Vaginal intraepithelial neoplasia: clinical-therapeutic analysis of 33 cases
Vaginal intraepithelial neoplasia: clinical-therapeutic analysis of 33 cases
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DOI：
10.1007/s00404-005-0022-1
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发表时间：
2005-10-01
影响因子：
2.6
通讯作者：
Maluf, Paulo J.
中科院分区：
文献类型：
--
作者：
Murta, Eddie F. C.;Junior, Milton A. Neves;Maluf, Paulo J.
阴道上皮内瘤变 (VAIN) 占所有下生殖道上皮内瘤变的 1%。我们的目的是研究 VAIN 患者的临床治疗特征。对 19 月 3 日至 2003 年期间在门诊就诊并诊断为 VAIN 的所有患者进行了回顾性研究。在此期间，进行了 84,293 例巴氏涂片（三重采集），总共 33 名（50.32 +/- 11.5 岁）患者被诊断为 VAIN。在这些患者中，26 名（78.8%）是白人，17 名（51.5%）是吸烟者。 23 人（69.6%）之前曾接受过子宫切除术。 20例（87%）宫颈上皮内或浸润性肿瘤（CIN）出现VAIN之前有子宫切除指征，2例（8.6%）出现子宫肌瘤后有子宫切除指征。子宫切除术和 VAIN 出现之间的中位时间为 41 个月。 VAIN 11 级和 III 级分别为 13 例（39.4%）、11 例（33.3%）。 28 名患者 (84.8%) 出现影响阴道上三分之一的单一病变。最常见的发现是 17 名患者 (51.5%) 存在白色上皮。局部应用 5-氟尿嘧啶 (5-FU) 的 16 例患者中有 10 例获得缓解。七名患者接受了手术，其中六名患者病情得到缓解，一名患者病变持续存在。我们的结论是，因良性改变而接受子宫切除术的患者可能会发生 VAIN。这证明了使用常规巴氏试验的合理性。手术和 5-FU 治疗均有效。
Vaginal intraepithelial neoplasia (VAIN) represents 1% of all intraepithelial neoplasia of the lower genital tract. Our aim was to study the clinical-therapeutic characteristics of patients with VAIN. A retrospective study was made of all cases of patients who attended within the outpatient service between 19 3 and 2003, with a diagnosis of VAIN. During this period, 84,293 Papanicolaou smears (triple collection) were performed and a total of 33 (50.32 +/- 11.5 years old) patients with VAIN were diagnosed. Among these patients, twenty-six (78.8%) were white, 17 (51.5%) were smokers. and 23 (69.6%) had undergone hysterectomy previously. The indications for hysterectomy prior to the appearance of VAIN were found in 20 cases (87%) of cervical intraepithelial or invasive neoplasia (CIN), and in two (8.6%) cases after myoma uterine. The median time elapsed between the hysterectomy and the appearance of VAIN was 41 months. Thirteen (39.4%), 11 (33.3%) cases were, respectively, VAIN 11 and III. Twenty-eight patients (84.8%) presented a single lesion affecting the upper third of the vagina. The commonest finding was the presence of white epithelium in 17 patients (51.5%). Ten of 16 cases submitted to topical application of 5-fluorouracil (5-FU) achieved remission. Surgery was utilized for seven patients, of whom six achieved remission and one had persistence of the lesion. We conclude that VAIN may occur in patients who have undergone hysterectomy due to benign alterations. This justifies the use of routine Papanicolaou tests. Both surgical and 5-FU treatments are efficient.