Surgery of high-grade vaginal squamous intraepithelial lesions:an analysis of 28 clinical cases
Objective To analyze the clinicopathological features and effect of patients who underwent surgery for high-grade squamous intraepithelial lesion(HSIL)of vagina.Methods The clinical records and follow-up data of patients with vaginal HSIL from January 2012 to March 2023 in Peking University People's Hospital were analyzed.Results Total of 28 patients were included in the study,with an age of(51.71±11.19)years old.There were 24 patients(85.7％)with cervical HSIL or cervical cancer.27 cases with high-risk human papilloma virus(HPV)positive.Among the 28 patients,the number of lesions in colposcopy was ≥ 2 sites in 18 cases,located in the upper third of the vagina in 20 cases.The pathological findings of colposcopy biopsy were＜VaIN3 in 15 cases,VaIN3 in 13 cases,the pathological diagnosis was inconsistent in 14 cases,among which 13 cases were downgraded.The postoperative pathological coincidence rate of patients with VaIN3 was significantly higher than that of＜VaIN3(P＜0.05).14 cases underwent local excision,10 cases underwent upper vaginal resection,and 4 cases underwent total vagotomy and vaginoplasty.The median follow-up time was 32 months(6～78 months).There were 3 cases of recurrence and 2 cases of progression,and the recurrence and progression rate was 17.9％.All patients were VaIN3 patients before the operation,and all of them were positive for high-risk HPV after the operation.Conclusions Vaginal HSIL often coexists with cervical lesions,and is closely related to high-risk HPV infection.The lesions are often located in the upper third of the vagina and are multifocal.The effective rate of surgical treatment is high,and previous hysterectomy due to cervical cancer or CIN,patients with VaIN3 and high-risk HPV after operation are prone to relapse or progress.It is suggested that surgical treatment should be the first choice,and close follow-up should be conducted after operation.
high-grade squamous intraepithelial lesions of vaginasurgeryprognosis
万方数据
维普
