Value of Screening Procedures for the Detection of Vaginal Adenosis
Value of Screening Procedures for the Detection of Vaginal Adenosis
复制标题
阴道腺病筛查程序的价值
作者：
J. Gunning;D. Ostergard
本研究描述了3871例青春期后女性患者使用常规阴道碘染色和其他筛查程序检测阴道腺病的情况。碘染色确定了65例患者的阴道非染色区域。阴道镜检查证实65例患者中有11例存在阴道腺病。10例患者的直接活检证实了诊断。碘染色程序仅在1例无DES暴露阳性史或共存身体检查结果的患者中检测到阴道腺病。阴道碘染色作为阴道腺病的筛查方法价值不大。基于这些发现，仔细的病史和阴道检查被推荐为阴道腺病最有效的常规筛查程序。对有子宫内DES暴露史或提示阴道腺病的体格检查结果的患者进行评价和随访，应包括阴道巴氏涂片检查，并辅以6个月至1年的阴道镜检查。所有异常区域都应进行阴道镜下直接活检。
This study describes the use of routine vaginal iodine staining and other screening procedures for the detection of vaginal adenosis in 3871 postpubertal female patients. Iodine staining identified 65 patients with nonstaining areas in the vagina. Colposcopy verified the presence of vaginal adenosis in 11 of the 65 patients. Directed biopsies confirmed the diagnosis in 10 patients. The iodine staining procedure detected vaginal adenosis in only 1 patient who did not have a positive history of DES exposure or coexisting physical findings. Iodine staining of the vagina has little value as a screening procedure for the detection of vaginal adenosis. Based on these findings, a careful medical history and vaginal examination are recommended as the most productive routine screening procedures for vaginal adenosis. Evaluation and followup of those patients with a history of DES exposure in utero or physical findings suggestive of vaginal adenosis should include vaginal Papanicolaou smears supplemented by colposcopy at 6-month to 1-year intervals. Colposcopically directed biopsies of all abnormal areas should be obtained.