Authors: Mullerat J.¹; Wong Te Fong L.F.²; Davies S.E.³; Winslet M.C.¹; Perrett C.W.²

Source: Colorectal Disease, Volume 5, Number 4, July 2003 , pp. 353-357(5)

Publisher: Wiley-Blackwell

Abstract:

Introduction

Most cases of anal carcinoma seem to develop from high grade anal intraepithelial neoplasia (AIN) caused by persistent anal warts. Similar pre-invasive epithelial genital lesions (e.g. those of the cervix and vulva) have been shown to be associated with increased angiogenesis. In this study we examined biopsies of anal lesions ranging from warts to invasive anal carcinoma, with the aim of assessing the degree of angiogenesis in pre-invasive anal lesions. Method

Samples from 70 patients (51 male) who had undergone excision biopsy or resection of anal wart lesions (20), low grade AIN (12), high grade AIN (27) and anal squamous cell carcinoma (SCC) (11) were studied. Samples (6) from normal HIV-anal skin were used as controls. The samples were stained for von Willebrand factor, a specific marker of endothelial cells. Angiogenesis was measured by microvessel density (MVD) analysis, quantifying the microvessels in the stroma adjacent to the epithelial lesion. Results

There was a statistically significant (P < 0.001) progressive increase in MVD between low grade AIN, high grade AIN and anal SCC. The difference in MVD between normal skin, warts and low grade AIN was not statistically significant. Conclusion

There are progressive abnormal patterns of angiogenesis in highly dysplastic lesions, similar to those found in cervical and vulvar pathology. These findings may have biological, prognostic and therapeutic implications.

Keywords: Anal warts; angiogenesis; AIN; anal SCC

Document Type: Research article

DOI: http://dx.doi.org/10.1046/j.1463-1318.2003.00481.x

Affiliations: 1: Departments of Surgery, 2: Obstetrics and Gynaecology and 3: Histopathology, Royal Free and University College Medical School, London, UK

Publication date: 2003-07-01

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