外阴上皮内瘤变45例临床分析

目的 探讨外阴上皮内瘤样瘤变（VIN）的临床特点、病理特征、治疗及预后情况.方法 选取2009年7月至2012年12月在我院宫颈门诊阴道镜下活检病理诊断VIN患者45例,分析其临床资料、病灶特征及治疗结果.结果 45例患者中,妇科检查异常25例,有明显临床症状17例.阴道镜下显示醋白突起19例,平坦醋白上皮17例,色素增加5例,色素减退4例.病检显示普通型VIN 37例,分化型VIN8例.45例患者中40例激光治疗,5例病灶切除术治疗,除2例激光治疗复发后再次治疗,其余病例追踪随访3个月至3年无复发.结论 妇科医师应提高外阴上皮内瘤样病变诊断意识,及时行活组织检查,确诊患者根据病情行病灶切除术或激光治疗,复发病例可再次手术.

Clinical analysis of 45 cases with vulvar intraepithelial neoplasia

Objective To investigate the clinical and pathologic features of vulvar intraepithelial neoplasia （VIN）. Methods The clinical features of 45 patients with VIN diagnosed by colpscopically directed biopsy from July 2009 to December 2012 in our hospital were analyzed. Results Of the 45 patients, 25 were found with abnormal gy- necological examination results, 17 with obvious symptoms. Colposcopy showed aceto-white bump in 24 cases, flat aceto-white epithelium in 12 cases, increased pigmentation in 5 cases and degmentation in 4 cases. Pathological re- suits showed that 37 patients were usual type V1N, 8 patients were differentiated type VIN. Forty patients were treated with laser therapy and 5 underwent lumpectomy. During the follow-up of 3 months to 3 years, all patients were cured and showed no recurrence except 2 by laser therapy. Conclusion Gynecologists should pay more attention to VIN and perform biopsy promptly. The diagnosed patients should be treated by laser or lumpectomy according to the dis- ease. The recurrent patient can be treated by operation again.