McFadden K M, Sharp L, Cruickshank M E
University of Aberdeen, Aberdeen, Scotland, UK.
J Obstet Gynaecol. 2009 Nov;29(8):749-53. doi: 10.3109/01443610903191285.
Vulval intraepithelial neoplasia (VIN) is a premalignant skin condition with significant morbidities from standard surgical treatment. This two-year prospective study recruited women with newly diagnosed VIN for careful observation rather than primary surgical excision. Surgery was performed to exclude progression or for uncontrollable symptoms. Participants were seen six-monthly for clinical review and completion of questionnaires assessing depression and anxiety, quality of life, sexual functioning, and partner relationships. Eight women were recruited. Six women required immediate treatment and two women were observed carefully. By study completion, seven participants had undergone surgical treatment, often for symptom control. Women scored poorly on quality of life and sexual functioning scores; this did not appear to be due to depression or anxiety. In conclusion, careful observation does not appear a feasible option for most women with VIN since the majority require surgical treatment. VIN has an adverse impact on quality of life and sexual functioning.
外阴上皮内瘤变（VIN）是一种癌前皮肤疾病，标准手术治疗会带来显著的发病率。这项为期两年的前瞻性研究招募了新诊断为VIN的女性进行仔细观察，而非进行初次手术切除。进行手术是为了排除病情进展或治疗无法控制的症状。每六个月对参与者进行一次临床检查，并让他们完成评估抑郁和焦虑、生活质量、性功能及伴侣关系的问卷。招募了8名女性。6名女性需要立即治疗，2名女性接受仔细观察。到研究结束时，7名参与者接受了手术治疗，通常是为了控制症状。女性在生活质量和性功能评分方面得分较低；这似乎并非由抑郁或焦虑所致。总之，对于大多数VIN女性而言，仔细观察似乎并非可行选择，因为大多数患者需要手术治疗。VIN对生活质量和性功能有不利影响。
