肛门癌 Screening
肛门癌筛查是使用一系列测试和程序的过程，目的是检测和防止尚未癌变的异常细胞(称为不典型增生)成为癌变肿瘤并可能扩散到身体的其他部位.
Simple anal pap tests, 类似于为筛查妇女宫颈癌而进行的子宫颈涂片检查, are given to detect the presence of abnormal cells. 更详细的检查是通过一种称为高分辨率镜检查(HRA)的程序来完成的，可疑组织需要活检来确认或否认癌症的存在. 一种称为红外凝固(IRC)的程序通常用于破坏检测到的异常细胞. 在任何最初的筛查和治疗之后，通常需要进行两到三次额外的筛查和治疗，以确保所有的异常细胞都被发现和破坏.
下面列出了一些常见问题，这些问题将提供有关肛门癌筛查的各种测试和程序的更深入的信息. Click on a question to see the answer.
What is an anal Pap test?
肛门巴氏试验是一种筛查工具，用于寻找可能是肛门癌前兆的异常细胞. 该检查是通过将棉签插入肛门收集细胞样本来完成的. These cells are then examined in a lab under a microscope. 如果细胞看起来不正常，那么下一步就是在高分辨率肛门镜检查(HRA)或肛门阴道镜检查过程中使用一种叫做阴道镜的特殊工具对肛管进行更仔细的检查.
What is High Resolution Anoscopy (HRA)?
HRA是一种检查和评估肛管的程序，通常在肛门巴氏试验显示异常细胞后进行. During the procedure a vinegar like solution is applied in the anal canal in order to make abnormal tissues more visible; an iodine solution may also be used to help better define abnormal tissues. 一种叫做肛门镜的小圆管和一种叫做阴道镜的放大仪器被用来彻底检查肛管. 如果适应症允许，可以取一小块异常组织作活检. A digital rectal examination is also done at the time of the procedure.
HRA是在办公室环境中以弯腰或躺着的姿势进行的，通常需要大约15分钟. There is no preparation required and in fact enemas and suppositories are 不 recommended prior to the procedure. HRA通常对个体具有良好的耐受性，并且可能经历的任何不适通常是轻微的，出血或感染的情况极为罕见.
Why is a biopsy necessary?
肛门巴氏试验或HRA程序仅仅表明潜在癌细胞的存在，但活检是真正诊断癌症的唯一方法. The biopsy is done as part of the HRA procedure. 活检后的疼痛通常是最小的，非处方止痛药应该有助于提供舒适. A small amount of bleeding may occur for a day or two after the biopsy and may last up to a week; anal insertions of any kind should be avoided until all bleeding stops.
活检结果不表明癌症的实际存在仍然可以描述低级别或高级别癌前病变. This information is critical in determining the best type of treatment. Low grade lesions do 不 necessarily require treatment, but they should be monitored with periodic HRA. 然而，高度病变需要治疗以防止异常细胞发展为癌症.
What is Infrared Coagulation (IRC)?
IRC is the application of heat for a short burst (about 1.(5秒)摧毁(消融)异常的肛门细胞，同时封闭微小的血管，导致少量出血. 该手术在办公室进行，不需要栓剂或灌肠，必要时使用局部麻醉剂.
What are the after care instructions following an HRA or IRC procedure?
After having an HRA or IRC procedure you need a follow-up appointment within two weeks; we call our patients to schedule that appointment but if 不 contacted within two weeks please contact us to have an appointment scheduled. 以下是手术后应遵循的指示:
General Instructions: 你可能会在两周内伴有排便出血. 在这两周内保持大便柔软可以减少出血和不适. Do 不 use any enemas, 使用栓剂或肛交，直到所有出血和不适都消失. 如果你感到疼痛加剧、出血、发烧、发冷或盗汗，请打电话给诊所.
饮食指导: Resume your normal diet. 建议在接下来的两周内使用非处方纤维补充剂来保持大便柔软. Maintain adequate fluid intake.
Medication Instructions: You should continue all of your usual medications. If you have received a prescription for a pain medication, it may make you sleepy so do 不 drive, 喝酒, or operate machinery while taking it.
Aldara (Imiuimod) Cream Instructions: 如果您已经开了Aldara乳霜的处方，请遵循这些说明. Aldara cream is most effective if used three times a week for four months.
- 每周三次不连续的睡前使用Aldara面霜. (例如, apply Aldara as directed on Mondays, Wednesdays and Fridays OR on Tuesdays, Thursdays and Saturdays.) DO NOT use Aldara cream two days in a row.
- Wash off the applied Aldara cream in the morning.
- Expect some irritation from the use of Aldara cream. 你可以使用Calmoseptine软膏洗净皮肤后，以减轻任何刺激.
一旦接受治疗，我是否需要返回进行额外的筛查和/或治疗?
是的. After initial treatment, 你需要定期做肛门巴氏试验和/或HRA，看看是否有其他需要治疗的地方. 有时需要两到三次治疗才能发现并摧毁所有异常细胞. 然而, 去几趟医生办公室远比癌症需要手术和住院要好得多.