drs D'Hauwers and Tjalma for their interest in our study published in Gynecologic Oncology in 2011. They request clarifications on the rates of inadequate samples, the reported rates of anal intercourse and the number of women that attended a second anal smear. The following are our responses to their queries as stated in their Letter to the Editor.Certainly obtaining an adequate anal sample is more difficult than obtaining a cervical one. In our study we used an endocervical brush with a rounded tip as we believed that it would be well tolerated by the women while providing a good specimen. In the first months we had a frustratingly high unsatisfactory smear rate. We then started to be more meticulous with the sampling by rotating the brush for 30 s at least, occasionally angling the axis of the brush to the axis of the woman and took great care to transfer as many of the cells as possible to the vial with the help of a second brush. It should be kept in mind that having a satisfactory smear for molecular marker analysis is different from having a satisfactory smear for morphological cytology analysis. In our study we have not reported yet the cytological results, but we have seen samples which were adequate for HPV mRNA testing but inadequate for morphological cytology.