外阴皮肤活检4736例临床及组织病理诊断回顾性分析  

Retrospective analysis of clinical and pathological diagnoses of 4 736 genital skin biopsy cases

作　　者：陈槿 马英 范逍遥 陈连军 陈虎艳 黄琼 姜子琪 CHEN Jin;MA Ying;FAN Xiao-yao(Department of Dermatology,Huashan Hospital,Fudan University,Shanghai 200040,China)

机构地区：[1]复旦大学附属华山医院皮肤科,上海200040

出　　处：《实用皮肤病学杂志》2023年第5期257-261,共5页Journal of Practical Dermatology

基　　金：国家自然科学基金资助项目(82173444)

摘　　要：目的分析外阴皮肤活检患者的病种构成和临床病理诊断的一致性。方法收集复旦大学附属华山医院2011年1月—2020年12月4736例外阴皮肤活检组织,进行苏木精-伊红染色,部分行免疫组化染色检查,回顾性研究其临床和组织病理诊断资料。结果根据组织病理诊断结果,将疾病分为9大类超50种,以尖锐湿疣、硬化萎缩性苔藓、乳腺外Paget病最为常见,且不同性别及年龄段患者的疾病构成存在差异。总体来看,外阴疾病临床和组织病理诊断一致率较低,最高为50.44%(乳房外Paget病),最低为0%(疣状癌、恶性黑素瘤)。其中1022例(21.58%)进一步行免疫组化染色明确诊断。结论外阴皮肤疾患的病种有别于身体其他部位,且诊断准确率低,故临床上有必要提高对外阴疾病的认识,并纳入皮肤活检辅助诊断。Objective To analyze the disease constitution and clinicopathological consistency/inconsistency of genital skin biopsy cases.Methods A total of 4736 genital skin biopsy cases from January 2011 to December 2020 were collected from Huashan Hospital Affiliated to Fudan University,all stained with hematoxylin-eosin,and some underwent further immunohistochemical staining.We retrospectively studied the clinical and pathological diagnosis.Results Based on the pathological diagnoses,the cases were divided into 9 categories,encompassing more than 50 diseases.Condyloma acuminatum,Lichen sclerosus et atrophicus and extramammary Paget’s disease were the most common diseases.The disease composition varied among different genders and age groups.The clinicopathological consistency rate was low,ranging from 0%(verrucous carcinoma,malignant melanoma)to 50.44%(extramammary Paget’s disease).Immunohistochemical staining was performed on 1022 of all biopsies to establish definitive diagnosis.Conclusions Disease categories of genital diseases differed from those of other anatomical parts,and the diagnostic accuracy was significantly lower.It’s necessary to improve the understanding of genital diseases and carry out skin biopsy to assist the diagnosis.

关 键 词：外阴疾病 活组织检查 组织病理诊断 临床诊断 免疫组化染色 

分 类 号：R711.72[医药卫生—妇产科学]