Read T R H, Huson K L, Millar J L, Haydon A, Porter I W T, Grulich A E, Hocking J S, Chen M Y, Bradshaw C S, Fairley C K
Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia.
Int J STD AIDS. 2013 Nov;24(11):879-82. doi: 10.1177/0956462413486776. Epub 2013 Jul 15.
Anal squamous cell carcinoma is more common in HIV-positive homosexual men than in the general population and prognosis worsens with increasing tumour size. To identify opportunities for earlier diagnosis, we aimed to determine size and visibility of anal squamous cell carcinoma at diagnosis. We conducted a retrospective review of medical records between 1992 and 2010 from one hospital radiotherapy centre, a major centre for HIV care, in Melbourne, Australia. Of 128 cases of anal squamous cell carcinoma, 24 (19%) were in HIV-positive men. At diagnosis, half (52%) of the tumours were externally visible and mean estimated tumour size was 36 mm (29 mm in HIV-positive and 38 mm in HIV-negative patients; p = 0.04) and 114/121 (94%) tumours were 1 cm or larger. The most frequent symptoms were bleeding (43%) and pain (36%) and mean duration of symptoms was 22 weeks. This suggests most anal squamous cell carcinoma were visible or palpable for some time before diagnosis, meaning that screening high-risk groups by anal inspection and palpation is plausible.
肛门鳞状细胞癌在HIV阳性的同性恋男性中比在普通人群中更常见，并且预后随着肿瘤大小的增加而恶化。为了确定早期诊断的机会，我们旨在确定肛门鳞状细胞癌在诊断时的大小和可见性。我们对澳大利亚墨尔本一家医院放疗中心（一个主要的HIV护理中心）1992年至2010年的病历进行了回顾性研究。在128例肛门鳞状细胞癌病例中，24例（19%）为HIV阳性男性。在诊断时，一半（52%）的肿瘤在体外可见，估计肿瘤平均大小为36毫米（HIV阳性患者为29毫米，HIV阴性患者为38毫米；p = 0.04），121例中有114例（94%）肿瘤直径为1厘米或更大。最常见的症状是出血（43%）和疼痛（36%），症状平均持续时间为22周。这表明大多数肛门鳞状细胞癌在诊断前一段时间内是可见或可触及的，这意味着通过肛门检查和触诊对高危人群进行筛查是可行的。
