Lafferre Emilie, Abramowitz Laurent, Walker Francine, Benabderrhamanne Dalila, Laurain Anne, Duval Xavier, Tubach Florence
Polyclinique Reims-Bezannes, Bezannes, France.
Gastroenterology and Proctology Unit, Bichat University Hospital, Paris, France.
Ann Coloproctol. 2021 Aug;37(4):212-217. doi: 10.3393/ac.2020.06.11.1. Epub 2020 Jul 29.
Anal dysplasia is caused by chronic infection with the human papillomavirus and exposes to the risk of anal cancer. The aim of this study was to evaluate the distribution of dysplasia anal grade among patients operated on for multiple anal condylomas with no macroscopic differences.
This is a cross-sectional study of patients operated on for multiple anal condylomas including a mapping of dysplasia by performing systematically for each patient one biopsy on visible lesion from each of the 4 quadrants on anal margin and in anal canal. All biopsies were read independently by 2 different pathologists.
Among 72 patients, 60 were men and 48 were human immunodeficiency virus (HIV)-infected with a median age of 37.5 years. The proportion of high-grade squamous intraepithelial lesion (HSIL) was higher in the anal canal (41.7%) compared to the margin (20.8%) (P = 0.004). HSIL frequency did not differ according to the quadrant (anterior, posterior, right, and left) of the 2 areas. HSIL on anal canal was not associated with HSIL on anal margin and vice versa (P = 0.390). Neither age nor sex was associated to HSIL but HIV positivity increased the risk of HSIL on the anal margin (P = 0.010).
Anal dysplasia is heterogeneously distributed in the anal canal as well as between anal canal and anal margin. The diagnostic of the grade of dysplasia for a person should require multiple biopsies on the canal and anal margin.
肛管发育异常由人乳头瘤病毒慢性感染引起，存在肛管癌风险。本研究旨在评估在接受手术治疗的多发肛门湿疣患者中，肛管发育异常分级的分布情况，这些患者在宏观上并无差异。
这是一项针对接受多发肛门湿疣手术患者的横断面研究，通过对每位患者的肛门边缘和肛管的4个象限的可见病变系统地进行一次活检来绘制发育异常图谱。所有活检样本由2名不同的病理学家独立阅片。
72例患者中，60例为男性，48例感染了人类免疫缺陷病毒（HIV），中位年龄为37.5岁。与边缘（20.8%）相比，肛管高级别鳞状上皮内病变（HSIL）的比例更高（41.7%）（P = 0.004）。两个区域的HSIL频率在象限（前、后、右和左）方面无差异。肛管HSIL与肛门边缘HSIL无关，反之亦然（P = 0.390）。年龄和性别均与HSIL无关，但HIV阳性增加了肛门边缘HSIL的风险（P = 0.010）。
肛管发育异常在肛管内以及肛管与肛门边缘之间分布不均。对一个人的发育异常分级诊断应需要对肛管和肛门边缘进行多次活检。
