The Clinical Analysis Of 126 Cases With Vaginal Intraepithelial Neoplasia

Objective:To explore the clinical-pathologic characteristics,diagnosis,treatment modalities and prognosis of patients with VAIN.Methods:The clinical and pathologic data of 126 cases with VAIN treated primarily in department of gynecology,in which affiliated Tumor Hospital of Xinjiang Medical University from May 2005 to May 2014,were reviewed and analyzed retrospectively.There are 30 cases of VAINI and VAINII respectively,and 66 patients with VAINIII.Results:(1)VAIN patients accounted for the hospital admitted in the same period of the female genital tract intraepithelial neoplasia(1993 cases) were 7.33%,between CIN(89.51%) and VIN (4.16%).(2)The age range of VAIN patients was 28 to 74 years,and the average age was 52.86±10.40 years.76.98% of patients with VAIN are in the menopausal status.The majority of patients had no clinical symptoms,and only 4 cases had clinical symptoms:1 cases had a small amount of vaginal discharge,3 cases had vaginal bleeding.94.44% of the lesions were located in the upper third of vagina.(3)71 cases detected by HPV,and 57 cases were positive.53 cases detected by TCT,and 43 cases were abnormal results.43 cases had a history of hysterectomy, and 37 cases were removed by CIN or cervical cancer.The average interval of VAIN occurrence after hysterectomy with or without cervix disease was 2.4 years and 7 years respectively.(4)28 cases were treated by surgery,14 cases were treated by drug,25 cases were treated by radiotherapy,18 cases were treated with combination therapy (two or more than two kinds of surgery, drugs, radiotherapy and chemotherapy),and 41 cases without treatment choosed follow-up.4 cases had a relapse.after about 2years.(5)The differences of VAIN in age were statistically significant(P<0.05).The results of HPV、menopausal status and the history of hysterectomy were not statistically significant(P>0.05).There were significant differences in pelvic radiotherapy history、combined with cervical intraepithelial neoplasia and cervical cancer、TCT results and colposcopy on different levels of VAIN(.P<0.05).In two group which divided by whether or not undergoing cervical-related hysterectomy,there were not statistically significant on levels of VAIN and the time after hysterectomy to diagnosis of VAIN(P>0.05).Conclusions:The older the patients,the higher level of VAIN;The level of VAIN with cervical disease was on the rise;VAINII/III required active treatment,and treated by operation primarily;When VAIN patients with cervical cancer,CIN and VIN,they should be treated with them at the same time,and the patients who combined with advanced cervical cancer should be treated with radiotherapy. VAIN patients who combined with cervical cancer should be followed up closely,especially in the treatment of two years later,and should guard against the recurrence of VAIN.