Rider Paul, Hunter John, Grimm Leander
Department of Surgery, Division of Colon and Rectal Surgery, University of South Alabama, 2451 USA Medical Center Drive, Mastin Building, Suite 702, Mobile, AL, 36617, USA.
Curr Gastroenterol Rep. 2018 Jul 5;20(8):38. doi: 10.1007/s11894-018-0640-y.
No single modality of care serves as the defined best practice for the treatment of anal intraepithelial neoplasia (AIN). This review aims to present the common treatment modalities germane to AIN while considering evolving evidence.
AIN affords an opportunity to evaluate and treat patients before the development of invasive diseases. Efforts to screen for AIN have yielded mixed results. The major available pharmacotheraputic and surgical options offer efficacious options to reduce the bioburden of disease but can be met with high levels of recurrent disease. None affords a predictably durable response in severe disease. Vaccination as primary prevention will likely reduce the overall upward trend in AIN. Evidence suggests vaccination also affords improvement in recurrent disease. Early evidence reveals potential benefit in multimodal approaches to control AIN. Valuable data is anticipated from the phase III, randomized ANCHOR study evaluating the management of high-grade AIN in HIV +patients.
对于肛管上皮内瘤变（AIN）的治疗，没有单一的护理模式可被定义为最佳实践。本综述旨在介绍与AIN相关的常见治疗模式，并考虑不断发展的证据。
AIN为在侵袭性疾病发生之前评估和治疗患者提供了机会。筛查AIN的努力取得了喜忧参半的结果。主要的药物治疗和手术选择为减轻疾病生物负荷提供了有效的选择，但可能会出现高复发率。在严重疾病中，没有一种方法能提供可预测的持久反应。作为一级预防的疫苗接种可能会降低AIN总体上升趋势。有证据表明，疫苗接种也能改善复发性疾病。早期证据显示，多模式方法控制AIN有潜在益处。期待来自评估HIV阳性患者高级别AIN管理的III期随机ANCHOR研究的有价值数据。
