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Anal intraepithelial neoplasia (ain) anal intraepithelial neoplasia (ain) means there are abnormal cells in the lining of your anus. A pathologist looks at your cells under a microscope to check whether your anal cells look different to normal anal cells. anal intraepithelial neoplasia (ain) is a premalignant lesion for anal cancer. , human papilloma virus (hpv)human immunodeficiency virus infections, post-organ transplantation patients, and men who have sex with men) and development is driven by hpv infection. Anal squamous intraepithelial lesions (sils) in human immunodeficiency viruspositive men who have sex with men incidence and risk factors of sil and of progression and clearance of low-grade sils v w jongen, v w jongen department of infectious diseases, public health service amsterdam,. Anal intraepithelial neoplasia performing high-resolution anoscopy michelle d. Wu perioperative considerations anal squamous intraepithelial lesion (sil) precedes anal squamous cell carcinoma. The causative agent is human papillomavirus (hpv) in the majority of cases. Anal squamous cell cancer arises between the anal verge and the anorectal line (fig.). Anal intraepithelial neoplasia a carcinoma in situ of the anorectal mucosa that is embryologically, histologically, and pathologically analogous to cervical intraepithelial neoplasia, which is linked to hpv infection and divided into low-grade (lg-ain) and high-grade (hg-ain) tumours, the latter of which is associated with aggressive squamous cell carcinoma. Anal intraepithelial neoplasia (ain)high-grade squamous intraepithelial lesion (hsil) fig. Photograph of a lesion in a patient who sought a second opinion day before starting chemoradiation therapy for an anal cancer. Anal intraepithelial neoplasia (ain) is a premalignant lesion of the anal mucosa that is a precursor to anal cancer. per scholefield et al the estimated risk of progression from anal intraepithelial neoplasia (ain) to invasive anal cancer is 10 in 5 years. However, this rate needs to be interpreted with caution as progression rates may vary according to such factors as eradication of disease by surgical therapy and the aforementioned risk factors that increase the risk of progression to invasive disease. Anal dysplasia, anal intraepithelial neoplasia (ain) and anal squamous intraepithelial lesion (sil) are terms used to describe conditions that occur before the onset of anal squamous cell cancer (scc). As shown in figure 1, the anus is located at the end of the intestinal tract.