Noh Sangkyu, Liu Franklin, Cheong Samuel H, Taleban Sasha
Internal Medicine, University of Arizona College of Medicine - Tucson, Tucson, AZ.
Gastroenterology and Hepatology, University of Arizona College of Medicine - Tucson, Tucson, AZ.
ACG Case Rep J. 2025 Jan 17;12(1):e01598. doi: 10.14309/crj.0000000000001598. eCollection 2025 Jan.
Rectal squamous metaplasia in inflammatory bowel disease is rare. We present 2 cases of rectal squamous metaplasia, one in a patient with Crohn's disease and another with ulcerative colitis. Given the risk of malignant transformation, dysplasia surveillance is important particularly in areas of chronic inflammation. Furthermore, human papilloma virus (HPV) is involved in the pathogenesis of anal squamous cell carcinoma (SCC), but no guidelines exist in the United States for HPV prophylaxis against anal SCC in inflammatory bowel disease. HPV vaccination should be considered in high-risk patients younger than 45 years for prevention of anal SCC, including those with rectal squamous metaplasia.
炎症性肠病中的直肠鳞状化生罕见。我们报告2例直肠鳞状化生病例，1例为克罗恩病患者，另1例为溃疡性结肠炎患者。鉴于存在恶变风险，异型增生监测很重要，尤其是在慢性炎症区域。此外，人乳头瘤病毒（HPV）参与肛管鳞状细胞癌（SCC）的发病机制，但美国尚无针对炎症性肠病患者预防肛管SCC进行HPV预防的指南。对于45岁以下的高危患者，包括那些有直肠鳞状化生的患者，应考虑接种HPV疫苗以预防肛管SCC。
