Application value of the vaginal endoscopy in the diagnosis and treatment of the vaginal intraepithelial neoplasia of patients after hysterectomy
Objective:To explore the application value of vaginal endoscopy in the diagnosis and treatment of vaginal in-traepithelial neoplasia(VAIN)of patients after hysterectomy.Methods:The data of 120 patients with VAIN after hysterectomy in the hospital from October 2020 to October 2022 were retrieved.The samples were collected from the patients with abnormal results of thinprep cytology test(TCT)and/or with positive high-risk human papillomavirus(HPV)after surgery.All these patients had received examination of the colposcopy combined with vaginal endoscopy.The diagnostic value of the vaginal endoscopy for the VAIN of the patients after hysterectomy was explored based on their final pathological diagnosis as the gold standard.Results:167 lesions of these patients were found among 120 pa-tients with VAIN after hysterectomy,including 125(74.9％)lesions in vaginal wall and 42(25.1％)lesions in vaginal apex,113(67.7％)lesions with high-grade squamous intraepithelial lesions(HSIL)and 54(32.3％)lesions with low-grade SIL lesions(LSIL),and 54(32.3％)lesions with VAIN grade I,74(44.3％)lesions with VAIN grade Ⅱ and 39(23.3％)lesions with VAIN grade Ⅲ.There were 65(54.2％)patients with cervical intraepithelial neoplasia(CIN)and 89(74.2％)patients with positive high-risk HPV.The detection rates of the VAIN and the different degrees of VAIN of the patients by colposcopy combined with vaginoscopy were significantly higher than those of the patients by colposcopy alone(P＜0.05).The detection rate of the vaginal apex VAIN of the patients by colposcopy combined with vaginosco-py was significantly higher than that of the patients by colposcopy alone(P＜0.05),but the detection rate of the vagi-nal wall VAIN of the patients by colposcopy combined with vaginoscopy had no significantly different from that of the patients by colposcopy alone(P＞0.05).In 120 patients with VAIN,there were 45(37.5％)cases given followed up and observation,39(32.5％)cases with treated by CO2 laser vaporization,27(22.5％)cases with the treatment of drug and 9(7.5％)cases with the treated with vaginal local excision surgery.All 89 patients with high-risk HPV infection were treated with anti-HPV therapy.Conclusion:The examination of colposcopy combined with vaginal endoscopy for the patients after hysterectomy is helpful to improve their detection rate of VAIN,and it is helpful to guide the disease management measures,and to ensure the life and health of the patients.
万方数据
维普
