Lyons Keegan M, Butler Samantha L
Department of Pathology and Laboratory Services, San Antonio Military Medical Center, Ft. Sam Houston, Texas.
Clin Colon Rectal Surg. 2018 Nov;31(6):328-335. doi: 10.1055/s-0038-1668102. Epub 2018 Nov 2.
Anal squamous cell carcinoma is a relatively rare diagnosis, but its incidence has continued to rise. Anal squamous cell carcinoma and its precursor lesion, anal intraepithelial neoplasia (AIN), are human papillomavirus (HPV)-associated squamous neoplasias. High-risk HPV subtypes cause cellular proliferation in the anal transformation zone mucosa leading to similar dysplastic changes as seen in the cervix. Unified cytologic and histologic classification systems have emerged for all HPV-associated squamous lesions of the lower anogenital tract due to recent advancements in the understanding of these lesions. P16 immunohistochemical stain, a biomarker for HPV, is recommended in the diagnosis of HPV-associated lesions. The unity of terminology will aid in communication between pathologists and clinicians, ultimately leading to improved patient care.
肛管鳞状细胞癌是一种相对罕见的诊断，但它的发病率持续上升。肛管鳞状细胞癌及其前驱病变，即肛管上皮内瘤变（AIN），是与人乳头瘤病毒（HPV）相关的鳞状上皮肿瘤。高危HPV亚型导致肛管转化区黏膜细胞增殖，进而产生与宫颈所见类似的发育异常变化。由于对这些病变的认识取得了最新进展，针对下肛管生殖道所有HPV相关鳞状病变，已经出现了统一的细胞学和组织学分类系统。P16免疫组化染色作为HPV的生物标志物，在HPV相关病变的诊断中受到推荐。术语的统一将有助于病理学家和临床医生之间的沟通，最终改善患者护理。
