| 摘要: |
| 目的:探索阴道上皮内瘤变(VAIN)的发病模式及治疗后的消退情况。方法:回顾性收集2000~2015年在北京协和医院妇产科治疗的、经组织病理学证实为VAIN 74例患者的临床病理资料,所有入组患者治疗后于妇科门诊规律复查细胞学或病毒学,必要时复查阴道镜活检。对发病模式和治疗结局进行分析。结果:发病平均年龄50.8±11.2岁,24例(32.4%)VAINⅠ~Ⅱ级病变,46例(62.2%)VAINⅢ及合并阴道原位癌(VAIS)级病变,4例(5.4%)合并早期浸润癌病变,既往和(或)目前合并HPV相关疾病者61例(82.4%),子宫切除术后发病者28例(37.8%),而其中21例(75.0%)是因HPV相关疾病切除子宫,另外7例(25.0%)因子宫良性病变切除子宫。经过最初的阴道病变切除术(57例,77.0%)、病变烧灼术(8例,10.8%)和期待治疗(9例,12.2%),中位随访12.9月(1.9~113.4月),复发率为14.9%(11例),中位复发间隔时间为10.4月(1.9~31.2月),最终达到了70.3%(52例)病变消退率,病变稳定和病变降级者占23.0%(17例),仅6.7%(5例)病变进展。结论:VAIN多合并HPV相关疾病,经过最初的病灶切除、烧灼或期待治疗后,治疗效果好,大部分病变消退,预后良好。 |
| 关键词: 阴道上皮内瘤变 发病模式 治疗方式 结局 |
| DOI： |
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| Patterns and Outcomes of Vaginal Intraepithelial Neoplasia with Various Treatment Modalities |
| JIANG Xuan;YANG Jiaxin;CAO Dongyan |
| (Peking Union Medical College Hospital,Chinese Academy of Medical Science & Peking Union Medical College) |
| Abstract: |
| Objective: The purpose of this study was to review a cohort of patients with vaginal intraepithelial neoplasia( VAIN) and to analyze the patterns and outcomes with various treatment modalities.Methods: A retrospective review of the medical records was performed to collect clinical,pathological and follow-up data of 74 patients who were pathologically confirmed and treated for VAIN between 2000 and 2015 at Peking Union Medical College Hospital.All included patients were and regularly followed up by cytological examination,virus test or colposcopy if necessary in the clinic.Primary findings were patterns and outcomes of these patients after various treatments.Results: Seventy-four patients were included in the study: mean age,50. 8 ± 11. 2 years; 24 patients( 32. 4%) had VAIN Ⅰ-Ⅱ,46 patients( 62. 2%) had VAINⅢ/VAIS,and 4 patients( 5. 4%) had early staged invasive carcinoma;61 patients( 82. 4%) were accompanied with other HPV-related diseases concomitantly or antecedently; 28 patients( 37. 8%) were diagnosed after hysterectomy,which was performed due to HPV-related diseases( 75. 0%)or uterus corpus diseases( 25. 0%).Among them,77. 0% of the patients underwent focal resection,10. 8% of the patients underwent electrofulguration,and 12. 2% of the patients underwent expectant treatment. After a median follow-up of 12. 9 months( range,1. 9-113. 4 months),recurrence was observed in 11 patients( 14. 9%). The median recurrence interval was 10. 4 months( range,1. 9-31. 2). The rates of disease regression and progression were 70. 3% and 6. 7%,respectively.The rate of disease degradation and stable disease was 23. 0%.Conclusions: Vaginal intraepithelial neoplasia was frequently diagnosed in company with other HPV-related diseases.After focal resection,electrofulguration or expectant treatment,most of the diseases were regressed and patients had a good prognosis |
| Key words: Vaginalintraepithelialneoplasia Pattern Treatment Outcome |
