EP1093 - Potential Correlation Between Androgens and Cryptoglandular Perianal Fistula: A Histopathological Study

Purpose/Background: Androgens have been implicated in cryptoglandular perianal fistula （CAF） development, but direct pathological and histological evidence remains limited. This study investigates the distribution of androgen receptor (AR) in fistula tissues across different age groups to provide preliminary histological data for further exploration of AR involvement in CAF.

Methods/Interventions: Adult patients (30 males, 30 females; ≥18 years) and infant/toddler patients (30 cases; 0~3 years) with CAF were included. Fistula tissue samples were collected during fistulectomy and analyzed using AR immunohistochemical staining and hematoxylin and eosin (H&E) staining.

Results/Outcomes: AR expression was predominantly localized around anal gland tissue in both adult and infant/toddler patients. The AR positivity rate in the secretory and basal cells of anal glands was significantly higher in infant/toddler patients than in adult patients (p≤0.05). Among adult patients, female patients showed a higher AR positivity rate in secretory cells than male patients (p≤0.05). Additionally, AR positivity was increased in abnormally hyperplastic compared to normal glands. Histopathological analysis highlighted distinct regions of the fistula tract.

Conclusion/Discussion: The anal gland may serve as a target tissue for androgen activity, as suggested by the observed distribution of AR expression. The observed elevation of AR expression, particularly in hyperplastic glands, raises the possibility of an association with pathological processes such as glandular hyperplasia and local inflammation; however, further mechanistic studies are required to confirm any causal relationship.. These findings provide preliminary histological evidence supporting further investigation into the potential involvement of androgen-related pathways in CAF pathophysiology.