Scholefield J H, Ogunbiyi O A, Smith J H, Rogers K, Sharp F
Department of Surgery, Northern General Hospital, Sheffield, UK.
Br J Surg. 1994 Aug;81(8):1238-40. doi: 10.1002/bjs.1800810855.
The natural history and malignant potential of anal intraepithelial neoplasia (AIN) remain uncertain, making management decisions about such lesions difficult. The management of 70 patients with AIN is described. The majority of lesions encountered were low grade (AIN I and II; 43 of 70) and required no treatment, but eight invasive anal cancers associated with high-grade AIN occurred over the 4-year study period. Three were a result of apparent progression of high-grade lesions; three more invasive lesions were found in areas of AIN III on histological examination. Surgical excision was used to treat 27 patients with AIN III. Treatment of extensive lesions involving the perianal and anal canal epithelium circumferentially in six patients involved excision of the whole of this epithelium and application of split skin grafts.
肛管上皮内瘤变（AIN）的自然病程及恶变潜能仍不明确，这使得针对此类病变的管理决策颇具难度。本文描述了70例AIN患者的管理情况。所遇到的大多数病变为低级别（AIN I和II；70例中有43例），无需治疗，但在4年的研究期内出现了8例与高级别AIN相关的浸润性肛管癌。其中3例是高级别病变明显进展的结果；在组织学检查中，在AIN III区域又发现了3例浸润性病变。手术切除用于治疗27例AIN III患者。6例累及肛周和肛管上皮全周的广泛性病变的治疗包括切除整个该上皮并应用中厚皮片移植。
