Herat Asoka, Whitfeld Margot, Hillman Richard
Skin and Cancer Foundation, Darlinghurst, New South Wales, Australia.
Australas J Dermatol. 2007 Aug;48(3):143-53; quiz 154-5. doi: 10.1111/j.1440-0960.2007.00369.x.
Anal intraepithelial neoplasia is considered to be a precursor lesion of invasive anal cancer. It is now increasingly recognized in high-risk groups, such as men who have sex with men and HIV-infected patients. Human papillomaviruses are considered to be an important aetiological agent in both anal intraepithelial neoplasia and anal cancer. Dermatologists are likely to encounter these conditions among the differential diagnoses to be considered in high-risk patients presenting with perianal and anal lesions. Anal cancer rates are also increasing among the HIV-infected and HIV-non-infected population. The successful treatment of anal intraepithelial neoplasia may reduce the risk of subsequent development of anal cancer. However, current therapies for anal intraepithelial neoplasia may be associated with treatment-related morbidity and are not well validated. It is currently not proven that they reduce the likelihood of the development of anal cancer. Nevertheless, screening for anal intraepithelial neoplasia is being advocated for high-risk groups and may become standard dermatological care for these patients. In view of recent developments in the understanding of this condition, this article reviews the current understanding of anal intraepithelial neoplasia and its treatment from a dermatological perspective.
肛管上皮内瘤变被认为是浸润性肛管癌的前驱病变。目前在高危人群中越来越多地被认识到，比如男同性恋者和艾滋病毒感染患者。人乳头瘤病毒被认为是肛管上皮内瘤变和肛管癌的重要病因。皮肤科医生在对有肛周和肛管病变的高危患者进行鉴别诊断时，很可能会遇到这些病症。在艾滋病毒感染者和未感染艾滋病毒的人群中，肛管癌的发病率也在上升。成功治疗肛管上皮内瘤变可能会降低随后发生肛管癌的风险。然而，目前用于肛管上皮内瘤变的治疗方法可能与治疗相关的发病率有关，且未得到充分验证。目前尚未证实它们能降低肛管癌发生的可能性。尽管如此，仍提倡对高危人群进行肛管上皮内瘤变筛查，这可能会成为这些患者的标准皮肤科护理。鉴于对这种病症认识的最新进展，本文从皮肤科角度综述了目前对肛管上皮内瘤变及其治疗的认识。
