Xu Jian, Zhou Haiyang
a Department of Surgery , Shanghai Baoshan District Combining Traditional Chinese and Western Medicine Hospital , No. 181, Youyi Road, Shanghai , China.
b Division of Colorectal Surgery, Changzheng Hospital , Second Military Medical University , No. 415, Fengyang Road, Shanghai , China.
J Invest Surg. 2019 Jan;32(1):93-94. doi: 10.1080/08941939.2017.1369608. Epub 2017 Sep 27.
Anal cancer is biological similar to cervical cancer, and is preceded by anal intraepithelial neoplasia (AIN). Screening for AIN and treatments to reduce the risk of anal cancer are not established as guidelines of care for HIV-infected patients. It is mainly because screening and treating of AIN is not yet proven to reduce the incidence of anal cancer. The present study preliminarily demonstrated that a successful screening program in preventing squamous cell anal cancer in HIV positive patients. The authors achieved their purpose of controlling the evolution of all abnormalities identified during the anal cancer screening, preventing AIN to progress towards anal cancer, and reversing any form of AIN by surgery, ablation or medical therapy. Randomized controlled multi-center trials with a large sample size should be carried out to validate the study results. It is wise for the physicians to actively screen and treat AIN in HIV-infected patients whenever possible unless the results of randomized controlled study demonstrate that doing so is inappropriate.
肛管癌在生物学上与宫颈癌相似，且肛管上皮内瘤变（AIN）是其前驱病变。对AIN进行筛查以及采取降低肛管癌风险的治疗方法，尚未被确立为HIV感染患者的护理指南。这主要是因为对AIN进行筛查和治疗尚未被证明能降低肛管癌的发病率。本研究初步证明了一个成功的筛查项目可预防HIV阳性患者的鳞状细胞肛管癌。作者实现了控制肛管癌筛查期间发现的所有异常病变的进展、防止AIN进展为肛管癌以及通过手术、消融或药物治疗逆转任何形式的AIN的目标。应开展大样本量的随机对照多中心试验以验证研究结果。只要随机对照研究结果未表明这样做不合适，医生尽可能积极筛查和治疗HIV感染患者的AIN是明智的。
