2013—2015年阴道镜下阴道上皮内瘤变检出率的变化趋势

摘要

Objective To explore the detection trend of vaginal intraepithelial neoplasia(VaIN)of lower genital tract from 2013 to 2015. Methods A retrospective analysis was undertaken of colposcopy-directed biopsy of cervical, vaginal and vulvar intraepithelial neoplasia lesions include cervical intraepithelial neoplasia (CIN), VaIN and vulvar intraepithelial neoplasia (VIN) in Obstetrics and Gynecology Hospital of Fudan University from January 2013 to December 2015. Results (1) Overall data of CIN, VaIN and VIN:a total of 16732 cases were diagnosed of lower genital intraepithelial neoplasia in 3 years, accounting for 23.20% (16732/72128) of total colposcopy-directed biopsy cases. Among them, CIN, VaIN and VIN accounted for 19.48%(14053/72128), 2.67%(1923/72128), 1.05%(756/72128) of total colposcopy-directed biopsy cases of the lower genital tract, 83.99%(14053/16732), 11.49%(1923/16732), 4.52%(756/16732) of total lower genital intraepithelial neoplasia, respectively. (2) Annual data of CIN, VaIN and VIN from 2013 to 2015. The annual proportion of CIN in all intraepithelial neoplasia of lower gential tract was basically stable, consisting of 86.02%(3955/4598),83.25%(4795/5760) and 83.20%(5303/6374), respectively. The annual proportion of VaIN was gradually increasing, consisting of 8.09% (372/4598), 12.45%(717/5760) and 13.08%(834/6374), respectively. The annual proportion of VIN was gradually decreasing, consisting of 5.89% (271/4598), 4.31% (248/5760) and 3.72% (237/6374), respectively. Conclusion The increasing detection of VaIN from 2013 to 2015 might correlate with the increasing attention to inspection of the entire vaginal wall.%目的 探讨2013—2015年阴道镜下阴道上皮内瘤变(VaIN)检出率的变化趋势.方法收集2013年1月1日至2015年12月31日复旦大学附属妇产科医院在阴道镜引导下活检后诊断为下生殖道上皮内瘤变的数据,包括子宫颈上皮内瘤变(CIN)、VaIN、外阴上皮内瘤变(VIN),回顾性分析2013—2015年VaIN检出率的变化趋势.结果(1)2013—2015年3年间CIN、VaIN、VIN的总体发生情况:2013—2015年阴道镜引导下活检妇女共72128例,诊断为下生殖道上皮内瘤变的患者为16732例,占23.20%(16732/72128).其中,CIN 14053例、VaIN 1923例、VIN 756例,分别占阴道镜引导下活检妇女的19.48%(14053/72128)、2.67%(1923/72128)、1.05%(756/72128),分别占下生殖道上皮内瘤变患者的83.99%(14053/16732)、11.49%(1923/16732)、4.52%(756/16732).(2)2013—2015年每年CIN、VaIN、VIN的发生情况:2013、2014、2015年,CIN占下生殖道上皮内瘤变比例基本平稳,分别为86.02%(3955/4598)、83.25%(4795/5760)、83.20%(5303/6374),VaIN占下生殖道上皮内瘤变比例逐年上升,分别为8.09%(372/4598)、12.45%(717/5760)、13.08%(834/6374),VIN占下生殖道上皮内瘤变比例逐年下降,分别为5.89%(271/4598)、4.31%(248/5760)、3.72%(237/6374).结论2013—2015年VaIN的检出率不断增高,与阴道镜检查医师重视对整个阴道壁的检查有关.