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分析宫颈上皮内瘤变合并阴道上皮内瘤变的相关因素。

Analysis of related factors of cervical intraepithelial neoplasia complicated with vaginal intraepithelial neoplasia.

机构信息

Department of Gynecology, Cancer Hospital of China Medical University, 44 River Road, Dadong, Shenyang, Liaoning, 110042, People's Republic of China.

Department of Pain and Rehabilitation (Psychology Clinic), Cancer Hospital of China Medical University, Shenyang, Liaoning, 110042, People's Republic of China.

出版信息

Clin Transl Oncol. 2022 May;24(5):902-908. doi: 10.1007/s12094-021-02739-x. Epub 2022 Jan 10.

Abstract

PURPOSE

To explore the underlying risk factors and to prevent misdiagnosis of cervical intraepithelial neoplasia (CIN) coexisted with vaginal intraepithelial neoplasia (VaIN).

METHODS

Clinical data of patients pathologically diagnosed with CIN were collected from January 2017 to December 2018. A total of 446 cases were analyzed, including 406 cases of single lesions ('CIN single' group) and 40 cases complicated with VAIN ('VAIN concurrent' group).

RESULTS

The median age of the VAIN concurrent group was 53 years (46.25-59 years), and the median age of the CIN single group was 44 years (36-50 years). Regarding menopausal status, there were 28 cases (70.0%) in the VAIN concurrent group and 89 cases (21.9%) in the CIN single group (P < 0.005). The median load of high-risk human papillomavirus (Hr-HPV) in the VAIN concurrent and CIN single group was 923.4 relative light units/cutoff (RLU/CO) (145-2172.2 RLU/CO) and 229.155 RLU/CO (18.615-638.1275 RLU/CO), respectively (P = 0.037). The results revealed that the menopausal status was an independent risk factor for VAIN occurrence in CIN patients. The risk of VAIN in menopausal patients was higher than that in non-menopausal CIN patients (OR = 8.311, 95% CI 4.062-17.005). Age and HPV load were also related to the concurrence of VAIN and CIN.

CONCLUSION

Examinations regarding vaginal screening are of great importance in the diagnosis of perimenopausal and postmenopausal CIN patients, especially patients with Hr-HPV load. Colposcopy and tissue biopsy should also be performed, when necessary, to avoid misdiagnosis and the appearance of vaginal lesions.

摘要

目的

探讨宫颈上皮内瘤变(CIN)合并阴道上皮内瘤变(VaIN)的潜在危险因素,以预防误诊。

方法

收集 2017 年 1 月至 2018 年 12 月病理诊断为 CIN 的患者临床资料,共分析 446 例,其中单发病灶 406 例(CIN 单发病灶组),40 例合并 VaIN(VAIN 并存组)。

结果

VAIN 并存组的中位年龄为 53 岁(46.25-59 岁),CIN 单发病灶组的中位年龄为 44 岁(36-50 岁)。绝经状态方面,VAIN 并存组 28 例(70.0%),CIN 单发病灶组 89 例(21.9%)(P<0.005)。VAIN 并存组和 CIN 单发病灶组高危型人乳头瘤病毒(Hr-HPV)负荷中位数分别为 923.4 相对光单位/截距(RLU/CO)(145-2172.2 RLU/CO)和 229.155 RLU/CO(18.615-638.1275 RLU/CO)(P=0.037)。结果表明,绝经状态是 CIN 患者发生 VaIN 的独立危险因素,绝经患者发生 VaIN 的风险高于非绝经 CIN 患者(OR=8.311,95%CI 4.062-17.005)。年龄和 HPV 载量也与 VaIN 和 CIN 的并存相关。

结论

对于围绝经期和绝经后 CIN 患者,阴道筛查非常重要,特别是对于高危型 HPV 载量患者。必要时应行阴道镜检查及组织活检,避免误诊及阴道病变漏诊。

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