宫颈癌术后阴道断端VAIN55例临床分析

Clinicopathologic Study of 55 Patients with Vaginal Cuff Intraepithelial Neoplasia after Operation of Cervical Cancer

目的:研究宫颈癌术后阴道断端上皮内瘤变(vaginal intraepithelial neoplasia,VAIN)的诊断、治疗及阴道断端VAIN级别与宫颈癌病理类型、临床分期、转移部位、癌灶大小、患者年龄的关系。方法:总结2001年1月至2006年5月共55例宫颈癌术后阴道断端VAIN患者的临床资料,对其临床表现、病理、治疗方法及复发等进行回顾分析。结果:55例患者中年龄≤40岁13例,>40岁42例,其中阴道断端VAINⅠ11例,VAINⅡ11例,VAINⅢ33例,均经病理检查确诊,采用手术治疗,术前或术后加用放化疗,随访1例患者复发。结论:阴道断端VAIN级别与宫颈癌病理类型、临床分期、转移部位癌灶大小、患者年龄均无关。但因它们有相似的病因,常同时或相继发生,故对宫颈癌术后发现阴道断端VAIN患者应加强随访,以便早期发现阴道浸润癌。

Objective： To study the diagnosis and therapy of patients with vaginal intraepithelial neoplasia after operation of cervical cancer,explore the correlation of the grade of vagina cuff VAIN with cervical cancer.Methods： The data of 55 patients with vagina cuff VAIN from 2001 to 2006 were reviewed and analysed retrospectively.Results： Among these 55 patients,42 patients（76.4%） were aged over 40 years and 13 patients（23.6%） were younger than 40 years.There were 11 cases（20%） of VAIN Ⅰ,11 cases（20%） of VAIN Ⅱ,33 cases（60%） of VAIN Ⅲ confirmed by biopsy.All patients were treated with operation,before or after operation were added radiotherapy or chemotherapy.One patient recurred.Conclusion： The grade of vaginal cuff VAIN is no correlation with cervical cancer and patients＇ age.But they have similar etiological factors and usually occur at same time or one after another.Periodical follow-up should be done in order to discover invasive vaginal cancer at early stage.