Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen-European Metropolitan Area of Nuremberg (CCC ER-EMN), Universitätsstrasse 21-23, 91054 Erlangen, Germany.
Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen-European Metropolitan Area of Nuremberg (CCC ER-EMN), Universitätsstrasse 21-23, 91054 Erlangen, Germany.
Gynecol Oncol. 2020 May;157(2):463-468. doi: 10.1016/j.ygyno.2020.02.026. Epub 2020 Feb 24.
Colposcopy-guided punch biopsy is a cornerstone method for diagnosing vulvar diseases. The aim of this study was to evaluate the concordance rate of clinical findings in vulvar diseases during examinations, in comparison with colposcopy-directed punch biopsy. We also developed a new classification to simplify the categorization of vulvoscopic findings.
The concordance rate of the clinical findings was compared with the final histology results from punch biopsies. The data were collected between January 2014 and May 2017 at the Erlangen University Hospital.
A total of 482 colposcopy-directed punch biopsies of the vulva were obtained in 420 women. The overall concordance rate of the clinical findings in comparison with the histological vulvar punch-biopsy findings was 53.9% for all entities - benign lesions, lichen, low- and high-grade squamous intraepithelial lesions (LSIL/HSILs), and vulvar carcinoma. The concordance rate for detecting LSILs was 64.3% (45/70). The concordance rate for detecting HSILs was 62.3% and for Vulvar carcinoma 65.2%.
Punch biopsy of suspicious lesions continues to be a cornerstone in diagnosing HSILs and carcinoma of the vulva. Careful work-up of the vulva is recommended when patients have symptoms such as pruritus or pain. The new classification is more specific for diagnosing lesions in the vulva.
阴道镜引导下的活检是诊断外阴疾病的基石方法。本研究旨在评估外阴疾病检查中临床发现与阴道镜引导下活检的一致性，并开发一种新的分类方法以简化外阴镜下发现的分类。
将临床发现的一致性与活检的最终组织学结果进行比较。该数据于 2014 年 1 月至 2017 年 5 月在埃尔朗根大学医院收集。
对 420 名女性共进行了 482 次阴道镜引导下外阴活检。所有实体（良性病变、苔藓、低级别和高级别鳞状上皮内病变[LSIL/HSIL]以及外阴癌）的临床发现与组织学外阴活检发现的总体一致性为 53.9%。检测 LSIL 的一致性为 64.3%（45/70）。检测 HSIL 的一致性为 62.3%，检测外阴癌的一致性为 65.2%。
对于 HSIL 和外阴癌，活检仍然是诊断的基石。当患者出现瘙痒或疼痛等症状时，建议仔细检查外阴。新的分类方法对于诊断外阴病变更具特异性。
