The diagnosis and management of vulval intraepithelial neoplasia

The diagnosis and management of vulval intraepithelial neoplasia
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外阴上皮内瘤变的诊断和治疗

DOI:
10.1111/tog.12906
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发表时间:
2023
期刊:
The Obstetrician & Gynaecologist
影响因子:
--
通讯作者:
Henderson I
Henderson I
中科院分区:
--
文献类型:
--
作者:
Henderson I

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高危型人乳头状瘤病毒(HPV)相关的外阴高度鳞状上皮内病变和HPV非依赖性分化型外阴上皮内病变代表了不同的疾病过程,其进展为外阴鳞状细胞癌的风险不同。一线医疗管理适用于活检证实的外阴高度鳞状上皮内病变的女性,这些女性已经充分告知了隐匿性浸润性疾病的风险。局部治疗应在专科诊所进行,因为它不适合所有患者。分化型外阴上皮内瘤变需要手术治疗。学习目的了解外阴上皮内瘤变的临床,组织学,鳞状上皮内病变的病理分类和诊断挑战。能够为鳞状上皮内病变的多学科研究和诊断做出贡献。了解为可疑鳞状上皮内病变的调查、诊断和治疗提供以患者为中心的咨询的基础。伦理问题治疗必须根据患者对风险和益处的认识,并根据疾病的临床和病理特征进行调整。
Key contentHigh‐risk human papilloma virus (HPV)‐associated vulval high‐grade squamous intraepithelial lesions and HPV‐independent differentiated vulval intraepithelial lesions represent distinct disease processes with different risks of progression to vulval squamous cell carcinoma.First‐line medical management is appropriate for women with biopsy‐confirmed vulval high‐grade squamous intraepithelial lesions who have been adequately counselled on the risk of occult invasive disease. Topical treatment should be undertaken in the context of a specialist clinic because it is not suitable for all patients.Surgical management is needed for differentiated vulval intraepithelial neoplasia.Learning objectivesTo understand the clinical, histological, and pathological classification of squamous intraepithelial lesions and diagnostic challenges.To be able to contribute to the multidisciplinary investigation and diagnosis of squamous intraepithelial lesions.To understand the basis for patient‐centred counselling on the investigation, diagnosis and treatment of suspected squamous intraepithelial lesions.Ethical issuesTreatment must be tailored towards the patient's appreciation of risk and benefit, informed by the clinical and pathological features of the disease.
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