Aparicio-Duque R, Mittal K R, Chan W, Schinella R
Service of Anatomic Pathology, Hospital General Rio Carrión, Palencia, Spain.
Cancer. 1991 Dec 1;68(11):2422-5. doi: 10.1002/1097-0142(19911201)68:11<2422::aid-cncr2820681116>3.0.co;2-r.
Five cases of cloacogenic carcinoma were analyzed for microscopic human papilloma virus (HPV)-induced changes and with in situ hybridization technique for HPV types 6/11, 16/18 and 31/35/51. Four of the five cases showed epithelial foci of koilocytotic atypia. HPV type 16/18 was present in four of the five cases. The surface epithelium in two of the four cases with koilocytotic changes showed HPV type 16/18. HPV type 6/11 was seen in surface epithelium in one case in which invasive carcinoma showed HPV type 16/18. This double infection with double morphologic expression could mean that the same behavioral pattern (anal intercourse) may contribute to both anal condyloma and carcinoma and, although patients with condyloma are at risk for carcinoma, condyloma may not be the precursor lesion in all cases with coexistent condyloma and carcinoma. Because of the similarity between pathogenesis of anal and cervical carcinomas, a periodic cytologic screening of anal mucosa could be indicated in populations at risk: homosexual men, patients with condyloma, women having dysplasia or carcinoma of the uterine cervix, and patients with immunosuppressive disorders.
对5例泄殖腔源癌进行分析，观察微观层面人乳头瘤病毒（HPV）诱导的变化，并采用原位杂交技术检测HPV 6/11型、16/18型及31/35/51型。5例中有4例显示挖空细胞异型性的上皮病灶。5例中有4例存在HPV 16/18型。4例有挖空细胞变化的病例中，有2例的表面上皮显示为HPV 16/18型。1例浸润性癌显示为HPV 16/18型的病例中，其表面上皮可见HPV 6/11型。这种具有双重形态学表现的双重感染可能意味着，相同的行为模式（肛交）可能导致肛门尖锐湿疣和癌，并且，尽管尖锐湿疣患者有患癌风险，但在尖锐湿疣和癌并存的所有病例中，尖锐湿疣可能并非癌前病变。鉴于肛门癌和宫颈癌发病机制之间的相似性，对于高危人群：男同性恋者、尖锐湿疣患者、患有子宫颈发育异常或癌的女性以及免疫抑制性疾病患者，可能需要定期对肛门黏膜进行细胞学筛查。
