Shatz P, Bergeron C, Wilkinson E J, Arseneau J, Ferenczy A
Department of Pathology, Sir Mortimer B. Davis Jewish General Hospital, Montreal, Quebec, Canada.
Obstet Gynecol. 1989 Nov;74(5):769-74.
Vulvar intraepithelial neoplasia may extend into the pilosebaceous units of the hairy and non-hairy skin of the vulva, and inadequate removal may cause treatment failure. We measured with a calibrated microscope the thickness of vulvar intraepithelial neoplasia and the depth to which it extended into the underlying pilosebaceous units of the vulvar skin. The mean thickness of vulvar intraepithelial neoplasia in 329 histologic sections from 62 cases was 0.38 mm; 99.5% of all vulvar intraepithelial neoplasia measured less than 0.77 and 0.69 mm in the hairy and non-hairy skin, respectively. Sebaceous-gland and hair-follicle involvement by vulvar intraepithelial neoplasia was 21 and 32%, respectively. The mean depth of sebaceous-gland involvement was 0.77 mm in the hairy skin and 0.50 mm in its non-hairy counterpart; 99.5% of all vulvar intraepithelial neoplasias extended less than 2.03 and 1.07 mm in the hairy and non-hairy skin, respectively. The mean depth of hair-follicle involvement was 1.04 mm; 99.5% of all hair follicles were involved less than 2.55 mm. Our findings suggest that removal of vulvar intraepithelial neoplasia to a depth of 1.0 and 2.0 mm in the non-hairy and hairy skin, respectively, is appropriate for successful treatment.
外阴上皮内瘤变可能会延伸至外阴有毛和无毛皮肤的皮脂腺单位，切除不充分可能导致治疗失败。我们用校准显微镜测量了外阴上皮内瘤变的厚度及其延伸至外阴皮肤下方皮脂腺单位的深度。62例患者的329个组织学切片中外阴上皮内瘤变的平均厚度为0.38毫米；在有毛和无毛皮肤中，分别有99.5%的外阴上皮内瘤变测量值小于0.77毫米和0.69毫米。外阴上皮内瘤变累及皮脂腺和毛囊的比例分别为21%和32%。在有毛皮肤中，皮脂腺受累的平均深度为0.77毫米，在无毛皮肤中为0.50毫米；在有毛和无毛皮肤中，分别有99.5%的外阴上皮内瘤变延伸深度小于2.03毫米和1.07毫米。毛囊受累的平均深度为1.04毫米；99.5%的毛囊受累深度小于2.55毫米。我们的研究结果表明，分别在无毛和有毛皮肤中切除深度为1.0毫米和2.0毫米的外阴上皮内瘤变，对于成功治疗是合适的。
