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目的:探讨外阴上皮内瘤变(VIN)的临床病理特征、鉴别诊断及病因。方法:应用原位杂交及免疫组化方法对35例VIN上皮组织中HPV DNA及P53蛋白、Ki-67进行检测。结果:35例VIN患者的年龄为22～68岁,平均35.24岁。病变外观为色素性扁平丘疹,组织学上有鳞状上皮增生及不典型增生。35例病变组织HPV6、11、16、18型病毒基因检测阳性33例,P53蛋白阳性16例,Ki-67阳性33例。结论:VIN的诊断应当结合临床特点,该病部分属于良性病变,部分属于癌前病变。其发病与人乳头状瘤病毒(HPV)感染关系密切。
Objective: To investigate the clinical and pathological features, differential diagnosis and etiology of vulvar intraepithelial neoplasia (VIN). Methods: HPV DNA, P53 protein and Ki-67 in 35 cases of VIN epithelial tissue were detected by in situ hybridization and immunohistochemistry. Results: The age of 35 patients with VIN was 22 to 68 years old, with an average of 35.24 years. The appearance of the lesion is pigmented flat papules, histologically squamous epithelial hyperplasia and atypical hyperplasia. Among the 35 cases of pathological tissues, 33 cases were positive for HPV6, 11, 16 and 18 viral genes, 16 cases were positive for P53 protein and 33 cases were positive for Ki-67. Conclusion: The diagnosis of VIN should be combined with clinical features, the disease is part of benign lesions, some of them are precancerous lesions. Its incidence and human papilloma virus (HPV) infection are closely related.