Practice Parameters for Anal Squamous Neoplasms

PURPOSE:To investigate the differences in Langerhans cells (LCs) populations between HIV-positive and negative anal squamous cell carcinomas patients. METHODS:Twenty five patients (14 HIV-positive and 11 HIV-negative) were evaluated. Paraffin-block transversal thin sections from biopsies of anal squamous cell carcinomas (ASCC) were stained using the anti-CD1A antibody that identifies activated LCs. LCs counts were performed using histometry at 20 different sites, at baseline in the ASCC cases. These were then compared with LCs counts in anal canal specimens from HIV-negative and positive patients without ASCC (controls groups). RESULTS:In patients with ASCC, the LC count was greater among HIV-negative individuals than among HIV-positive individuals (p<0.05). The LC count was greater in the control HIV-negative group than in HIV-positive patients with ASCC (p<0.05). CONCLUSION:There was a lower amount of activated LCs in HIV-positive patients with anal squamous cell carcinomas than in HIVnegative patients, thereby suggesting worsening of the immune response. MÉTODOS:Avaliamos 25 pacientes, sendo 11 HIV-negativo e 14 HIV-positivo portadores do CEC do canal anal. Realizamos estudo com a coloração imunoistoquímica anti-CD1A para avaliar as CL ativadas. Utilizamos as lâminas coradas e pelo método da histometria contamos em 20 campos diferentes as células coradas na camada basal da lâmina própria, onde era evidente a disseminação tumoral.Realizamos dois grupos controles compostos por pacientes submetidos à biopsia anal sem neoplasia (sete pacientes HIV-negativo e quatro HIV-positivo). Comparamos as contagens de CL. RESULTADOS:A quantidade de CL foi superior nos pacientes portadores do CEC do canal anal soronegativo para o HIV, em relação aos soropositivos (p<0,05). A quantidade de CL foi superior no grupo controle HIV-negativo em relação ao grupo composto por pacientes soropositivos portadores do CEC do canal anal (p<0,05). CONCLUSÃO:Houve aumento das células de Langerhans ativadas na área peritumoral dos pacientes soropositivos para o HIV, o que sugere diminuição da resposta imune local.

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“…The change in the epidemiological profile of ASCC patients seem to be related to HIV infection and immunosuppression 2,26 .…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Langerhans cells counts comparing HIV-positive and negative anal squamous cell-carcinoma patients

Cruz

Nadal

Nadal³

et al. 2012

Acta Cir. Bras.

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“…The recommended resection margin is 1 cm (44). There are different opinions about the tumor size which is considered to be adequate for a local excision: some say it is 2 cm in diameter (T1), while others consider 7 mm in diameter with the excision into the healthy tissue of 3 mm.…”

Section: Treatmentmentioning

confidence: 99%

Anal Carcinoma: A Series of Cases with a Literature Review

Stosic¹,

Stojanovic²,

Mihajlovic³

et al. 2016

Acta Facultatis Medicae Naissensis

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The aim of this study was to analyze the cases of five patients with squamous cell carcinoma (SCC)and to draw attention to the dilemma in the treatment of incontinence on admission of these patients and to present, through a literature review, locations of the surgical treatment.The anal carcinoma is a rare disease which involves different histopathological (HP) types of cancer. They account for about 2.5% of all digestive cancers. The treatment of the disease is multimodal. There are dilemmas about screening of precancerous lesions and treatment of diagnosed incontinence. There is a high similarity between HPV infection and SCC. Our methods and results were compared with the data from the literature.In the period of three years (from 2013 to 2015), five cases of the anal carcinoma were diagnosed and treated in the regional hospital. In all of our cases, the disease was histopathologically confirmed as SCC of the anal and perianal areas. It excluded the cases of anal adenocarcinoma (AAC).Nearly half of the patients (40%) were incontinent and the rectum excision was one of the possible solutions. Distinction in histopathological structure created the confusion in the treatment of these patients. The dilemma we had was whether to do an amputation of the rectum in patients with incontinence before the standardized Chemoradiation therapy (CRT). The review of the literature sums up certain conclu-sions.The diagnosis of SCC includes the perianal "ulcer" that does not heal, as well as atypical anoperianal growths. Surgical treatment of SCC is indicated when the diameter of lesion is small (2 cm), or the disease is persistent or recurrent. In the case of anal incontinence because of the tumor changes, the abdominoperineal resection of the rectum (APR) is an alternative to performing bipolar colostomy and CRT. The review of the literature using MEDLINE/PubMed databases did not find the case with restoring anal continence after this treatment. Testing a larger number of patients with incontinence on admission would provide a more clear answer to the question of the treatment of these patients.

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“…O tratamento do carcinoma epidermoide de canal anal sofreu importante modificação nas últimas décadas e, atualmente, é baseado em quimioterapia e radioterapia combinadas, no esquema de Nigro 20 , como substituição ao procedimento cirúrgico 16,21 . O procedimento cirúrgico baseado na amputação abdominoperineal é indicado como tratamento de resgate nos casos que apresentaram falha à terapia combinada (QT-RT) ou nos casos de recidiva local do tumor 22 .…”

Section: Figura 7 -Ressonância Nuclear Magnética Evidenciando Lesões unclassified

Carcinoma epidermoide de canal anal estádio IV: complicações clínicas de doença avançada

Formiga¹,

Credidio²,

Rosa³

et al. 2010

Rev bras. colo-proctol.

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450FORMIGA FB, CREDIDIO AV, ROSA DL, ASSEF JC, FANG CB, CAPELHUCHNIK P, KLUG WA. Carcinoma epidermoide de canal anal estádio iv: complicações clínicas de doença avançada. Rev bras Coloproct, 2011;30 (4) O carcinoma epidermoide é o tipo histológico mais comum dentre as neoplasias do canal anal, responsável por aproximadamente 85% das lesões malignas dessa região 3 . Atualmente, tem sido observada uma modificação na epidemiologia dessa doença em decorrência do aumento da população de homens jovens homossexuais infectados pelo vírus da imunodeficiência humana (HIV) 4-6 , porém ainda se observa um predomínio em mulheres entre a sexta e sétima décadas de vida 7,8 . RELATO DO CASOJ.A.S., 54 anos, sexo masculino, negro. Paciente deu entrada no Serviço de Emergência apresentando lesões fétidas e dolorosas no glúteo, bolsa escrotal e coxa esquerda. A lesão inicial, localizada na coxa, havia surgido há cinco anos e estava sendo tratada como furunculose, com recorrência frequente. Relatava que a lesão havia progredido em extensão nos últimos dois meses, associada à dor, incontinência fecal, perda ponderal de 10 kg e dificuldade de mobilização da perna esquerda.Ao exame, apresentava-se taquicárdico, desidratado, descorado, com linfonodomegalia inguinal bila-

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Practice Parameters for Anal Squamous Neoplasms

Cited by 92 publications

References 82 publications

Evaluation of Langerhans cells counts comparing HIV-positive and negative anal squamous cell-carcinoma patients

Evaluation of Langerhans cells counts comparing HIV-positive and negative anal squamous cell-carcinoma patients

Anal Carcinoma: A Series of Cases with a Literature Review

Carcinoma epidermoide de canal anal estádio IV: complicações clínicas de doença avançada

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