| Objective: The purpose of this study is to understand the incidence trend, the related factors, the diagnosis and change of treatment, in order to avoid risk factors and search the method of prophase diagnosis and treatment, by the retrospective analysis the clinical data of vulvar intraepithelial neoplasia and Vulvar Cancer patients.Method: 41 VC patients and 22 VIN patients treated in the obstetrics and gynecology at the first hospital of jilin university from Jan.1991 to Dec.2010 were collected and analyzed by retrospective comparative methods:1) the incidence trend of Vulvar Cancer2) Compare the invasion related factors of vulvar intraepithelial neoplasia and Vulvar Cancer3) Compare the symptoms and signs of vulvar intraepithelial neoplasia and Vulvar Cancer4) the diagnostic method and reliability of vulvar intraepithelial neoplasia and Vulvar Cancer5) To analysis infiltration and metastasis of Vulvar Cancer by pathologic type and clinical stage 6) the effect of Peroperative Period recuperative of Vulvar Cancer patients by different modus operandiThe clinical data is analyzed by chi-aquare and F test statistic methods .Results: (1) During 20 years,we treated 1918 cases of the primary malignant tumors that occurred in the female reproductive system in our hospital, including 41 VC cases, the percentage of VC was 2.14%( 41/1918). (2) The age of 22 VIN patients was between 23～78 years old, mean age was 47.3±12.7 years old . while the age of 41 VC patients was between 29～80 years old, mean age was 52.7±14.0 years old, Compares the four periods of the patient's age distribution, found that the variable age of VC had been juvenescence trend, but for VIN patients, the variable age was not seen obviously decreased. Compared with the patient's age situation of this two groups, found that the age distribution between VC and VIN patients had no significant difference. (3) The proportion of VC patients with menopause was 58.5% (24/41), proportion of postmenopause had been changed from the first five years of 75% (3/5) dropped to the last five years of 43.8% (7/16), but no-menopause's proportion had been rised, from 25% (1/4) to 56.2% (9/16). By statistical analysis, this change has no significance.The proportion of no-menopause in VIN patients was 63.6% (14/22). (4) The differences of city and countryside residential area might have some influence to the onset of VC. The proportion of VC rural patients was 53.7% (22/41), while for VIN, the city patients accounted for 86.4%(19/22). By statistical analysis, region distribution in this two groups was remarkably different. (5) By statistic analysis of gravidity and parity, found that the increase of gravidity and parity could make some influence to the onset of VC. (6) Chronic vulvar dystrophy accounted for 29.3%(12/41) in VC patients, while in VIN patients is 9.1%(2/22), considering it's a factor in the onset of VC. By statistical analysis, chronic vulvar dystrophy and obesity had not seen obvious significance between this two group,but had positive correlation Malignant tumor history had some correlation with the onset of VC. (7) The main clinical manifestations were vulvar pruritus and neoplasm.The lesions were lateral side;and the VC lesions were bigger than VIN lesions. (8)Squamous-cell type still accounts for significantly larger proportions in VC(80.5%),positive lymph node accounts for 2.5%(5/197). (9) The scope of the vulva surgery effected the patient's incision healing and hospital length of stay; while with the same vulvar resect scope, inguinal lymph node dissection had no effect to the postoperative incision recovery, but significantly increased the hospital day of those who underwent simple vulvectomy, while had little effect on the patients who underwent radical vulvectomy.Conclusion: (1) The onset ages of VC had younger trend; most VIN patients were premenopause women. (2) VC patients were mainly in rural, and the VIN patients were mainly in cities. (3) Gestation,malignant tumor history and obesity have the positive correlation with VC onset. (4)The relationship of vulvar non-neoplastic epithelial disorders,VIN and VC was close. (5) Vulvar resect scope may has effect on healing,shape and physiological function.
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