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coloproctology

, Volume 40, Issue 1, pp 55–66 | Cite as

Anale intraepitheliale Neoplasie

CME
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Zusammenfassung

Die anale intraepitheliale Neoplasie (AIN) ist eine histologische Diagnose für Dysplasien im analen Plattenepithel. Sind diese Dysplasien auf das untere Drittel des Epithels beschränkt, werden sie AIN ersten Grades oder Low-grade-AIN (LGAIN) genannt, sind das mittlere und obere Drittel dysplastisch durchsetzt, AIN zweiten oder dritten Grades (High-grade-AIN [HGAIN]). Auslöser ist meist eine Infektion mit dem humanen Papillomavirus (HPV). Unbehandelt kann die AIN invasiv wachsen. Risikofaktoren für AIN sind u. a. Rauchen, Immunsuppression, Human-immunodeficiency-virus-Infektion, Condylomata acuminata, intraepitheliale Neoplasien und HPV-assoziierte Tumoren in der Anamnese. Eine AIN kann sich klinisch unauffällig zeigen, aber auch als Dermatose. LGAIN bzw. Condylomata acuminata sind leitliniengerecht zu behandeln. Bei HGAIN stehen chirurgische, ablative und topische Therapiemodalitäten zur Verfügung. Rezidive sind häufig, weswegen bei HGAIN eine Nachsorge erfolgen soll.

Schlüsselwörter

Analkarzinom Humanes Papillomavirus Morbus Bowen HIV Immunsuppression 

Anal intraepithelial neoplasia

Abstract

Anal intraepithelial neoplasia (AIN) is a histological diagnosis for dysplasia in the anal squamous epithelium. If the dysplasia is limited to the lower third of the dermis, it is classified as AIN 1° or low grade AIN (LGAIN); in cases of involvement of the middle and upper third it is called AIN 2 and 3° (high grade AIN/HGAIN). Infection with human papilloma virus (HPV) is generally the underlying cause. Untreated AIN may become invasive. Risk factors are, among others, smoking, immunosuppression, human immunodeficiency virus infection, a history of anogenital warts, intraepithelial neoplasia and HPV-associated cancer. AIN may present as clinically inconspicuous, but also as eczematous or papulous lesions. LGAIN or anogenital warts should be treated according to the guidelines. HGAIN can be treated using excisional, ablative, and topical treatment modalities. Because recurrence is frequent, follow-up of HGAIN is mandatory.

Keywords

Anal canal carcinoma Human papilloma virus Bowen’s disease HIV Immunosuppression 

Notes

Danksagung

Die Autoren möchten sich bei Frau Dr. Monika Dresen, Pathologin in Kiel, und Herrn PD Dr. Stephan Esser, Dermatologe in Essen, für das kritische Durchlesen des Manuskripts bedanken.

Einhaltung ethischer Richtlinien

Interessenkonflikt

J. Jongen und V. Kahlke geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2017

Authors and Affiliations

  1. 1.Proktologische Praxis Kiel, Abteilung Proktologische ChirurgiePark-KlinikKielDeutschland

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