Mo1645 High-Resolution Microendoscopy (HRME) in the Detection of Anal Intraepithelial Neoplasia: Assessment of Accuracy and Interobserver Variability

      While anal cancer is a relatively rare malignancy, its incidence has been increasing at a rate of approximately 2% per year in both men and women. High-grade squamous intraepithelial lesions (HSIL) are the putative anal cancer precursors and immunocompromised patients are at particular risk. Early identification and treatment of HSIL using high-resolution anoscopy (HRA) has been postulated to prevent progression to invasive cancer. High-resolution microendoscopy (HRME)—a low cost device that allows for in vivo, subcellular imaging at 1000x magnification—has been demonstrated to have beneficial use in the detection of neoplastic epithelium. In this study, we investigated the accuracy and interobserver variability between experienced and novice endoscopists and anoscopists in detecting HSIL in HRME images of anal epithelium, thereby determining the feasibility and utility of HRME as an adjunct tool to standard HRA.
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