Anal Dysplasia Among Patients With Multiple Human Papillomavirus Anal Lesions: Mosaic or Homogeneity?

Emilie Lafferre; Laurent Abramowitz; Francine Walker; Dalila Benabderrhamanne; Anne Laurain; Xavier Duval; Florence Tubach

doi:10.3393/ac.2020.06.11.1

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저자정보: Emilie Lafferre (Polyclinique Reims-Bezannes Bezannes) Laurent Abramowitz (Gastroenterology and Proctology Unit Bichat University Hospital Paris) Francine Walker (Université Paris-Diderot Sorbonne Paris Cité Laboratoire d’Excellence Inflamex Faculté de Médecin) Dalila Benabderrhamanne (Gastroenterology and Proctology Unit Bichat University Hospital Paris) Anne Laurain (Gastroenterology and Proctology Unit Bichat University Hospital Paris) Xavier Duval (Center of Clinical Investigations Inserm CIC 1425 Bichat Hospital) Florence Tubach (Sorbonne Université Inserm Institut Pierre Louis d’Epidémiologie et de Santé Publique UMR 1136)

저널정보: 대한대장항문학회 Annals of Coloproctology Annals of Coloproctolgy Vol.37 No.4

발행연도: 2021.8

수록면: 212 - 217 (6page)

DOI: 10.3393/ac.2020.06.11.1

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Purpose: 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.Methods: 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.Results: 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).Conclusion: 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.

#Anus #Neoplasm #Papillomavirus infections

참고문헌 (25)

참고문헌 신청

Ferlay J / 2010 / Cancer incidence in five continents, vol. I to IX / IARC Scientific Publications

Piketty C / 2012 / Incidence of HIV-related anal cancer remains increased despite long-term combined antiretroviral treatment: results from the french hospital database on HIV / J Clin Oncol 30:4360~4366

Melbye M / 1991 / Aetiological parallel between anal cancer and cervical cancer / Lancet 338:657~659

Palefsky JM / 1998 / High incidence of anal high-grade squamous intra-epithelial lesions among HIV-positive and HIV-negative homosexual and bisexual men / AIDS 12:495~503

Abramowitz L / 2007 / Anal squamous intraepithelial lesions and condyloma in HIV-infected heterosexual men, homosexual men and women: prevalence and associated factors / AIDS 21:1457~1465

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