阴道上皮内瘤变与宫颈上皮内瘤变的相关性分析

摘要

Objective To investigate the correlation between vaginal intraepithelial neoplasia (VAIN) and cervical intraepithelial neoplasia (CIN).Methods 46 VAIN cases of cervical disease outpatients with pathological diagnosis based on biopsy under colposcope were selected from January 2013 to December 2014, their clinical date were analyzed, such as clinical manifestation, vaginal exfoliated cells, human papilloma virus (HPV) infection.Results Among these 46 cases, 18 cases were diagnosed VAIN I, 22 cases VAIN Ⅱ, 6 cases VAIN Ⅲ.Patients were aged form 21 to 77, and 11 cases (23.91％) of the menopause.Ultrathin liquid based cytology smear (TCT) checked exception 40 cases (86.96％).Test positive for human papillomavirus (HPV) in 44 cases (95.65％).Merger of 22 cases of cervical intraepithelial neoplasia, 6 cases had CIN.5 cases have the comorbidity of cervical cancer and 5 cases the combination of vulvar intraepithelial neoplasia, 8 cases had the hysterectomy.Conclusion HPV infection, cervical lesion and hysterectomy caused by cervical cancer are factors of high risk for VAIN.Cytology-colposcope-histopathology is suitable for the diagnosis and follow-up of VAIN.Hysterectomy caused by cervical lesions should be closely followed up, especially within three years after hysterectomy should be vigilant against VAIN.%目的 探讨阴道上皮内瘤变(VAIN)与宫颈上皮内瘤变(CIN)的相关性.方法 选取2013年1月至2014年12月宫颈疾病门诊阴道镜下活检病理诊断VAIN患者46例,分析其临床表现、阴道脱落细胞、人乳头瘤病毒(HPV)感染等临床资料.结果 46例患者中VAINⅠ期18例、VAINⅡ期22例、VAINⅢ期6例.患者年龄21～77岁.绝经11例(23.91％).超薄液基细胞学涂片(TCT)检查异常40例(86.96％).乳头瘤病毒(HPV)检测阳性44例(95.65％).合并宫颈上皮内瘤变22例,曾患CIN 6例,合并宫颈癌5例,合并外阴上皮内瘤变5例,8例有子宫切除史.结论 HPV病毒感染、宫颈病变和宫颈癌行子宫切除术史是VAIN的危险因素;细胞学-阴道镜-组织病理学检查适用于VAIN的诊断及随诊;因宫颈病变切除子宫治疗后应密切随访,尤其是术后3年内应警惕VAIN.