Beck D E, Fazio V W
Department of Colorectal Surgery, Wilford Hall USAF Medical Center, Lakeland AFB, Tex. 78236.
South Med J. 1989 Apr;82(4):470-4. doi: 10.1097/00007611-198904000-00016.
Premalignant lesions of the anal margin include Bowen's disease (intraepithelial squamous cell carcinoma) and Paget's disease (intraepithelial adenocarcinoma). Our experience includes 11 patients with perianal Paget's disease and 37 patients with perianal Bowen's disease treated from 1957 to 1986. The patients with perianal Paget's disease were older, had a higher incidence of invasive cancer, and had a worse prognosis than those with perianal Bowen's disease. The characteristic appearance of these lesions and their failure to respond to conventional therapy should lead the clinician to obtain a biopsy, which readily establishes the diagnosis. Our experience confirms that adequate evaluation followed by wide local excision is the appropriate therapy. Close follow-up is recommended to identify recurrence of the perianal disease or development of other malignancies.
肛管边缘的癌前病变包括鲍温病（上皮内鳞状细胞癌）和佩吉特病（上皮内腺癌）。我们的经验包括1957年至1986年期间治疗的11例肛周佩吉特病患者和37例肛周鲍温病患者。肛周佩吉特病患者年龄较大，浸润性癌的发生率较高，预后比肛周鲍温病患者差。这些病变的特征性表现以及对传统治疗无反应，应促使临床医生进行活检，这很容易确立诊断。我们的经验证实，充分评估后进行广泛局部切除是合适的治疗方法。建议密切随访，以发现肛周疾病的复发或其他恶性肿瘤的发生。
