Elorza Garazi, Saralegui Yolanda, Enríquez-Navascués Jose María, Placer Carlos, Velaz Leyre
Cirugía General y Digestiva, Hospital Universitario Donostia, España.
Rev Esp Enferm Dig. 2016 Jan;108(1):31-9.
Anal intraepitelial neoplasia (AIN) constitutes a major health problem in certain risk groups, such as patients with immunosuppression of varied origin, males who have sexual relations with other males, and females with a previous history of vaginal or cervical abnormalities in cytology. Its relationship with the human papillomavirus (HPV) infection has been well documented; however, many of the factors involved in the progression and regression of the viral infection to dysplasia and anal carcinoma are unknown. AIN can be diagnosed through cytology of the anal canal or biopsy guided by high-resolution anoscopy. However, the need for these techniques in high-risk groups remains controversial. Treatment depends on the risk factors and given the high morbidity and high recurrence rates the utility of the different local treatments is still a subject of debate. Surgical biopsy is justified only in the case of progression suggesting lesions. The role of the vaccination in high-risk patients as primary prevention has been debated by different groups. However, there is no general consensus on its use or on the need for screening this population.
肛管上皮内瘤变（AIN）在某些高危人群中是一个主要的健康问题，这些人群包括各种原因导致免疫抑制的患者、与其他男性有性关系的男性以及既往有阴道或宫颈细胞学异常病史的女性。其与人类乳头瘤病毒（HPV）感染的关系已有充分记载；然而，病毒感染进展为发育异常和肛管癌以及消退过程中涉及的许多因素尚不清楚。AIN可通过肛管细胞学检查或在高分辨率肛门镜引导下进行活检来诊断。然而，高危人群对这些技术的需求仍存在争议。治疗取决于风险因素，鉴于高发病率和高复发率，不同局部治疗方法的效用仍是一个争论的话题。仅在病变提示进展的情况下进行手术活检才合理。不同团体对高危患者接种疫苗作为一级预防的作用存在争议。然而，对于其使用或对该人群进行筛查的必要性尚未达成普遍共识。
