Anal intraepitelial neoplasia (AIN) constitutes a major health problem in certain risk groups, such as patients with immunosuppression of varied origin, males who have sexual relations with other males, and females with a previous history of vaginal or cervical abnormalities in cytology. Its relationship with the human papillomavirus (HPV) infection has been well documented; however, many of the factors involved in the progression and regression of the viral infection to dysplasia and anal carcinoma are unknown. AIN can be diagnosed through cytology of the anal canal or biopsy guided by high-resolution anoscopy. However, the need for these techniques in high-risk groups remains controversial. Treatment depends on the risk factors and given the high morbidity and high recurrence rates the utility of the different local treatments is still a subject of debate. Surgical biopsy is justified only in the case of progression suggesting lesions. The role of the vaccination in high-risk patients as primary prevention has been debated by different groups. However, there is no general consensus on its use or on the need for screening this population.

译文

:在某些风险人群中,肛门上皮内瘤变(AIN)构成了主要的健康问题,例如,具有不同血统的免疫抑制的患者,与其他男性发生性关系的男性,以及在细胞学上曾有阴道或宫颈异常病史的女性。它与人乳头瘤病毒(HPV)感染的关系已有很好的文献证明。但是,涉及病毒感染发展和消退,发育不良和肛门癌的许多因素尚不清楚。可以通过肛管细胞学检查或高分辨率肛门镜检查活检来诊断AIN。但是,在高风险人群中对这些技术的需求仍然存在争议。治疗取决于风险因素,并且鉴于高发病率和高复发率,使用不同的局部治疗仍然是一个争论的话题。仅在提示病灶进展的情况下才需要进行手术活检。不同人群对疫苗接种在高危患者中作为一级预防的作用进行了辩论。但是,关于其用途或筛查该人群的需求尚无普遍共识。

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