Ruiz-Moreno J A, Garcia-Gomez R, Vargas-Solano A, Alonso P
Department of Gynecology and Obstetrics, Hospital Central Militar, Mexico City, Mexico.
Int J Gynaecol Obstet. 1987 Oct;25(5):359-62. doi: 10.1016/0020-7292(87)90340-7.
From 1978 to 1985 we have found 14 cases of vaginal intraepithelial neoplasia (VAIN) in patients previously hysterectomized. VAIN was detected by an abnormal cytology; diagnostic process included a second cytology, colposcopy, Schiller test, and directed biopsies. VAIN was classified as grade I in 5 patients (35.7%); grade II in 5 patients (35.7%); and grade III in 4 patients (28.6%). Pathogenic classification of VAIN was: VAIN de novo 9 cases (64.3%); VAIN after vaginal irradiation, 3 cases (21.4%); VAIN following incomplete removal of a cervical intraepithelial neoplasia, one case (7.1%); and VAIN as manifestation of a multicentric neoplasia of the lower genital tract, one case (7.1%). The mean time between hysterectomy and VAIN diagnosis was 6.9 years; this time was larger for those women hysterectomized by benign uterine diseases (9.0 years vs. 2.4 years). Our conclusion is that patients who have lost their uterus by malignant or benign diseases should be followed-up with periodic vaginal cytology in order to detect vaginal neoplasia in its pre-invasive stages.
1978年至1985年间，我们在先前接受过子宫切除术的患者中发现了14例阴道上皮内瘤变（VAIN）。VAIN通过异常细胞学检查发现；诊断过程包括第二次细胞学检查、阴道镜检查、碘试验和定向活检。VAIN在5例患者中被分类为I级（35.7%）；5例患者中为II级（35.7%）；4例患者中为III级（28.6%）。VAIN的病因分类为：原发性VAIN 9例（64.3%）；阴道放疗后VAIN 3例（21.4%）；宫颈上皮内瘤变切除不完全后VAIN 1例（7.1%）；VAIN作为下生殖道多中心肿瘤的表现1例（7.1%）。子宫切除与VAIN诊断之间的平均时间为6.9年；因良性子宫疾病接受子宫切除术的女性的这一时间更长（9.0年对2.4年）。我们的结论是，因恶性或良性疾病失去子宫的患者应定期进行阴道细胞学检查，以便在阴道肿瘤的浸润前期进行检测。
