Universidade Federal Fluminense NiteróiRJ Brazil Universidade Federal Fluminense, Niterói, RJ, Brazil.
Universidade Federal do Paraná CuritibaPR Brazil Universidade Federal do Paraná, Curitiba, PR, Brazil.
Rev Bras Ginecol Obstet. 2024 Jul 26;46. doi: 10.61622/rbgo/2024rbgo62. eCollection 2024.
To report the prevalence of malignant transformation of vulvar lichen sclerosus (VLS) and possible risk factors.
This is a cohort study with data analysis from medical records of 138 patients with histological diagnosis of VLS registered at the Vulvar Pathology Outpatient Clinic of the University Hospital, between 2007 and 2017. Predominance of risk factors was performed using logistic regression analysis. The variables studied were the length of follow-up, age, regular or irregular follow up; presence of symptoms (dyspareunia, pruritus and/or vulvar burning); histology characteristics, the presence of epithelial hyperplasia; and the presence of autoimmune diseases.
There were 138 patients included in the study, and among them five progressed to malignant transformation. The patients had a median age of 59 years and 83% were symptomatic. The most frequent symptom was itching with 72%. Autoimmune diseases were present in 11.6%, the most prevalent being thyroid disease. All five case of malignant transformation (0.6%) had an irregular follow up. The logistic regression analysis was used among the studied variables, and no statistical significance was found among them (p ≥ 0.05). The relationship between hyperplasia and the clinical outcome of malignant transformation, in which non-significant but acceptable p value close to 0.05 was observed.
The prevalence of malignant transformation in patients with VLS was 0.6%, and common factors were the lack of adherence to medical treatments and the loss of follow-up.
报告外阴硬化性苔藓（VLS）恶变的发生率及可能的危险因素。
这是一项队列研究，对 2007 年至 2017 年间在大学医院外阴病理门诊登记的 138 例组织学诊断为 VLS 的患者的病历进行数据分析。使用逻辑回归分析来评估危险因素的优势。研究的变量包括随访时间、年龄、定期或不定期随访、症状（性交困难、瘙痒和/或外阴烧灼感）、组织学特征（上皮增生）、自身免疫性疾病。
本研究共纳入 138 例患者，其中 5 例发生恶变。患者的中位年龄为 59 岁，83%有症状。最常见的症状是瘙痒，占 72%。自身免疫性疾病的发生率为 11.6%，最常见的是甲状腺疾病。所有 5 例恶变病例（0.6%）均未定期随访。对研究变量进行逻辑回归分析，未发现统计学意义（p≥0.05）。在增生与恶性转化的临床结局之间存在一定的关系，但观察到的 p 值接近 0.05，无统计学意义。
VLS 患者恶变的发生率为 0.6%，常见的因素是不遵医嘱和失去随访。
