Changes Of Collagen Fibers,nerves,microvessels And Efficacy Of Focused Ultrasound On Non-neoplastic Epithelial Disorders Of The Vulva

Section one:Observation of collagen fibers,nerves and microvessels in non-neoplastic epithelial disorders of the vulvaObjective:To observe the pathological changes of collagen fibers,nerves and microvessels in non-neoplastic epithelial disorders of the vulva(NNEDV).Method:The typical vulva lesions and the surrounding tissues of 10patients with NNEDV were evaluated by HE staining,Sirius red staining,CD34 and PGP9.5 immunohistochemical staining respectively.The types and distributions of collagens were identified by polarized light microscope.The histopathology features,the distribution of nerves and microvessels were observed by the light microscope.The difference in the ratio of I/III type collagen,intraepidermal nerve fiber density(IENFD)and microvessels density(MVD)between the typical lesions and surrounding tissues were investigated.Results:Typical lesions of 10 patients had classical pathological features of NNEDV.Surrounding tissues were manifested with chronic nonspecific inflammation.The ratio of I/III type collagen in the typical lesions was significantly higher than that in the surrounding tissues(3.91±1.85 VS 1.76±0.48,t=3.857,P=0.004).The IENFD and MVD in typical lesions were substantially lower than that in surrounding tissues(25.59±11.59/mm VS 36.43±8.31/mm,t=-2.739,P=0.023;11.58±3.37/mm~2 VS23.23±9.65/mm~2,t=-4.745,P=0.001).Conclusion:NNEDV is possibly characterized with the increase of the ratio of I/III type collagen fibers,and the decrease of IENFD and MVD.Section two: Evaluation of the efficacy of focused ultrasound and the quality of life on non-neoplastic epithelial disorders of the vulvaObjective: To evaluate the efficacy of focused ultrasound and the changes of quality of life on non-neoplastic epithelial disorders of the vulva(NNEDV).Method: Sixty-eight patients were enrolled in this study and received the focused ultrasound treatment from December 2018 to April 2019.Three months after treatment,the symptoms and signs,Dermatology Life Quality Index(DLQI),Four-Item Itch Questionnaire(FIIQ),Visual Analogue Scale(VAS)were compared with the baseline to evaluate the clinical effect.Results: The total effective rate of focused ultrasound was 86.76% in three months after treatment.The symptoms and signs were significantly improved,and the median scores decreased from 8 to 6(Z=-6.721,P =0.000).Patients achieved better quality of life,and the median scores of DLQI were reduced from 6 to 5(Z=-2.338,P=0.027).The symptoms of pruritus were obviously relieved,and patients presented with statistically lower median scores of VAS and FIIQ compared with the baseline(6 vs 2,Z=-6.922,P=0.000;7 vs 4,Z=-4.654,P=0.000)..Conclusion: The focused ultrasound is an effective method for NNEDV and can improve the symptoms and signs as well as quality of life.