295例阴道上皮内瘤变临床分析  

The Clinical Analysis of Two Hundred and Ninety-five Cases of Vaginal Intraepithelial Neoplasia

作　　者：薛慧丰[1] 戴丽玉[1] 陈建翠[1] 陈巧云[1] 郑锦文[1] XUE Huifeng;DAI Liyu;CHEN Jiancui;CHEN Qiaoyun;ZHENG Jinwen(Cervical Disease Diagnosis and Treatment Health Care Center,Fujian Provincial Maternity and Children′s Hospital,Fuzhou Fujian 350001,China)

机构地区：[1]福建省妇幼保健院宫颈疾病诊治保健中心

出　　处：《中国卫生标准管理》2019年第24期35-38,共4页China Health Standard Management

摘　　要：目的探讨阴道上皮内瘤变(vaginal intraepithelial neoplasia,VAIN)的临床特点。方法回顾性分析2013年1月1日—2018年12月31日在福建省妇幼保健院宫颈疾病诊治中心进行阴道镜检查并发现的VAIN患者的临床资料。结果共收集到295例VAIN患者,其中高级别VAIN(high-grade squamous intraepithelial lesion,HSIL)89例,低级别VAIN(low-grade squamous intraepithelial lesion,LSIL)206例。HSIL患者平均年龄高于LSIL患者平均年龄(P<0.001)。共获得272例患者液基细胞学检测结果,VAIN的病变程度与细胞学结果异常程度存在正相关趋势(P<0.001)。共获得139例患者人乳头瘤病毒(HPV)检测结果,HSIL患者的HPV型别排前5位的是HPV 16型,58型,52型,33型和18型。67例患者曾行子宫切除病术,手术的主要原因是宫颈病变。228例患者无子宫切除术史,其中104例合并宫颈病变,VAIN病变程度与合并的宫颈病变程度存在正相关趋势(P<0.001);124例无合并宫颈病变,其中LSIL 110例,HSIL 14例。结论年龄增大,VAIN的级别较高。VAIN的病变程度与细胞学结果异常程度呈正比,宫颈病变程度越严重,合并VAIN的级别越高,故阴道镜检查时应重视观察阴道壁。因宫颈上皮内瘤变或宫颈癌行子宫切除术前,建议阴道镜检查有否阴道上皮内瘤变,以避免阴道病变残留。Objective To summarize the clinical features of vaginal intraepithelial neoplasia(VAIN).Methods A retrospective study was conducted on the medical records of VAIN patients diagnosed by colposcopy-directed biopsy in Cervical Disease Diagnosis and Treatment Health Center,Fujian Provincial Maternity and Children’s Hospital from 1st January 2013 to 31st December 2018.Results A total of 295 cases with VAIN were collected,including 89 cases with high VAIN(HSIL)and 206 cases with low VAIN(LSIL).The average age of HSIL patients was higher than that of LSIL patients(P<0.001).Two hundred seventy-two patients received by liquid-based cytology examination.There was a positive correlation between the lesion degree of VAIN and the abnormal degree of cytology(P<0.001).A total of 139 patients received HPV detection,and the top 5 HPV types in HSIL patients were HPV 16,58,52,33 and 18.67 cases had undergone a hysterectomy,the main reason of which was cervical lesion.228 patients had no history of hysterectomy,of which 104 patients had cervical lesions,and VAIN lesions showed a positive correlation with the cervical lesions(P<0.001).There were 124 cases without cervical lesions,including 110 cases of LSIL and 14 cases of HSIL.Conclusion Age is related to the high level of VAIN.The lesion degree of VAIN was positively proportional to the abnormal degree of cytology.The severity of cervical lesions was correlated with the high-grade VAIN lesions,so the vaginal wall should be carefully observed during colposcopy.Before hysterectomy for cervical intraepithelial neoplasia or cervical cancer,colposcopy is recommended to check for vaginal lesions to avoid residual vaginal lesions.

关 键 词：阴道上皮内瘤变 液基细胞学 人乳头瘤病毒 阴道镜引导下活检 宫颈病变 子宫切除 

分 类 号：R115[医药卫生—公共卫生与预防医学]