Lee R A, Symmonds R E
Obstet Gynecol. 1976 Jul;48(1):61-4.
Sixty-six patients were seen at the Mayo Clinic from 1950 through 1974 with in situ carcinoma of the vagina following various forms of treatment for a similar lesion of the cervix. Sixty-three patients have remained free of recurrent disease. One patient has been lost to followup, 1 patient required a second local excision, and 1 patient had recurrent carcinoma that progressed to invasive vaginal malignant disease. The recurrent malignant disease was usually asymptomatic; its presence was suggested by an abnormal Papanicolaou smear and confirmed by Schiller stain or colposcopically directed biopsy. Colposcopic examination of the vagina has greatly facilitated delineation of the lesion; this may allow relatively simple definitive therapy in some instances--that is, local excision or partial vaginectomy. Total vaginectomy, with or without skin graft vaginal reconstruction, must be carried out in patients who have multicentric lesions. The use of vaginal radium or external beam therapy should be limited to the elderly patients or those to whom a functional vagina is unimportant.
1950年至1974年期间，梅奥诊所共收治了66例因宫颈类似病变接受过各种治疗后发生阴道原位癌的患者。63例患者未出现疾病复发。1例患者失访，1例患者需要再次进行局部切除，1例患者出现复发性癌，进展为浸润性阴道恶性疾病。复发性恶性疾病通常无症状；其存在通过异常巴氏涂片提示，并通过席勒染色或阴道镜引导活检确诊。阴道镜检查极大地有助于病变的描绘；在某些情况下，这可能允许相对简单的确定性治疗，即局部切除或部分阴道切除术。对于有多中心病变的患者，必须进行全阴道切除术，可选择或不选择皮肤移植阴道重建。阴道镭疗或体外照射疗法应仅限于老年患者或对功能性阴道不重要的患者。
