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Anal neoplasia — Epidemiological considerations

Anale Neoplasie — epidemiologische Betrachtungen

  • Themenschwerpunkt: „Analkarzinom“
  • Published:
Acta Chirurgica Austriaca Aims and scope Submit manuscript

Abstract

Background: Squamous cell carcinoma (SCC) of the anus appears to be associated with human papilloma virus (HPV) infection.

Methods: Based on the literature epidemiological and biological evidence is reported, that corroborates the relation of anal SCC and presence of HPV.

Results: The embryologically similar endocervical and anal transitional zones are predisposed to the development of certain precancerous and malignant lesions, associated with HPV infection in a number of cases. There is a strong relation between sexually transmitted condylomata acuminata, anal cancer and HPV, type 16 and 18 in particular. The epidemiological observations have been increasingly supported by investigations with electron microscopy and DNA hybridisation. The diagnosis of ano-genital HPV infection is based on histology. Particular attention is to be directed to the direction of subclinical lesions by inspection of the epithelial surfaces under magnification after soaking the suspected areas with acetic acid.

Conclusions: There exist high risk groups for anal SCC linked with HPV infection: homosexual men; patients who are immunosuppressed, either for medical reasons or due to HIV infection. These groups of patients and the reliable detection of subclinical lesions will be the object of future research.

Zusammenfassung

Grundlagen: Das anale Plattenepithelkarzinom scheint mit einer Infektion durch humanes Papillomavirus (HPV) assoziiert zu sein.

Methodik: Aus der Literatur ergeben sich epidemiologische und biologische Hinweise auf die Beziehung zwischen Plattenepithelkarzinom des Anus und dem Auftreten von HPV.

Ergebnisse: Die empbryologisch ähnlichen Übergangszonen von Endozervix und Analkanal sind prädisponiert zur Entwicklung von gewissen präkanzerösen und malignen Läsionen, die in einer Zahl von Fällen mit einer HPV-Infektion vergesellschaftet sind. Es gibt eine deutliche Beziehung zwischen sexuell übertragenen Condylomata acuminata, Analkarzinom und HPV, insbesondere Typ 16 und 18. Die epidemiologischen Beobachtungen wurden zunehmend durch Untersuchungen mit Elektronenmikroskop und DNA-Hybridisierung bestätigt. Die Diagnose der anogenitalen HPV-Infektion wird histologisch gestellt. Besondere Aufmerksamkeit muß der Entdeckung subklinischer Läsionen gewidmet sein, durch Inspektion der Schleimhautoberflächen unter Vergrößerung und nach Behandlung der verdächtigen Areale mit Essigsäure.

Schlußfolgerungen: In Verbindung mit HPV-Infektion gibt es Risikogruppen für anales Plattenepithelkarzinom: homosexuelle Männer, Patienten mit Immunsuppression, aus medizinischen Gründen oder aufgrund einer HIV-Infektion. Gegenstand zukünftiger Forschung werden diese Patientengruppen und die verläßliche Entdeckung subklinischer Läsionen sein.

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  1. From the Department of Surgery, University Hospital, Queen’s Medical Centre, NG7 2UH, Nottingham, United Kingdom

    J. H. Scholefield

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Scholefield, J.H. Anal neoplasia — Epidemiological considerations. Acta Chir Austriaca 26, 352–357 (1994). https://doi.org/10.1007/BF02620034

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