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目的探讨阴道上皮内瘤变或癌与宫颈上皮内瘤变或癌的临床特点相关性。方法回顾性分析2005年1月至2012年9月中国医科大学附属盛京医院收治的阴道上皮内瘤变(VAIN)、阴道癌合并宫颈上皮内瘤变(CIN)或宫颈癌患者36例作为观察组,同期收治的单发阴道癌患者20例(VAC组)及单发宫颈癌Ⅱa期患者30例(CC组)为对照组,进行对比分析。对全部入组患者进行术后随访。结果观察组与CC组比较,平均年龄、绝经情况、人乳头瘤病毒(HPV)阳性率及临床症状差异均无统计学意义(P>0.05);而与VAC组比较,平均年龄轻、绝经后患者少、HPV感染者多(P<0.05)。各组比较,有临床症状者差异无统计学意义,但观察组内,合并宫颈癌(10/12)或阴道癌(5/6)组多有症状,而CIN+VAIN组有症状者较少(10/18)。随访病例进行生存分析显示,观察组病例平均生存时间为(40.42±4.74)个月[其中CC+VAIN为(43.97±5.05)个月,CIN+VAC为(27.50±1.75)个月],VAC组平均生存时间为(32.00±5.22)个月,CC组平均生存时间为(38.18±1.24)个月。结论高危型HPV感染是阴道病变与宫颈病变的共同致病因素,而HPV感染导致的阴道病变的临床特点与单纯宫颈病变更相似。阴道癌除了与HPV感染相关外,其他致病因素也不容忽视。
Objective To investigate the clinical features of intravaginal intraepithelial neoplasia or carcinoma and cervical intraepithelial neoplasia or cancer. Methods A retrospective analysis of 36 patients with vaginal intraepithelial neoplasia (VIN), vaginal cancer with cervical intraepithelial neoplasia (CIN) or cervical cancer admitted from Shengjing Hospital Affiliated to China Medical University from January 2005 to September 2012 was performed. In the same period, 20 patients with single vaginal cancer (VAC group) and 30 patients with single cervical cancer Ⅱa group (CC group) were selected as the control group for comparative analysis. All patients were followed up. Results Compared with CC group, the average age, menopause, HPV positive rate and clinical symptoms were not significantly different between the observation group and the CC group (P> 0.05). Compared with the VAC group, the average age, postmenopausal Fewer patients, HPV infection were more (P <0.05). In each group, there was no significant difference in clinical symptoms, but there were more symptoms in the combined group of cervical cancer (10/12) and vaginal cancer (5/6) in the observation group, and fewer symptoms in the CIN + VAIN group (10/18). Survival analysis of follow-up cases showed that the mean survival time in the observation group was (40.42 ± 4.74) months [(43.97 ± 5.05) months for CC + VAIN and (27.50 ± 1.75) months for CIN + VAC) The average survival time was (32.00 ± 5.22) months, and the average survival time in CC group was (38.18 ± 1.24) months. Conclusions High-risk HPV infection is a common risk factor for vaginal lesions and cervical lesions. However, the clinical features of vaginal lesions caused by HPV infection are more similar to cervical lesions. In addition to vaginal cancer associated with HPV infection, other risk factors can not be ignored.