摘要
目的 探讨阴道镜指导下活检诊断阴道上皮内瘤变（VaIN）的临床价值.方法 回顾性分析阴道镜指导下活检诊断的106例VaIN患者的临床资料.既往有宫颈癌病史46例,宫颈上皮内瘤变病史43例,因良性疾病切除子宫病史13例,无明确病史4例.结果 106例患者97例（91.51％,97/106）阴道残端细胞学检查异常,9例（8.49％,9/106）宫颈细胞学检查异常.诊断出VaIN Ⅰ 69例,VaINⅡ24例,VaINⅢ13例.VaIN患者高危型人乳头瘤病毒（HPV）阳性者98例（92.45％,98/106）,阴性者8例（7.55％,8/106）.VaIN发生于阴道上1/3者87例,其他部位者19例.98例患者病变呈多灶性分布,8例呈局灶性分布.结论 阴道镜指导下活检诊断VaIN具有较高的临床应用价值,但应密切结合患者既往病史,阴道镜检查应检查全阴道,可疑部位多点活检,以提高病变检出率.
Objective To explore the clinical value of colposcopy directed biopsy in diagnosis of vaginal intraepitheal neoplasia （VaIN）.Methods The clinical data of 106 VaIN patients diagnosed by colposcopy directed biopsy were reviewed and analyzed retrospectively.In the past medical history of 106 patients,46 patients had cervical cancer history,43 patients had cervical intraepithehal neoplasia history,13 patients had previous hysterectomy because of benign disease and 4 patients had uncertain past medical history.Results Among 106 patients,97 patients（91.51％,97/106） had abnormal pap smears of vagina,9 patients （8.49％,9/106） had abnormal pap smears of cervix.Histological analysis revealed that 69 patients were VaIN Ⅰ,24 patients were VaIN Ⅱ,13 patients were VaIN Ⅲ.The high-risk human papilloma virus （HPV） test at diagnosis were positive in 98 patients （92.45％,98/106）,negative in 8 patients （7.55％,8/106）.Eighty-seven patients VaIN were localized in the upper one third of the vagina,19 patients VaIN were localized in other parts of vaginal wall.Ninety-eight patients VaIN affected to the multifocal vaginal wall,8 patients VaIN affected to the focal vaginal wall.Conclusions It has highly therapeutic value of colposcopy directed biopsy in diagnosis of VaIN.But should closely correlated to past medical history,colposcopy should performed on the whole vagina wall and multiple punch biopsy to elevated positive rate.
出处
《中国医师进修杂志》
2013年第33期1-4,共4页
Chinese Journal of Postgraduates of Medicine
基金
首都医科大学附属北京妇产医院院内课题（200913）
关键词
阴道镜检查
阴道上皮内瘤变
临床价值
Colposcopy
Vaginal intraepithelial neoplasia
Clinical value
作者简介
通信作者：吴玉梅，Email：wym-530@sohu．com
