宫颈癌术后阴道上皮内瘤变11例分析

Cervical vaginal intraepithelial neoplasia after analysis of 11 cases

目的探讨宫颈癌术后阴道上皮内瘤变(VaIN)的早期诊断路径、发生部位、治疗及预后。方法总结2007年至2011年宫颈癌术后患者在门诊随访中发现VaIN11例,对其临床症状、HPV(人乳头瘤病毒)感染情况、阴道镜表现、治疗及预后进行回顾性分析。结果患者中HPV感染11例,阳性率100%,其中HPV16阳性8例、HPV18阳性1例、HPV33阳性1例、HPV52阳性1例;TCT:ASCUS 2例,阳性率为18.19%,阴道镜下阳性率达100%,阴道镜下活检病理示VaINI(4例),VaINII(6例),VaINIII(1例),仅1例VaINIII行手术治疗,余病例均行CO2激光消融治疗,所有患者病变部位均位于阴道上段,呈多灶性表现,其中2例VaIN治疗半年后复发,予再次激光治疗。结论高危型HPV感染是VaIN发病的主要原因,尤其需加强宫颈癌术后HPV16阳性的筛查,并联合阴道镜进行术后随访,CO2激光治疗对VaIN治疗有效,预后好。

Objective To study cervical carcinoma after vaginal intraepithelial neoplasia（VaIN） path,part of early diagnosis,treatment and prognosis.Methods summarizing 2007-2011 in patients with cervical cancer after VaINl 1 cases discovered in the follow-up,its clinical manifestations,HPV（human papilloma virus） infection,vaginal Speculum,treatment and prognosis for retrospective analysis.Results 11 cases of HPV infection in 11 cases,positive rate of 100%;TCT：ASCUS 2 cases, positive rate 18.19%, vaginal mirror Xia positive rate up 100%,which 2 cases VaIN treatment half Hou recurrence,to again laser treatment.Conclusion the main reasons for the occurrence of high-risk HPV infection is VaiN,in particular strengthening of HPVl6 positive after operation of cervical carcinoma screening,and combined with colposcopy for postoperative follow-up,VaiN CO2 laser therapy in the treatment effective,prognosis is good.