5-FU局部注射逆转治疗阴道上皮内瘤样病变的临床与病理研究

目的:探讨阴道上皮内瘤样病变(VAIN)的临床及病理表现。观察5-FU局部注射治疗VAIN的疗效。方法:应用5-FU局部注射治疗VAIN2例。通过临床表现,阴道脱落细胞检查,阴道镜检查及病理检查,观察VIAN在治疗前后的表现。结果:5-FU局部注射治疗2例VAIN患者,治疗前后阴道断端多次脱落细胞检查均为阴性,阴道镜下醋酸试验及碘试验表现典型。应用5-FU局部注射治疗逆转了组织学异常改变。结论:①VAIN的诊断依靠病理组织学检查。阴道镜可以提高活检的准确性。②VAIN3级患者接受5-FU局部注射能逆转了组织学的异常改变。③发现生殖道一种上皮内瘤样病变或癌变时,应注意生殖道其它部位合并癌前病变或癌变的情况。

A clinical and pathological research on the local injection of 5-FU in the reversal treatment of vaginal intraepithelial neoplasia

Objective:To explore the clinical and pathological features of vaginal intraepithelial neoplasia (VAIN), observe the treatment effects by local injection of 5-FU.Methods:2 cases with VAIN were injected by 5-FU. Clinical manifestations were observed, examinations of castoff cells, colposcopies and histological examinations were conducted before and after treatment.Results:Examinations of castoff cells in two cases were negative. The acetic acid test and iodine test under colposcopy were typical. Local injection of 5-FU therapy reversed the histological abnormality.Conclusion:①The diagnosis of VAIN depends on the histopathologic examination. Colposcopy can improve the accuracy of biopsy. ②VAIN3 patients received 5-FU injection reverse their histological abnormality. ③Once one kind of reproductive tract intraepithelial neoplasia or cancer was found, we should pay attention to other kinds of reproductive tract cancer or precancerous lesions.