What Is Vulvar Intraepithelial Neoplasia?

Vulvar intraepithelial neoplasia

Vulvar intraepithelial neoplasia disease name

Vulvar intraepithelial neoplasia

Overview of vulvar intraepithelial neoplasia disease

Vulvar intraepithelial neoplasia is a group of vulvar lesions that are precancerous lesions of vulvar cancer, including atypical hyperplasia of vulvar epithelium and carcinoma in situ. Vulvar skin or mucosal squamous epithelium starts from the basal layer, and when the degree of atypical hyperplasia increases, it increases in level, and in addition, according to the abnormality of cell arrangement, it is found by pathological cytology The degree and the range occupied are divided into I, II, and III (ie, light, medium, and severe).

Clinical manifestations: some patients are asymptomatic, and the common symptoms are:

1. Itching of the vulva is a common complaint, and about 60% of patients have this discomfort;

2. I stumbled across the vulva nodules.

Vulvar intraepithelial neoplasia disease classification

Obstetrics and Gynecology

Vulvar intraepithelial neoplasia disease description

Vulvar intraepithelial neoplasia is the name of a group of pathological diagnoses of vulvar lesions. Including vulvar squamous cell intraepithelial neoplasia and vulvar non-squamous cell intraepithelial neoplasia (paget's disease, uninfiltrated melanoma) are more common in women aged about 45. The incidence of VIN has increased in recent years. VIN rarely develops into invasive cancer, but young patients over 60 years of age or with immunosuppression may become invasive.

Signs and symptoms of vulvar intraepithelial neoplasia

The symptoms of VIN are non-specific, and like vulvar malnutrition, it is mainly itching, skin damage, burning sensation, and ulcers. Signs sometimes appear as pimples or spots, single or multiple, fused or scattered, gray or pink; a few are slightly hyperpigmented.

Causes of vulvar intraepithelial neoplasia

Not entirely clear. Modern molecular technology tests found that 80% of VIN was associated with HPV (type 16) infection. Other risk factors are sexually transmitted diseases, anal-genital tumor-like lesions, immunosuppression, and smoking.

Pathophysiology of vulvar intraepithelial neoplasia

Modern molecular technology tests found that 80% of VIN was associated with HPV (type 16) infection. Cytopathological changes include halo formation of viral proteins around the nucleus, thickening of cell membranes, and nuclear fusion. These changes mostly occur in the surface cells of the lesion.

Diagnosis of vulvar intraepithelial neoplasia

1. A biopsy should be performed at any point for any suspicious lesion. In order to exclude invasive cancer, the depth of the material needs to be determined according to the condition of the lesion. Generally, it does not need to reach the subcutaneous fat layer.

2. Pathological diagnosis and classification (1) Vulvar squamous intraepithelial neoplasia was classified into 3 grades. VIN I: That is, mild atypical hyperplasia. VIN II: Moderately atypical hyperplasia. VIN III: Severe atypical hyperplasia, and carcinoma in situ. (2) Non-squamous intraepithelial neoplasia of the vulva mainly refers to Paget's disease of the vulva. Its pathological feature is that the basal layer can be seen as large, irregular, garden-shaped, oval or polygonal cells, the cytoplasm is empty and transparent, and the size and shape of the nucleus Different staining (so-called Paget's cells), the epidermal basement membrane is intact.

Treatment options for vulvar intraepithelial neoplasia

1. Squamous intraepithelial neoplasia of the vulva:

(1) VINI: drug treatment, 5% fluorouracil (5-Fu) ointment, smear of vulvar lesions, once a day. Laser treatment, the method can retain the appearance of vulva after treatment, the effect is better.

(2) VIN-: Surgery treatment is performed for a wide range of vulvar lesions (0.5-1.0cm from the edge of the lesion) or simple vulvar resection.

2. Vulvar non-squamous intraepithelial neoplasia Paget's disease tumor cells mostly exceed the margin of the lesion seen by the naked eye, and occasionally infiltration. Treatment should be more extensive local lesion resection or simple vulvar resection. If infiltration or sweat gland cancer occurs, radical vulvectomy and bilateral inguinal lymph node dissection are required.