Kesterson Joshua P, Lele Shashikant
Division of Gynecologic Oncology, Roswell Park Cancer Institute, Buffalo, NY.
J Low Genit Tract Dis. 2009 Oct;13(4):196-199. doi: 10.1097/LGT.0b013e318196bd23.
To examine the outcome of women diagnosed with vulvar intraepithelial neoplasia (VIN) 3 at less than 35 years.
All cases of VIN 3 treated in women less than 35 years treated at Roswell Park Cancer Institute between January 1973 and January 2008 were reviewed. Medical records were reviewed for year of diagnosis, treatment modality, recurrence and/or progression, associated medical conditions, history of genital condyloma, smoking status, history of cervical pathology, and treatment.
Thirty-one women were identified. The mean age at diagnosis was 29 years. Smoking status was available in 28 patients, of which 82% (23/28) were current or former smokers. Eighty-one percent (25/31) of the women had cervical disease. Fifty-two percent (16/31) had a history of genital condyloma. Ten of the 31 women (32%) were diagnosed with persistence or recurrence of VIN 3. Three women (9.7%) progressed to invasive carcinoma.
Women diagnosed with VIN 3 at less than 35 years are at risk for persistence and/or recurrence of their disease as well as progression to carcinoma, warranting frequent and prolonged follow-up with liberal utilization of directed biopsies of suspicious lesions.
研究35岁以下被诊断为外阴上皮内瘤变(VIN)3级的女性的病情转归。
回顾了1973年1月至2008年1月在罗斯韦尔帕克癌症研究所接受治疗的所有35岁以下VIN 3级女性病例。查阅病历,了解诊断年份、治疗方式、复发和/或进展情况、相关疾病、生殖器尖锐湿疣病史、吸烟状况、宫颈病变史及治疗情况。
共确定31名女性。诊断时的平均年龄为29岁。28例患者有吸烟状况记录,其中82%(23/28)为现吸烟者或既往吸烟者。81%(25/31)的女性有宫颈疾病。52%(16/31)有生殖器尖锐湿疣病史。31名女性中有10名(32%)被诊断为VIN 3级持续存在或复发。3名女性(9.7%)进展为浸润性癌。
35岁以下被诊断为VIN 3级的女性有疾病持续存在和/或复发以及进展为癌症的风险,需要频繁且长期随访,并对可疑病变进行广泛的定向活检。