AbstractObjective To investigate the clinical features and treatment of vaginal intraepithelial neoplasia (VAIN). Methods Clinical data of 50 patients with VAIN, aged 33-76 years, were retrospectively analyzed. Among them, 16 patients were diagnosed with grade Ⅰ VAIN, 5 with grade Ⅱ VAIN and 29 with grade Ⅲ VAIN. Results A majority of VAIN patients presented with no clinical symptoms, whereas few cases were manifested with increased vaginal secretion. The lesions were located in the vaginal fornix or the upper 1/3 of the vagina in 82% of patients, and in the middle and lower 1/3 of the vagina in the remaining 18% cases. Patients with VAIN Ⅰ were observed during follow-up, VAIN Ⅱ patients were given with local administration of medication, and VAIN Ⅲ patients received three-dimensional high-dose rate after loading intracavitary radiotherapy. Human papilloma virus (HPV) infection was positively correlated with VAIN grade (P=0.028). Conclusions The VAIN grade is positively correlated with high-risk HPV infection. Afterloading intracavitary radiotherapy is an efficacious therapeutic approach for VAIN Ⅲ patients,which yields slight adverse events and high cure rate.
Zhong Wei,Na Renhua,Gulina·kuerban. Analysis of clinical treatment of 50 cases of vaginal intraepithelial neoplasia[J]. Chinese Journal of Radiation Oncology, 2018, 27(4): 378-381.
Zhong Wei,Na Renhua,Gulina·kuerban. Analysis of clinical treatment of 50 cases of vaginal intraepithelial neoplasia[J]. Chinese Journal of Radiation Oncology, 2018, 27(4): 378-381.
[1] Graham JB,Meigs JV.Recurrence of tumor after total hysterectomy for carcinoma in situ[J].Am J Obstet Gynecol,1952,64(5):1159-1162.DOI:10.1016/0002-9378(52)90380-3. [2] Hodeib M,Cohen JG,Mehta S,et al. Recurrence and risk of progression to lower genital tract malignancy in women with high grade VAIN[J].Gynecol Oncol,2016,141(3):507-510.DOI:10.1016/j.ygyno.2016.03.033. [3] Massad LS,Xie XH,Greenblatt RM,et al. Effect of human immunodeficiency virus infection on the prevalence and incidence of vaginal intraepithelial neoplasia[J].Obstet Gynecol,2012,119(3):582-589.DOI:10.1097/AOG.0b013e318244ee3 d. [4] Liao JB,Jean S,Wilkinson-Ryan I,et al. Vaginal intraepithelial neoplasia (VAIN) after radiation therapy for gynecologic malignancies:a clinically recalcitrant entity[J].Gynecol Oncol,2011,120(1):108-112.DOI:10.1016/j.ygyno.2010.09.005. [5] Boonlikit S,Noinual N.Vaginal intraepithelial neoplasia:a retrospective analysis of clinical features and colpohistology[J].J Obstet Gynaecol Res,2010,36(1):94-100.DOI:10.1111/j.1447-0756.2009.01108.x. [6] 李淑敏,章文华,白萍,等.阴道上皮内瘤变20例临床分析[J].中华妇产科杂志,2009,44(4):277-280.DOI:10.3760/cma.j.issn.0529-567x.2009.04.010. Li SM,Zhang WH,Bai P,et al. Clinical analysis of 20 patients with vaginal intraepithelial neoplasia[J].Chin J Obstet Gynecol,2010,36(1):94-100.DOI:10.1111/j.1447-0756.2009.01108.x. [7] Horn LC,Klostermann K,Hautmann S,et al. HPV-associated alterations of the vulva and vagina. Morphology and molecular pathology[J].Pathologe,2011,32(6):467-475.DOI:10.1007/s00292-011-1476-5. [8] 宋昱,戴斐,隋龙,等.CO2激光气化治疗外阴和阴道上皮内瘤变191例临床分析[J].复旦学报:医学版,2015,42(4):511-516.DOI:10.3969/j.issn.1672-8467.2015.04.014. Song Y,Dai F,Sui L,et al. Clinical analysis on 191 cases of vaginal and vulvar intraepithelial neoplasia treated with CO2 laser vaporization[J].Fudan Univ J Med Sci,2015,42(4):511-516.DOI:10.3969/j.issn.1672-8467.2015.04.014. [9] Gurumurthy M,Cruickshank ME.Management of vaginal intraepithelial neoplasia[J].J Low Genit Tract Dis,2012,16(3):306-312.DOI:10.1097/LGT.0b013e31823 da7fb. [10] 林荣春,姚婷婷,凌小婷,等.《FIGO2015妇癌报告》解读连载六——阴道癌诊治指南解读[J].中国实用妇科与产科杂志,2016,32(1):54-56.DOI:10.7504/fk2015120112. Lin RC,Yao TT,Ling XT,et al. FIGO2015 Women′s Cancer Report" interpretation of serial six—interpretation of the guidelines for diagnosis and treatment of vaginal cancer[J].Chin J Pract Gynecol Obstet,2016,32(1):54-56.DOI:10.7504/fk2015120112. [11] Zolciak-Siwinska A,Gruszczynska E,Jonska-Gmyrek J,et al. Brachytherapy for vaginal intraepithelial neoplasia[J].Eur J Obstet Gynecol Reprod Biol,2015,194:73-77.DOI:10.1016/j.ejogrb.2015.08.018.
2018, Vol. 27 
