Development of lower genital carcinomas in patients with anal carcinoma.A more than casual relationship

Abstract

In a series of 64 anal carcinomas in the female 11 had multiple primaries in the ano‐genital tract. Statistical analysis using control series illustrated that this incidence is more than a casual association of these tumors. In 5 patients the second or third primaries were diagnosed within a period of one year or less (synchronous tumors). In 6 patients the time interval for the appearance of other primaries was of more than one year (metachronous tumors). Of the latter group, 5 had previous x‐ray therapy to the area and the enhancing or primary carcinogenic effect of the ionizing radiation cannot be ruled out. It appears evident, however, that primary tumor in the ano‐genital tract in the female deserves careful investigation and follow‐up if cancer patients are to be kept free of disease.

Angiogenesis in anal warts, anal intraepithelial neoplasia and anal squamous cell carcinoma

“…In 1965 there was a report of increased incidence of lower genital tract carcinomas in patients with anal cancer [18] and this has been further corroborated by several studies that have found a close relationship between anal and genital cancers [27,28,29]. This group of malignancies shares similar risk factors, seems to be preceded by similar intraepithelial lesions and occurs in anatomical sites lined with stratified squamous epithelium.…”

“…Recent work, however, has shown that angiogenic growth factors are already present in pre‐invasive lesions. Angiogenesis may be found in cervical intraepithelial neoplasia (CIN) [17], vulval intraepithelial neoplasia (VIN) [18] and also in pre‐invasive forms of bladder cancer [19], breast cancer [20] and colorectal cancer [21]. Recent studies have used microvessel density (MVD) analysis, a measure of tumour angiogenesis, as a prognostic factor for recurrence and outcome of both CIN and cervical cancer [13,22].…”

Anal condylomas

“…génotypes 16 et 18 sont oncogènes et à l'origine de 80 à 90 % [3] des cancers de l'anus et de 70 % des cancers du col utérin [4]. Le tropisme commun des HPV pour les muqueuses anale et endocervicale peut s'expliquer par leur origine embryologique commune [5] ; cependant, l'histoire naturelle de l'infection à HPV est mieux étudiée au niveau du tractus génital féminin qu'au niveau de l'anus [6].…”

Lésions anales précancéreuses liées aux papillomavirus humains. Histoire naturelle, épidémiologie et facteurs de risque

“…Les génotypes HPV 6 et 11 sont à l'origine de 90 % des condylomes anogénitaux et d'une partie des dysplasies de bas grade [13][14][15]. Le tropisme commun des HPV, pour les muqueuses anale et endocervicale, peut s'expliquer par leur origine embryologique commune [16], cependant l'histoire naturelle de l'infection à HPV est mieux étudiée au niveau du tractus génital féminin qu'au niveau de l'anus [17]. La première étape de la constitution d'une néoplasie intra-épithéliale de haut grade est l'intégration de l'ADN du génome viral d'HPV dans les cellules épithéliales de l'hôte.…”