Human papillomavirus(HPV) is one of the most common sexually transmitted infections worldwide. Exposure to HPV is very common,and an estimated 65%-100% of sexually active adults are exposed to HPV in their lifetime. T...Human papillomavirus(HPV) is one of the most common sexually transmitted infections worldwide. Exposure to HPV is very common,and an estimated 65%-100% of sexually active adults are exposed to HPV in their lifetime. The majority of HPV infections are asymptomatic,but there is a 10% chance that individuals will develop a persistent infection and have an increased risk of developing a carcinoma. The International Agency for Research on Cancer has found that the following cancer sites have a strong causal relationship with HPV: cervix uteri,penis,vulva,vagina,anus and oropharynx,including the base of the tongue and the tonsils. However,studies of the aetiological role of HPV in colorectal and esophageal malignancies have conflicting results. The aim of this review was to organize recent evidence and issues about the association between HPV infection and gastrointestinal tumours with a focus on esophageal,colorectal and anal cancers. The ultimate goal was to highlight possible implications for prognosis and prevention.展开更多
Anal cancers(AC)are relatively rare tumors.Their incidence is increasing,particularly among men who have sex with other men due to widespread infection by human papilloma virus.The majority of anal cancers are squamou...Anal cancers(AC)are relatively rare tumors.Their incidence is increasing,particularly among men who have sex with other men due to widespread infection by human papilloma virus.The majority of anal cancers are squamous cell carcinomas,and they are treated according to stage.In local and locally advanced AC,concomitant chemoradiation therapy based on mitomycin C and 5-Fluorouracil(5-FU)is the current best treatment,while metastatic AC,chemotherapy with 5-FU and cisplatin remains the gold standard.There are no indications for induction or maintenance therapies in locally advanced tumors.Many novel strategies,such as targeted therapies,vaccination,immunotherapy and photodynamic therapy are in clinical trials for the treatment of AC,with promising results in some indications.展开更多
This review focuses on the early diagnosis of anal cancerand its precursor lesions through routine screening. A number of risk-stratification strategies as well as screening techniques have been suggested, and current...This review focuses on the early diagnosis of anal cancerand its precursor lesions through routine screening. A number of risk-stratification strategies as well as screening techniques have been suggested, and currently little consensus exists among national societies. Much of the current clinical rationale for the prevention of anal cancer derives from the similar tumor biology of cervical cancer and the successful use of routine screening to identify cervical cancer and its precursors early in the disease process. It is thought that such a strategy of identifying early anal intraepithelial neoplasia will reduce the incidence of invasive anal cancer. The low prevalence of anal cancer in the general population prevents the use of routine screening. However, routine screening of selected populations has been shown to be a more promising strategy. Potential screening modalities include digital anorectal exam, anal Papanicolaou testing, human papilloma virus co-testing, and high-resolution anoscopy. Additional research associating high-grade dysplasia treatment with anal cancer prevention as well as direct comparisons of screening regimens is necessary to develop further anal cancer screening recommendations.展开更多
Anal cancer, especially squamous cell carcinoma (SCC) variety, is evolving with rising incidence globally. This is due to the increasing adoption of risky life styles and social habits even in populations with rare oc...Anal cancer, especially squamous cell carcinoma (SCC) variety, is evolving with rising incidence globally. This is due to the increasing adoption of risky life styles and social habits even in populations with rare occurrences previously. This case report aims to expose risk factors exhibited by a patient recently managed for anal cancer in our facility before his demise. Early exposure to bisexual orientation, receptive anal intercourse and multiple sexual partners, are notable high risk factors for the development of anal SCC. The permissive role of smoking, illicit drug and alcohol use enhances the disease occurrence. Acquisition of human immune-deficiency virus (HIV) sero-positive status further reduces the body’s immune competence and enhances early age of onset as well as accelerates development of anal SCC. Proper history exploring the risk factors, physical/anorectal examination and histological analysis, are vital for proper diagnosis and staging which guides appropriate treatment with chemo-radiation as mainstay.展开更多
The incidence of anal cancer in HIV-infected men who have sex with men (MSM) is increasing and screening is advo-cated. In a cross-sectional study anal cytology specimens from 58 HIV-infected MSM were analyzed for ade...The incidence of anal cancer in HIV-infected men who have sex with men (MSM) is increasing and screening is advo-cated. In a cross-sectional study anal cytology specimens from 58 HIV-infected MSM were analyzed for adequacy, cy-tology and HPV DNA testing results and compared to findings on anoscopy. The adequacy of cytology specimens was high. In 34 (63%) of anal swab samples any grade of dysplasia was observed compared to 41 (71%) of biopsy speci-mens. The cytology specimens revealed high-grade dysplasia in 4 (7%) compared to 29 (50%) of biopsy specimens. The prevalence of high-risk HPV types was 90% by using the SPF10 PCR and 81% by using the Hybrid Capture II assay. Because of the high HPV prevalence, HPV DNA testing alone is not a suitable diagnostic screening tool for detecting anogenital lesions in this specific MSM population. Screening should include both anal cytology and anoscopy.展开更多
目的探讨体质量指数(body mass index,BMI)对内括约肌切除术(intersphincteric resection,ISR)治疗直肠癌和肛管癌近期疗效的影响。方法回顾性分析2009年1月至2011年12月期间四川大学华西医院胃肠外科中心结直肠外科专业组收治的199例行...目的探讨体质量指数(body mass index,BMI)对内括约肌切除术(intersphincteric resection,ISR)治疗直肠癌和肛管癌近期疗效的影响。方法回顾性分析2009年1月至2011年12月期间四川大学华西医院胃肠外科中心结直肠外科专业组收治的199例行ISR术的直肠癌和肛管癌患者的临床资料,按BMI值将其分为消瘦组(n=23)、正常组(n=114)及超重组(n=62),比较3组患者的临床近期疗效。结果术后早期康复方面,3组患者的首次排气时间、首次排便时间、首次下床活动时间、首次经口进食时间及术后住院时间比较差异均无统计学意义(P>0.05)。管道管理方面,3组患者拔除引流管时间比较差异有统计学意义,正常组和超重组拔除引流管的时间较长(P<0.05),而拔除胃管和尿管时间的差异均无统计学意义(P>0.05)。3组患者术后并发症(包括吻合口漏、吻合口出血、肛周感染、肠梗阻、胃潴留、尿潴留、败血症、伤口感染及直肠阴道瘘)发生率比较差异均无统计学意义(P>0.05)。结论 BMI对ISR治疗直肠癌和肛管癌近期疗效的影响较小,肥胖不会提高术后并发症的发生率;在适当管理模式的配合下,也不会影响术后早期康复指标。展开更多
目的了解重庆市结直肠肛门癌疾病负担现状及特征,为开展结直肠肛门癌防治提供建议。方法收集分析2018年重庆市32个区县结直肠肛门癌个案资料(ICD-10:C18-C21),采用SPSS 25.0统计分析发病率、死亡率、标化发病率与标化死亡率、伤残调整...目的了解重庆市结直肠肛门癌疾病负担现状及特征,为开展结直肠肛门癌防治提供建议。方法收集分析2018年重庆市32个区县结直肠肛门癌个案资料(ICD-10:C18-C21),采用SPSS 25.0统计分析发病率、死亡率、标化发病率与标化死亡率、伤残调整寿命年(disability-adjusted life years,DALYs)、早死所致的寿命损失年(years of life lost,YLLs)、残疾所致寿命年损失(years lived with disability,YLDs)等指标。不同地区与性别间发病率、死亡率的比较采用χ^2检验。结果2018年重庆市结直肠肛门癌发病率与标化发病率分别为30.38/10万与19.17/10万,男性发病率(36.18/10万)高于女性(24.49/10万),差异有统计学意义(χ^2=17.32,P<0.001)。城市发病率(32.97/10万)高于农村(29.24/10万),差异有统计学意义(χ^2=5.09,P=0.024)。结直肠肛门癌死亡率与标化死亡率为13.84/10万与8.12/10万,死亡率男性(16.83/10万)高于女性(10.81/10万),差异有统计学意义(χ^2=13.22,P<0.001),城市与农村死亡率差异无统计学意义(χ^2=3.34,P=0.067)。结直肠肛门癌DALYs率为3.37人年/1000,其中YLLs率与YLDs率分别为3.01人年/1000与0.36人年/1000。结论重庆市结直肠肛门癌发病率与疾病负担高于全国平均水平,应重视结直肠肛门癌的防治,提高结直肠肛门癌的早诊早治水平。展开更多
文摘Human papillomavirus(HPV) is one of the most common sexually transmitted infections worldwide. Exposure to HPV is very common,and an estimated 65%-100% of sexually active adults are exposed to HPV in their lifetime. The majority of HPV infections are asymptomatic,but there is a 10% chance that individuals will develop a persistent infection and have an increased risk of developing a carcinoma. The International Agency for Research on Cancer has found that the following cancer sites have a strong causal relationship with HPV: cervix uteri,penis,vulva,vagina,anus and oropharynx,including the base of the tongue and the tonsils. However,studies of the aetiological role of HPV in colorectal and esophageal malignancies have conflicting results. The aim of this review was to organize recent evidence and issues about the association between HPV infection and gastrointestinal tumours with a focus on esophageal,colorectal and anal cancers. The ultimate goal was to highlight possible implications for prognosis and prevention.
文摘Anal cancers(AC)are relatively rare tumors.Their incidence is increasing,particularly among men who have sex with other men due to widespread infection by human papilloma virus.The majority of anal cancers are squamous cell carcinomas,and they are treated according to stage.In local and locally advanced AC,concomitant chemoradiation therapy based on mitomycin C and 5-Fluorouracil(5-FU)is the current best treatment,while metastatic AC,chemotherapy with 5-FU and cisplatin remains the gold standard.There are no indications for induction or maintenance therapies in locally advanced tumors.Many novel strategies,such as targeted therapies,vaccination,immunotherapy and photodynamic therapy are in clinical trials for the treatment of AC,with promising results in some indications.
文摘This review focuses on the early diagnosis of anal cancerand its precursor lesions through routine screening. A number of risk-stratification strategies as well as screening techniques have been suggested, and currently little consensus exists among national societies. Much of the current clinical rationale for the prevention of anal cancer derives from the similar tumor biology of cervical cancer and the successful use of routine screening to identify cervical cancer and its precursors early in the disease process. It is thought that such a strategy of identifying early anal intraepithelial neoplasia will reduce the incidence of invasive anal cancer. The low prevalence of anal cancer in the general population prevents the use of routine screening. However, routine screening of selected populations has been shown to be a more promising strategy. Potential screening modalities include digital anorectal exam, anal Papanicolaou testing, human papilloma virus co-testing, and high-resolution anoscopy. Additional research associating high-grade dysplasia treatment with anal cancer prevention as well as direct comparisons of screening regimens is necessary to develop further anal cancer screening recommendations.
文摘Anal cancer, especially squamous cell carcinoma (SCC) variety, is evolving with rising incidence globally. This is due to the increasing adoption of risky life styles and social habits even in populations with rare occurrences previously. This case report aims to expose risk factors exhibited by a patient recently managed for anal cancer in our facility before his demise. Early exposure to bisexual orientation, receptive anal intercourse and multiple sexual partners, are notable high risk factors for the development of anal SCC. The permissive role of smoking, illicit drug and alcohol use enhances the disease occurrence. Acquisition of human immune-deficiency virus (HIV) sero-positive status further reduces the body’s immune competence and enhances early age of onset as well as accelerates development of anal SCC. Proper history exploring the risk factors, physical/anorectal examination and histological analysis, are vital for proper diagnosis and staging which guides appropriate treatment with chemo-radiation as mainstay.
文摘The incidence of anal cancer in HIV-infected men who have sex with men (MSM) is increasing and screening is advo-cated. In a cross-sectional study anal cytology specimens from 58 HIV-infected MSM were analyzed for adequacy, cy-tology and HPV DNA testing results and compared to findings on anoscopy. The adequacy of cytology specimens was high. In 34 (63%) of anal swab samples any grade of dysplasia was observed compared to 41 (71%) of biopsy speci-mens. The cytology specimens revealed high-grade dysplasia in 4 (7%) compared to 29 (50%) of biopsy specimens. The prevalence of high-risk HPV types was 90% by using the SPF10 PCR and 81% by using the Hybrid Capture II assay. Because of the high HPV prevalence, HPV DNA testing alone is not a suitable diagnostic screening tool for detecting anogenital lesions in this specific MSM population. Screening should include both anal cytology and anoscopy.
文摘目的探讨体质量指数(body mass index,BMI)对内括约肌切除术(intersphincteric resection,ISR)治疗直肠癌和肛管癌近期疗效的影响。方法回顾性分析2009年1月至2011年12月期间四川大学华西医院胃肠外科中心结直肠外科专业组收治的199例行ISR术的直肠癌和肛管癌患者的临床资料,按BMI值将其分为消瘦组(n=23)、正常组(n=114)及超重组(n=62),比较3组患者的临床近期疗效。结果术后早期康复方面,3组患者的首次排气时间、首次排便时间、首次下床活动时间、首次经口进食时间及术后住院时间比较差异均无统计学意义(P>0.05)。管道管理方面,3组患者拔除引流管时间比较差异有统计学意义,正常组和超重组拔除引流管的时间较长(P<0.05),而拔除胃管和尿管时间的差异均无统计学意义(P>0.05)。3组患者术后并发症(包括吻合口漏、吻合口出血、肛周感染、肠梗阻、胃潴留、尿潴留、败血症、伤口感染及直肠阴道瘘)发生率比较差异均无统计学意义(P>0.05)。结论 BMI对ISR治疗直肠癌和肛管癌近期疗效的影响较小,肥胖不会提高术后并发症的发生率;在适当管理模式的配合下,也不会影响术后早期康复指标。
文摘目的了解重庆市结直肠肛门癌疾病负担现状及特征,为开展结直肠肛门癌防治提供建议。方法收集分析2018年重庆市32个区县结直肠肛门癌个案资料(ICD-10:C18-C21),采用SPSS 25.0统计分析发病率、死亡率、标化发病率与标化死亡率、伤残调整寿命年(disability-adjusted life years,DALYs)、早死所致的寿命损失年(years of life lost,YLLs)、残疾所致寿命年损失(years lived with disability,YLDs)等指标。不同地区与性别间发病率、死亡率的比较采用χ^2检验。结果2018年重庆市结直肠肛门癌发病率与标化发病率分别为30.38/10万与19.17/10万,男性发病率(36.18/10万)高于女性(24.49/10万),差异有统计学意义(χ^2=17.32,P<0.001)。城市发病率(32.97/10万)高于农村(29.24/10万),差异有统计学意义(χ^2=5.09,P=0.024)。结直肠肛门癌死亡率与标化死亡率为13.84/10万与8.12/10万,死亡率男性(16.83/10万)高于女性(10.81/10万),差异有统计学意义(χ^2=13.22,P<0.001),城市与农村死亡率差异无统计学意义(χ^2=3.34,P=0.067)。结直肠肛门癌DALYs率为3.37人年/1000,其中YLLs率与YLDs率分别为3.01人年/1000与0.36人年/1000。结论重庆市结直肠肛门癌发病率与疾病负担高于全国平均水平,应重视结直肠肛门癌的防治,提高结直肠肛门癌的早诊早治水平。
