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

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.