Vulvar intraepithelial neoplasia


Introduction to vulvar intraepithelial neoplasia

Vulvar intraepithelial neoplasia is a group of vulvar lesions, which are precancerous lesions of vulvar cancer, including vulvar epithelial dysplasia and carcinoma in situ. The dysplasia of the vulvar skin or mucosal squamous epithelium begins with the basal layer. When the degree of atypical hyperplasia increases, it expands upwards and increases the level. In addition, according to the abnormality of cell arrangement, the cell dysplasia is found by pathological cytology. The extent and scope of the division is divided into I, II, and III (ie, light, medium, and heavy).

basic knowledge

Sickness ratio: 0.01%-0.02%

Susceptible people: women

Mode of infection: non-infectious

Complications: early invasive squamous cell carcinoma of the vulva


Causes of vulvar intraepithelial neoplasia

The cause is not fully understood. Modern molecular techniques have found that 80% of VIN is associated with HPV (type 16) infection. Other risk factors include sexually transmitted diseases, anal-genital tumor-like lesions, immunosuppression, and smoking.


Prevention of vulvar intraepithelial neoplasia

Regular physical examination, early detection, early treatment.


Complications of vulvar intraepithelial neoplasia Complications of early invasive squamous cell carcinoma of the vulva

Vulvar cancer may occur as the disease progresses.


Symptoms of vulvar intraepithelial neoplasia Common symptoms Vulvar itching vulva burning irritating fine mesh to patchy... Vulvar damage

The symptoms of VIN are not specific. Like vulvar malnutrition, it is mainly itching, skin damage, burning sensation, and ulceration. Signs sometimes appear as papules or spots, single or multiple, fused or dispersed, gray or pink, and a few are slightly higher than the surface pigmentation.


Examination of vulvar intraepithelial neoplasia

1, immune examination

2, pathological biopsy

It can be stained with 1% toluidine blue, dried and then decolorized with 1% acetic acid solution. If dark blue area appears, it indicates keratosis or ulceration. The material in deep dyeing area can improve the diagnosis rate. Multiple biopsies must be performed to exclude invasive cancer.

3, colposcopy

It can improve the sensitivity of detecting adjacent tissue lesions.

4, other inspections

Secretory examination, tumor marker examination, immunological examination.


Diagnosis and diagnosis of vulvar intraepithelial neoplasia


1, biopsy pathological examination

Multiple biopsy should be performed on any suspected lesion. In order to eliminate invasive cancer, it is necessary to determine the depth of the material according to the condition of the lesion, and generally does not need to reach the subcutaneous fat layer.

2. Pathological diagnosis and classification

(1) Vulvar squamous intraepithelial neoplasia is classified into 3 grades. VIN I: mild dysplasia. VIN II: moderate dysplasia. VIN III: severe dysplasia, and carcinoma in situ.

(2) Non-squamous intraepithelial neoplasia of the vulva mainly refers to the Paget's disease of the vulva. The pathological feature is that the basal layer can be seen with large irregular facial, oval or polygonal cells. The cytoplasm is empty and translucent, and the size and shape of the nucleus Different staining (so-called Paget's cells), the epidermal basement membrane is intact.