摘要
目的:探讨女性下生殖道多中心上皮内瘤变的阴道镜图像特点及诊断要点。方法:回顾分析2008年3月至2016年12月重庆市妇幼保健院宫颈病特色专科门诊收治的53例下生殖道多中心上皮内瘤变的临床资料及阴道镜图像,采用卡方检验和Spearman等级相关分析比较不同等级病变的差异及相关性。结果:(1)宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)合并阴道上皮内瘤变(vaginal intraepithelial neoplasia,VAIN)52例,CIN+VAIN+外阴上皮内瘤变(vulvar intraepithelial neoplasia,VIN)1例。(2)79.25%(41/53)的病灶为同时检出,20.75%(12/53)的病灶为先后检出。(3)CIN行宫颈锥切术后检出VAIN的平均间隔时间[(14.33±10.46)月]早于CIN行全子宫切除术后检出阴道残端VAIN的平均间隔时间[(46.00±22.46)月](t=-2.885,P=0.034)。(4)CINⅡ~Ⅲ合并VAINⅡ~Ⅲ的比例(65.79%,25/38)高于合并VAINⅠ(34.21%,13/38)(χ2=6.644,P=0.009);随着CIN病变级别升高,VAIN病变级别呈升高趋势,呈正相关(r=0.354,P=0.009)。(5)50例(94.34%)CIN累及多个象限,25例(47.17%)VAIN为多发病灶;44例VAIN(83.02%)病灶位于阴道上1/3。(6)VAINⅡ~Ⅲ病灶与CIN病灶连续分布出现率(58.62%)高于VAINⅠ(25.00%),而VAINⅠ病灶与CIN病灶间断分布出现率(75.00%)高于VAINⅡ~Ⅲ(41.38%)(χ~2=6.043,P=0.014)。结论:女性下生殖道多中心上皮内瘤变以高级别病变联合存在最为常见,病变呈多象限累及,连续分布多见;应加强对高级别CIN患者术前阴道镜评估及术后阴道上皮病变的监测。
Objective：To explore colposcopic characteristics and diagnostic points of female patients with multicentric intraepithelial lesions in lower genital tract.Methods：A retrospective review of clinical data and colposcopic evaluation of 53 patients with multicentric intraepithelial lesions in lower genital tract in our department of cervical disease from March 2008 to December 2016 was con-ducted,and chi-square test and Spearman＇s correlation coefficient for ranked data were used to compare the difference and correlation between different grades of lesions.Results：（1） Fifty-two patients were diagnosed with cervical intraepithelial neoplasia（CIN）combined vaginal intraepithelial neoplasia（VAIN）,and one patient was diagnosed with CIN ＋VAIN ＋VIN.（2） Among all lesions,79.25%（41/53）were synchronous,and 20.75%（12/53）were metachronous.（3）The mean interval of VAIN[（14.33±10.46）months]after CIN following cervical conization was earlier than the mean interval of VAIN[（46.00±22.46）months] after CIN following total hysterectomy（t=-2.885,P=0.034）.（4）The ratio of CINⅡ-Ⅲ combined with VAINⅡ-Ⅲ（65.79%,25/38）was higher than that with VAINⅠ（χ^2=6.644,P=0.009）;with the progression of CIN lesion grade,the grade of VAIN lesion showed an upward trend,which was positively correlated（r=0.354,P=0.009）.（5）Fifty（94.34%）patients with CIN were involved in multiple quadrants,25（47.17%）patients with VAIN had multiple lesions,and 44（83.02%） patients with VAIN lesions located in the upper 1/3 vagina.（6） The continuous occurrence rate of VAINⅡ-Ⅲ and CIN lesions（58.62%）was significantly higher than that of VAINI（25.00%）,and the intermittent occurrence rate of VAINⅠ（75.00%）and CIN lesions was significantly higher than that of VAINⅡ-Ⅲ（41.38%）（χ^2=6.043,P=0.014）.Conclusion：Women with multicentric intraepithelial lesions in lower genital tract combined with high-grade lesions are the most common,which is characterized by mult
出处
《重庆医科大学学报》
CSCD
北大核心
2017年第12期1662-1666,共5页
Journal of Chongqing Medical University
基金
重庆市卫计委重点资助项目(编号:2013-1-043)
关键词
下生殖道
上皮内瘤变
多中心
阴道镜
lower genital tract
intraepithelial lesions
multi-center
colposcopy
