Pyper P C, Parks T G
Br J Surg. 1985 Sep;72(9):712-4. doi: 10.1002/bjs.1800720913.
A series of 89 cases of anal carcinoma presenting over a 20-year period is reviewed. The majority were epidermoid carcinomas, 57 arising in the anal canal and 13 at the anal margin. The remainder were melanomas and basal cell carcinomas, and these were not considered further. The main presenting symptoms of epidermoid anal carcinomas were bleeding and pain. Tumours arising in the anal canal were commoner in women whilst those at the margin were more frequent in men. The majority (51/70) had a clinical diagnosis of malignancy made but in 19 cases this was not considered initially. The necessity for routine early histological diagnosis is stressed. Treatment was mainly surgical, either abdominoperineal resection (37 canal, 2 margin) or wide excision (8 canal, 11 margin). The 5 year survival of patients with anal margin tumours was better than those with canal lesions (50 per cent compared with 36 per cent).
回顾了20年间出现的一系列89例肛管癌病例。大多数为表皮样癌，57例发生于肛管，13例发生于肛缘。其余为黑色素瘤和基底细胞癌，对此不再进一步考虑。表皮样肛管癌的主要症状为出血和疼痛。发生于肛管的肿瘤女性更为常见，而发生于肛缘的肿瘤男性更为常见。大多数（51/70）患者临床诊断为恶性肿瘤，但有19例最初未考虑此诊断。强调了常规早期组织学诊断的必要性。治疗主要为手术，包括腹会阴联合切除术（37例肛管癌、2例肛缘癌）或广泛切除术（8例肛管癌、11例肛缘癌）。肛缘肿瘤患者的5年生存率高于肛管病变患者（分别为50%和36%）。
