Background: The incidence of anal cancer has increased over at least the past decade, with estimates of a continued increase in the coming years. Women are more commonly affected than men in the general population; separate high-risk populations have also been identified. While the pathophysiology of anal cancer is thought to be similar to its cervical counterpart, well-defined and standardized screening guidelines have not been established as is seen in cervical cancer prevention. Nonetheless, multiple screening modalities have been examined and are components of proposed institutional and societal screening programs. Summary: Anal cytology is one modality that is a mainstay of many suggested screening guidelines. Interpretation and reporting follow current criteria for cervical/vaginal cytology per the Bethesda System, with site-specific alterations and changes in adequacy criteria to better accommodate some of the confounding factors encountered in anal cytology. While there are some limitations, such as a tendency to underestimate the degree of dysplasia and variable interobserver concordance rates, anal cytology, especially liquid-based preparations, overall performs well in detecting anal abnormalities and acts as an adequate screening tool. Importantly, most anal squamous dysplasias and cancers are also associated with human papillomavirus (HPV) infection, raising the possibility of HPV testing or genotyping as a component of screening and/or follow-up. Studies have also shown the efficacy of HPV vaccination in preventing anal lesions. Digital anorectal exam as well as anoscopy, particularly high-resolution anoscopy, are also often components of screening and follow-up. Management guidelines such as those put forth by the American Society for Colposcopy and Cervical Pathology (ASCCP) for cervical cancer are also not established for anal cancer. However, studies such as the Anal Cancer HSIL Outcomes Research (ANCHOR) trial have made significant strides in demonstrating successes in follow-up and treatment of anal lesions, findings that are crucial for establishing prevention and management guidelines going forward.
Acta Cytologica

中文翻译：

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肛门细胞学综合回顾

背景：至少在过去十年中，肛门癌的发病率有所增加，预计未来几年还会继续增加。在一般人群中，女性比男性更容易受到影响；还确定了单独的高风险人群。虽然肛门癌的病理生理学被认为与其宫颈癌相似，但尚未像预防宫颈癌那样建立明确和标准化的筛查指南。尽管如此，已经检查了多种筛查方式，并且它们是拟议的机构和社会筛查计划的组成部分。概括：肛门细胞学是一种模式，是许多建议的筛查指南的支柱。解释和报告遵循 Bethesda 系统宫颈/阴道细胞学的现行标准，并针对特定部位进行了更改，并改变了充分性标准，以更好地适应肛门细胞学中遇到的一些混杂因素。虽然存在一些局限性，例如倾向于低估异型增生的程度和不同的观察者间一致性率，但肛门细胞学，尤其是基于液体的制剂，总体上在检测肛门异常方面表现良好，并作为一种适当的筛查工具。重要的是，大多数肛门鳞状细胞发育不良和癌症也与人乳头瘤病毒 (HPV) 感染有关，这提高了将 HPV 检测或基因分型作为筛查和/或随访组成部分的可能性。研究还显示了 HPV 疫苗接种在预防肛门病变方面的功效。肛门直肠指检和肛门镜检查，尤其是高分辨率肛门镜检查，通常也是筛查和随访的组成部分。美国阴道镜检查和宫颈病理学协会 (ASCCP) 针对宫颈癌提出的管理指南也未针对肛门癌制定。然而，肛门癌 HSIL 结果研究 (ANCHOR) 试验等研究在证明肛门病变的随访和治疗成功方面取得了重大进展，这些发现对于制定未来的预防和管理指南至关重要。也常常是筛查和随访的组成部分。美国阴道镜检查和宫颈病理学协会 (ASCCP) 针对宫颈癌提出的管理指南也未针对肛门癌制定。然而，肛门癌 HSIL 结果研究 (ANCHOR) 试验等研究在证明肛门病变的随访和治疗成功方面取得了重大进展，这些发现对于制定未来的预防和管理指南至关重要。也常常是筛查和随访的组成部分。美国阴道镜检查和宫颈病理学协会 (ASCCP) 针对宫颈癌提出的管理指南也未针对肛门癌制定。然而，肛门癌 HSIL 结果研究 (ANCHOR) 试验等研究在证明肛门病变的随访和治疗成功方面取得了重大进展，这些发现对于制定未来的预防和管理指南至关重要。
细胞学报