超声辐射兔外阴皮肤后组织中bFGF蛋白和mRNA的变化

目的：探讨超声治疗外阴白色病变的机制.方法：采用免疫组织化学与原位杂交技术研究超声辐射兔外阴皮肤后组织中bFCF蛋白和mRNA的变化.结果：辐射后第4天和第7天bFGF蛋白和mRNA较辐射前明显升高（P＜0.01）,2周时已恢复正常.结论：通过超声的生物学效应可使组织发生可逆性损伤,细胞膜微小破裂增加,细胞膜通透性提高,同时细胞bFGF产生增加,最后bFGF分泌增加,促进局部微血管的形成,改善微血管和神经末梢的营养状况.     

Vulval squamous cell carcinoma and its precursors

Vulval squamous cell carcinoma (VSCC) can arise through two distinct pathways [human papillomavirus (HPV)-associated and HPV-independent], and these VSCC variants are recognised as different disease entities on the basis of different aetiologies, morphological features, molecular events during oncogenesis, precursor lesions, prognosis, and response to treatment. The precursor of HPV-associated VSCC, variously referred to as high-grade squamous intraepithelial lesion (HSIL) [vulvar intraepithelial neoplasia (VIN) 2/3] or usual-type VIN, is morphologically identical to the more common HSIL (cervical intraepithelial neoplasia 2/3) of the cervix. The precursor lesions of HPV-independent VSCC include differentiated VIN, differentiated exophytic vulvar intraepithelial lesion, and vulvar acanthosis with altered differentiation; these have been under-recognised by pathologists in the past, leading to delays in treatment. This review will discuss the recent advances in diagnostic surgical pathology of VSCC and its precursors, and how these diagnoses can impact on patient management.     

Expression of cyclin D1 and retinoblastoma protein in Paget’s disease of the vulva and breast: an immunohistochemical study of 108 cases

Aims: Loss of retinoblastoma protein expression and overexpression of cyclin D1 have been implicated in the development and progression of some cancers. Paget’s disease of the vulva (PDV) and Paget’s disease of the breast (PDB) are uncommon conditions and the pathogenesis of these diseases is still unclear. The aim was to examine the expression of the retinoblastoma and cyclin D1 proteins in PDV and PDB and to correlate any differences between PDV and PDB, and in the presence or absence of an underlying carcinoma. Methods and results: Seventy‐two archival cases of PDV including 10 with invasive disease and 36 cases of PDB were evaluated immunohistochemically for the expression of cyclin D1 and retinoblastoma protein. Forty‐four percent (32/72) of cases of PDV showed loss of expression of the retinoblastoma protein, compared with 67% (24/36) of PDB cases. Fifty‐nine percent (41/69) of PDV overexpressed cyclin D1. In PDB, 8% (3/34) overexpressed cyclin D1. There were no significant differences in the expression of retinoblastoma and cyclin D1 in PDV cases with or without underlying invasive disease. There were significant differences between the expression of retinoblastoma (P = 0.03) and cyclin D1 (P < 0.001) in PDV compared with PDB. Conclusions: The differences in the expression of cyclin D1 and retinoblastoma may indicate the differences in the pathogenesis of PDV and PDB.     

Novel Technique for Management of Bartholin Gland Cysts and Abscesses

Background: Definitive methods for treatment of a Bartholin cyst and abscess include placement of a Word catheter, marsupialization, application of silver nitrate, and surgical excision. Placement of a Word catheter is the most frequently employed technique for office and emergency department (ED) management. However, many institutions do not have the Word catheter available; in addition, the catheter has a tendency to dislodge before epithelialization, leading to recurrence of the cyst. Objective: We have developed a simple technique for management of Bartholin gland abscess or cyst using readily available materials. This technique involves using a small loop of plastic tubing, which is secured to prevent expulsion before epithelialization of a drainage tract. Case Report: A 25-year-old woman presented to the ED with a Bartholin gland abscess. After administration of local anesthetic, a loop of tubing was placed, allowing for drainage of the abscess. The patient was discharged home with a course of oral antibiotics. At 3-week follow-up, the Bartholin gland abscess was found to be healed; the device was removed without difficulty, leaving two drainage tracts. Conclusion: This technique may be used as an alternative to placement of a Word catheter for management of Bartholin gland abscess or cyst.     

胎盘肽注射液的研制及治疗外阴白斑的疗效

目的:研制胎盘肽注射液,并观察其治疗外阴白色病变的疗效。方法:以健康人胎盘为原料,采用冻融和超滤的方法制备了胎盘肽注射液。用福林-酚法测定多肽含量。观察了该注射液对156例外阴白色病变患者的疗效。结果:胎盘肽在20μg/mL至100μg/mL浓度范围内线性关系良好,平均回收率为100．16%,99．25%,98．59%,RSD分别为1．09,0．48,0．50(n=3)。治疗外阴白色病变的总有效率达100%。结论:胎盘肽注射液作为多肽类生化制剂,工艺简便可行,质量可控,临床疗效满意。     

Genetic aberrations detected by comparative genomic hybridisation in vulvar cancers

Squamous cell carcinoma of the vulva is a disease of significant clinical importance, which arises in the presence or absence of human papillomavirus. We used comparative genomic hybridisation to document non-random chromosomal gains and losses within human papillomavirus positive and negative vulvar cancers. Gain of 3q was significantly more common in human papillomavirus-positive cancers compared to human papillomavirus-negative cancers. The smallest area of gain was 3q22-25, a chromosome region which is frequently gained in other human papillomavirus-related cancers. Chromosome 8q was more commonly gained in human papillomavirus-negative compared to human papillomavirus-positive cancers. 8q21 was the smallest region of gain, which has been identified in other, non-human papillomavirus-related cancers. Chromosome arms 3p and 11q were lost in both categories of vulvar cancer. This study has demonstrated chromosome locations important in the development of vulvar squamous cell carcinoma. Additionally, taken together with previous studies of human papillomavirus-positive cancers of other anogenital sites, the data indicate that one or more oncogenes important in the development and progression of human papillomavirus-induced carcinomas are located on 3q. The different genetic changes seen in human papillomavirus-positive and negative vulvar squamous cell carcinomas support the clinicopathological data indicating that these are different cancer types.     

Majocchi's granuloma of the vulva caused by Trichophyton mentagrophytes

We report a case of Majocchi's granuloma caused by Trichophyton mentagrophytes on the vulva in a 23-year-old girl who had used topical steroids for many years. Her dog was a source of the infection.     

RhoA蛋白在外阴鳞癌组织中的表达及临床意义

目的 检测RhoA蛋白在外阴鳞癌(VSCC)组织中的表达情况,探讨其与VSCC临床病理因素关系,以期为VSCC的早期诊断、临床治疗及判断预后提供理论依据.方法 选取有完整临床资料及随访资料的40例VSCC病例石蜡包埋组织标本作为实验组,外阴鳞状上皮内肿瘤2级(VINⅡ)10例、正常外阴皮肤10例石蜡包埋组织作为对照组.应用免疫组化S-P法分别检测VSCC和对照组组织中RhoA蛋白的表达水平.统计方法分析RhoA与VSCC临床病理因素的相关性.结果 RhoA在正常外阴皮肤组织中未见表达,在VINⅡ阳性率为10％.RhoA在VSCC组织中的阳性表达显著高于对照组(P＜ 0.01).RhoA蛋白在VSCC组织中的表达与组织学分级无统计学意义(P＞0.05).RhoA蛋白在VSCC组织中表达与临床分期和有无淋巴结转移有相关性(P＜0.01).结论 RhoA蛋白参与VSCC发生、发展过程,在VSCC的浸润、转移临床过程中起一定作用.     

聚焦超声治疗外阴硬化性苔藓的疗效观察

目的探讨聚焦超声治疗外阴硬化性苔藓的疗效。方法2005年7月～2005年12月用聚焦超声治疗外阴硬化性苔藓病人30例(超声组),同期采用皮质激素、雄激素等药物治疗外阴硬化性苔藓病人33例(对照组),对两组病人的疗效进行比较分析。结果超声组与对照组在治疗后瘙痒评分有显著性差异(P<0.05),病灶面积缩小比较亦有显著性差异(P<0.01)。超声组和对照组的复发率分别为6.25%和50%。结论聚焦超声是一种安全、无创、疗效好、操作简便的治疗外阴硬化性苔藓的方法。