Gunning J E, Ostegard D R
Obstet Gynecol. 1976 Mar;47(3):268-71.
This study describes the use of routine vaginal iodine staining and other screening procedures for the detection of vaginal adenosis in 3871 postpubertal female patients. Iodine staining identified 65 patients with nonstaining areas in the vagina. Colposcopy verified the presence of vaginal adenosis in 11 of the 65 patients. Directed biopsies confirmed the diagnosis in 10 patients. The iodine staining procedure detected vaginal adenosis in only 1 patient who did not have a positive history of DES exposure or coexisting physical findings. Iodine staining of the vagina has little value as a screening procedure for the detection of vaginal adenosis. Based on these findings, a careful medical history and vaginal examination are recommended as the most productive routine screening procedures for vaginal adenosis. Evaluation and followup of those patients with a history of DES exposure in utero or physical findings suggestive of vaginal adenosis should include vaginal Papanicolaou smears supplemented by colposcopy at 6-month to 1-year intervals. Colposcopically directed biopsies of all abnormal areas should be obtained.
本研究描述了对3871例青春期后女性患者使用常规阴道碘染色及其他筛查程序来检测阴道腺病的情况。碘染色发现65例患者阴道存在不着色区域。阴道镜检查证实65例患者中有11例存在阴道腺病。直接活检确诊了10例患者。碘染色程序仅在1例既无己烯雌酚暴露阳性史也无并存体征的患者中检测出阴道腺病。阴道碘染色作为检测阴道腺病的筛查程序价值不大。基于这些发现，建议详细询问病史及进行阴道检查，作为检测阴道腺病最有效的常规筛查程序。对有子宫内己烯雌酚暴露史或有提示阴道腺病体征的患者进行评估及随访时，应包括阴道巴氏涂片检查，并每隔6个月至1年进行一次阴道镜检查。应对所有异常区域进行阴道镜引导下活检。
