Petrilli E S, Townsend D E, Morrow C P, Nakao C Y
Am J Obstet Gynecol. 1980 Oct 1;138(3):321-8. doi: 10.1016/0002-9378(80)90256-2.
A review of 41 evaluable patients was made in order to study vaginal intraepithelial neoplasia (VAIN) and to investigate new methods of treatment. Colposcopic examination of the vagina revealed white epithelium alone in 20 patients and white epithelium associated with vascular punctation in 15. No lesion had a vascular mosaic pattern. Most patients had multifocal disease located in the vaginal apex. Iodine staining was positive in six patients with negative colposcopic examinations. Twenty-four patients had severe dysplasia or carcinoma in situ, and 17 had minimal or moderate dyplasia. Associated genital disease occurred in 17 patients with antecedent cervical or vulvar squamous neoplasia, and six additional patients had coexistent lesions. The chronology of vaginal disease that appeared after treatment of cervical neoplasia suggests a persistent but decreasing likelihood of the development of VAIN with the passage of time. In patients followed without therapy, six had spontaneous remission of disease. Treatment was successful in 12 of 15 patients with topical 5-fluorouracil and in nine of 10 patients with the carbon dioxide laser. The advantage of these methods of treatment for patients with VAIN relative to surgical procedures and radiation therapy are considered.
对41例可评估患者进行了回顾性研究，以探讨阴道上皮内瘤变（VAIN）并研究新的治疗方法。阴道镜检查发现，20例患者仅见白色上皮，15例患者白色上皮伴有血管点状改变。无病变呈现血管镶嵌模式。大多数患者的多灶性病变位于阴道顶端。6例阴道镜检查阴性的患者碘染色呈阳性。24例患者有重度发育异常或原位癌，17例有轻度或中度发育异常。17例既往有宫颈或外阴鳞状肿瘤的患者出现相关生殖器疾病，另有6例患者存在并存病变。宫颈肿瘤治疗后出现的阴道疾病时间顺序表明，随着时间推移，VAIN发生的可能性持续存在但逐渐降低。在未接受治疗的随访患者中，6例疾病自发缓解。15例局部应用5-氟尿嘧啶的患者中有12例治疗成功，10例接受二氧化碳激光治疗的患者中有9例治疗成功。文中还讨论了这些VAIN治疗方法相对于手术和放射治疗的优势。
