A systematic review of anal squamous cell carcinoma in inflammatory bowel disease

作者：Slesser A A P; Bhangu A; Bower M; Goldin R; Tekkis P P^*

来源：Surgical Oncology-Oxford, 2013, 22(4): 230-237.

DOI：10.1016/j.suronc.2013.08.002

• Anal cancer
• Anal squamous cell carcinoma
• Crohn's disease
• Ulcerative colitis
• Inflammatory bowel disease

Aim: The aim of this systematic review was to determine the incidence, aetiology and clinical characteristics of anal squamous cell carcinomas (SCC) presenting in patients with inflammatory bowel disease.
Method: A systematic review of the literature was undertaken using Medline, Embase, Cochrane and Web of Science.
Results: A total of 33 cases of anal SCC were described, 7 in ulcerative colitis (UC) and 26 in Crohn's disease (CD). The annual incidence of anal SCCs was 0.9/100,000 and 2.0/100,000 in patients with UC and CD respectively. The gender ratio in CD was 3M:17F with a median age of 42 years, the main presenting symptom was anal pain and 85% of CD cases had peri-anal disease. No studies described anal intraepithelial neoplasia. The human papilloma virus was found to be positive in 2 out of 5 (40%) cases. The majority of patients (73%) with CD received radical surgery as their first line treatment. The cumulative overall and disease free survival in CD was 37 per cent at five years.
Conclusion: The findings of this review when contrasted with the data from cancer registries suggests that there is a higher incidence of anal SCC, an earlier age of presentation and poorer outcomes in patients with Crohn's disease compared to the general population implying a more aggressive neoplastic process. This review supports the hypothesis that peri-anal disease plays a contributing role in anal SCCs and as such targeted surveillance in patients with longstanding peri-anal disease should be considered.

• 出版日期2013-12