肛门上皮内瘤变诊治中国专家共识  

Chinese expert consensus on diagnosis and treatment of anal intraepithelial neoplasia

作　　者：中国优生科学协会阴道镜和宫颈病理学分会 中华医学会妇科肿瘤学分会 中国妇幼健康研究会子宫颈癌防控研究专业委员会 中华预防医学会肿瘤预防与控制专业委员会 李燕云[2] 隋龙[2] 李静然[3] 魏丽惠[3] Chinese Society for Colposcopy and Cervical Pathology of China Healthy Birth Science Association;Chinese Society of Gynecologic oncology,Chinese Medical Association;Chinese Association for Maternal and Child Health Studies;Branch of Cancer Prevention and Control,Chinese Preventive Medicine Association

机构地区：[1]不详 [2]复旦大学附属妇产科医院 [3]北京大学人民医院

出　　处：《肿瘤综合治疗电子杂志》2023年第3期49-56,共8页Journal of Multidisciplinary Cancer Management(Electronic Version)

基　　金：国家重点研发计划(2021YFC2701202);国家自然科学基金面上项目(82272970);北京市卫生健康科技成果和适宜技术推广项目(BHTPP2022008);上海市自然科学基金面上项目(22ZR1408800);上海市科委医学创新研究专项(21Y11906500)。

摘　　要：肛门上皮内瘤变(anal intraepithelial neoplasia,AIN)是肛门鳞状细胞癌的癌前病变,二者在全球范围内发病率逐年增高。高分辨率肛门镜(high-resolution anoscopy,HRA)检查、肛门人乳头瘤病毒(human papilloma virus,HPV)检测等是其重要检查手段。与较为完善的宫颈癌筛查体系不同,全球范围内AIN相关研究及临床实践开展时间总体尚短,国内外对肛门癌前病变的诊治标准尚未统一。近年,国际专业机构相继推出HPV感染相关肛门生殖道病变诊治、HRA筛查等共识。然而,临床中对于AIN的诊断和治疗仍存在很多误区,对其诊治缺乏清晰的统一认知,导致大量漏诊误诊。本共识基于现有国外指南和中国国内现状,立足于现有循证医学证据,对AIN的命名、流行病学、病因、临床表现、诊断、治疗及随访管理等进行全面总结,以期进一步规范AIN诊治和综合管理,从而降低肛门癌的发生。Anal intraepithelial neoplasia(AIN)is a precancerous condition that precedes anal squamous cell carcinoma.Diagnosis often involves the use of high-resolution anoscopy(HRA)and anal human papilloma virus(HPV)examination.Unlike the well-established cervical cancer screening system,AIN research and clinical practice worldwide are relatively new,resulting in a lack of unified diagnostic and treatment standards for anal precancerous lesions.In recent years,international institutions have introduced consensus guidelines on the diagnosis and treatment of HPV-related anal diseases,including HRA screening.However,misconceptions regarding the diagnosis and treatment of AIN still persist in clinical practice,leading to a significant number of missed diagnoses and misdiagnoses.This evidence-based consensus,based on existing international guidelines and the current situation in China,aims to summarize the terminology,epidemiology,etiology,clinical manifestations,diagnosis,treatment,and follow-up management of AIN.The goal is to comprehensively standardize the management of AIN,ultimately reducing the incidence of anal cancer.

关 键 词：肛门上皮内瘤变 高分辨率肛门镜 肛门癌 人乳头瘤病毒 高危人群 

分 类 号：R735.38[医药卫生—肿瘤]