[Clinical analysis of patients underwent hysterectomy for stage I cervical cancer or high grade cervical intraepithelial neoplasia with vaginal intraepithelial neoplasia].

OBJECTIVE

To analyse the necessity of colposcopic directed biopsy to vaginal intraepithelial neoplasia (VAIN) before hysterectomy due to early stage cervical cancer (stage I) or high grade cervical intraepithelial neoplasia (CIN).

METHODS

A total of 669 patients who underwent a hysterectomy due to early stage cervical cancer (stage I) and CIN III in Beijing Obstetrics and Gynecology Hospital, Capital Medical University, from January 1, 2009 to December 31, 2013 and followed up, 99 patients with VAIN were enrolled. The clinical data and following up the prognosis were prospectively analyzed retrospectively.

RESULTS

The occurrence rate of VAIN before and after hysterectomy due to cervical dysplasia was 14.8% (99/669), the occurrence rate and the grade of VAIN showed that significantly increased from CIN III to cervical cancer stage I (P < 0.05); Only 15 patients enrolled had undergone vaginal wall biopsy by colposcopy pre-hysterectomy, including 11 patients who were diagnosed with VAIN II-III and underwent vagina extended resection during the hysterectomy. The 5 year recurrence rate of vaginal stump VAIN after hysterectomy was 12.1% (12/99) and the progression rate was 4.0% (4/99), the recurrent rate was 2.0% (2/99).

CONCLUSIONS

For all the patients who are planning to undergo hysterectomy due to stage I cervical cancer and CIN III, routine upper side of the vagina wall colposcopic-directed biopsy prehysterectomy is strongly recommended. All the patients after hysterectomy due to cervical dysplasia should be followed up regularly within 3 years after hysterectomy.