297例女阴尖锐湿疣与假性湿疣临床病理观察

A clinicopathological observation of 297 cases of condyloma and pesudo condylema in female vulva

目的 :探讨女阴尖锐湿疣及假性湿疣的临床病理诊断和鉴别诊断依据。方法 :收集 2 97例患者的临床资料 ,观察尖锐湿疣及假性湿疣临床和病理学特点 ,部分病例做免疫组化人乳头瘤病毒检测。结果 :真假湿疣发病年龄高峰差异不大。部位 :尖锐湿疣多为两个以上部位同时发生 ,而假性湿疣多数只限于一个部位。局部表现 ,两种病变均形成乳头状突起 ,是临床误诊原因之一 ,但尖锐湿疣常融合成菜花状。组织学观察 ,鳞状上皮乳头状增生及诊断性空泡细胞是尖锐湿疣的主要诊断依据 ,假性湿疣中非诊断性空泡化细胞是病理诊断误诊原因之一。免疫组化染色 ,尖锐湿疣细胞核阳性率为 6 3 % ,假性湿疣为阴性。结论

Purpose To probe the evidence for the pathological diagnosis and its differential diagnosis of condyloma and pseudo condyloma in female vulva. Methods A total of 297 cases of condyloma and pseudo condyloma were studited clinically and pathologically, and 53 cases of them were tested for HPV by immunohistochemistry. Results Onset age: no significant difference was observed on the peak onset age between those two groups. Affected areas: the condyloma far often occure simultaneously at more than two sites, while the pseudu condylomata, most of them, and just confined to a single area. Local apperance: the papillapy process, which often led to the clinical misdiagnoses, is a common feature of these two lesions. However, the condyloma often fused into the shape of a cauliflwer. Histological observations: The papillary hyperplasia and diagnostic cells in the squmous epithelia are two major diognostic support for condyloma. the nou diagnostic kiolocytotic cells in the pseude condyloma are one of the misdiagnostic reason. Immulohistochemical staining: the positive rate for HPV detection in condyloma cells was 63%, which was negative in pseudo condyloma cells. Conclusion Diagnostic kilocytotic cells and the positive HPV results are two major evidence for the diagnosis of condyloma, as well as for its differentiation from pseudo condyloma.