CHU Pontchaillou, service des maladies de l’appareil digestif, 35033 Rennes Cedex, France
Université Rennes 1, Rennes, France
High grade Squamous Intra-epithelial Lesion (HSIL) is defined by the presence of cellular mucosa atypia accompanied by a cellular pleomorphic, as well as an important architectural disorganization. HSIL are clearly virus-induced because of human papillomavirus infection is found on biopsies in almost all the cases. As in many other tumors, a dysplasia-cancer filiation is proven, justifying, according to current recommendations, a high resolution anoscopy and the treatment of HSIL (surgical excision, electrodestruction, photodynamic therapy or immunomodulatory agents). However, natural history of HSIL lesions remains poorly known and recent data suggest that very few patients will progress to invasive cancer. Prospective studies and development of molecular biology markers will be helpful to better understand the natural history of these lesions and to stratify patients according to their risk level.