Angiogenesis, proliferation, and apoptosis in anal high-grade squamous intraepithelial lesions

作者：Virginia R. Litle, Jonathan D. Leavenworth, Teresa M. Darragh, Lauren Kosinski, H. D. M. Moore, Karen Smith‐McCune, Robert S. Warren, Joel M. Palefsky, Mark L. Welton · 发表于：Diseases of the Colon & Rectum · 年份：2000 · DOI：10.1007/bf02258300 · 被引用次数：36 · 研究领域：Cervical Cancer and HPV Research、Colorectal and Anal Carcinomas、Genital Health and Disease

PURPOSE: Management of anal high-grade squamous intraepithelial lesions is controversial. Anal and cervical high-grade squamous intraepithelial lesions are similar in that they occur in transitional squamous epithelium, are associated with human papilloma virus infection, and have increased incidence in the immunocompromised population. Ablation of cervical high-grade squamous intraepithelial lesions is preferred, but similar ablation or excision of anal high-grade squamous intraepithelial lesions may compromise bowel control; thus, there is a need to define the malignant potential of anal high-grade squamous intraepithelial lesions. METHODS: We analyzed 50 paraffin sections of normal anoderm, anal low-grade squamous intraepithelial lesions, high-grade squamous intraepithelial lesions, and anal squamous-cell carcinoma. Microvessels were detected immunohistochemically with von Willebrand factor and counted manually along the epithelial-stromal junction. Proliferation and apoptosis were determined in the epithelial cells with MIB-1 antibody immunostaining and the terminal deoxynucleotidyl transferase-mediated digoxigenin-11-dUTP nick end labeling, respectively. RESULTS: Microvascular density was significantly greater in anal high-grade squamous intraepithelial lesions (mean, 0.50 vessels/cm) vs. normal anoderm (mean, 0.21 vessels/cm; P = 0.0017, Mann-Whitney U test). The proliferative percentages were greater in low-grade squamous intraepithelial lesions, high-grade squamous in...