外阴和阴道上皮内瘤变的临床初步研究

目的：探讨外阴和阴道上皮内瘤变 (vulvar intraepithelial neoplasias, VIN, and vaginal intraepithelial neoplasias, VAIN) 的发病特点。方法：对2004年9月至2007年12月在北京大学第三医院阴道镜门诊行外阴或阴道活检的148例女性患者进行回顾性分析。结果：148例中经病理诊断为VIN 2,3或VAIN 2,3级23例, VIN1或VAIN 1级16例, 外阴或阴道湿疣61例, 以及外阴癌1例, 外阴或阴道炎症47例。VIN或VAIN患者中85%(33/39)年龄在30岁以上, 并且高于宫颈上皮内瘤变(cervical intraepithelial neoplasia , CIN) 患者的年龄。VIN，VAIN及湿疣的高危型人乳头瘤病毒(human papillomavirus, HPV) DNA检测结果阳性率达84%(84/100), 其中23例VIN 2,3或VAIN 2,3患者的高危型HPV DNA检测结果均为阳性。超过90% (69/75)的VAIN病灶位置在阴道上段。VIN或VAIN常与CIN或宫颈癌伴随存在或继其后发生(79%， 31/39), 并且高级别的VIN或VAIN常合并高级别的CIN或宫颈癌(70%， 16/23)。结论：高危型HPV感染也是VIN或VAIN及癌的主要致病因素, 对宫颈病变或宫颈癌患者应仔细检查外阴和阴道黏膜。

Preliminary study of vulvar and vaginal intraepithelial neoplasias

Objective:To detect the clinical features of vulvar and vaginal intraepithelial neoplasias(VIN and VAIN,respectively).Methods:Total 148 women were performed vulvar or vaginal coloposcopy-directed biopsy pathology tests,from Sep.2004 to Dec.2007.Results:Among 148 women,vulvar or vaginal histologic results were vulvar cancer for 1,VIN or VAIN 2,3 for 23,VIN or VAIN for 16,condyloma for 61,vulvitis and vaginitis for 47.Eighty-five percent(33/39) women with VIN or VAIN 2,3 were more than 30 years old.Compared t...