Sillman F H, Sentovich S, Shaffer D
Department of Obstetrics and Gynecology, Beth Israel-Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Ann Transplant. 1997;2(4):59-66.
Ano-genital neoplasia is about 20 x more common in renal transplant patients than the general population. Neoplasms in the immunosuppressed are more morbid and mortal because: patients are younger; tumors are more undifferentiated; they have more and larger foci; more sites are involved; neoplasms tend to persist, recur and progress; and there are more complications from treatments. Intraepithelial neoplasia engenders some morbidity. Invasion is rarer, but when it occurs, it is always morbid, and all too often mortal. Invasive ano-genital cancer is primarily preventable because the lower genital and anal tracts are accessible to inspection, cytologic screening, endoscopy and biopsy. Prime prevention is avoiding infection with the Human Papilloma Virus (HPV). Next best is detecting HPV/intraepithelial neoplasia early with frequent inspection, cytology and liberal biopsies; and then removing any condylomas or intraepithelial neoplasia that develop.
肛门生殖器肿瘤在肾移植患者中的发病率比普通人群高约20倍。免疫抑制患者的肿瘤更具致病性和致命性，原因如下：患者更年轻；肿瘤分化程度更低；病灶更多、更大；受累部位更多；肿瘤倾向于持续、复发和进展；治疗并发症更多。上皮内瘤变会引发一些发病率。侵袭较少见，但一旦发生，总是会致病，而且往往会致命。侵袭性肛门生殖器癌主要是可预防的，因为下生殖道和肛门易于进行检查、细胞学筛查、内镜检查和活检。一级预防是避免感染人乳头瘤病毒（HPV）。其次是通过频繁检查、细胞学检查和广泛活检早期检测HPV/上皮内瘤变；然后切除出现的任何尖锐湿疣或上皮内瘤变。
