Vulvar İntraepitelyal Neoplazi Olgularının Klinik ve Patolojik Verilerinin Retrospektif Analizi

Abstract

Amaç: Bu çalışma kliniğimizde Vulvar İntraepitelyal Neoplazi (VIN) tanısı alan vakaların klinik ve patolojik verilerini retrospektif olarak değerlendirmek için planlandı. Gereç ve Yöntemler: Pamukkale Üniversitesinde Ocak 2016- Haziran 2020 tarihleri arasında VIN tanısı almış olan 68 hastanın dosyası retrospektif olarak değerlendirildi. Patolojik preparatlar mikroskop ile tekrar değerlendirildi. Vakalara ait sosyodemografik veriler, biyopsi ve histopatolojik veriler elde edildi. VIN vakalarına eş zamanlı olarak alınmış olan servikal Pap-smear, HPV ve servikal biyopsi sonuçları gruplandırılarak değerlendirildi. Bulgular: Çalışmaya dahil edilen 68 hastanın 48’i düşük dereceli (vLSIL), 20’si yüksek dereceli (vHSIL)’ idi. Düşük dereceli grupta ortalama yaş 48,60±16,02; gravida 2,54±1,92; parite 2,02±1,60 iken; yüksek dereceli grupta sırasıyla 44,80±14,71; 2,40±1,81; 1,70±1,49 idi. Yüksek dereceli grupta; lezyon alanı (p=0,008), Ki-67 (p=0,001), p53 (p=0,036), p16 (p=0,034) immünhistokimya boyanmaları istatistiksel olarak anlamlı şekilde daha yüksekti. HPV boyanması açısından fark yoktu (p>0,05). Eş zamanlı servikal Pap-smear, HPV-pcr ve servikal biyopsi açısından gruplar arasında istatistiksel olarak anlamlı fark yoktu (p>0,05). Sonuç: Çalışmamızda, literatüre paralel olarak servikal intraepitelyal lezyonlarda (CIN) ve yapılmış VIN çalışmalarında olduğu gibi immünohistokimyasal belirteçler yüksek dereceli grupta daha yüksek bulunmuştur. CIN ile ortak risk faktörleri içermesine rağmen, VIN için toplum tabanlı bir tarama henüz mevcut değildir. Bu nedenle şüpheli vulvar lezyonların araştırılmasında tanı için altın standart prosedür biyopsidir. VIN hastalarının tanı ve tedavileri için algoritma oluşturacak çok merkezli ileri çalışmalara ihtiyaç vardır.

Keywords

• Servikal intraepitelyal lezyonlarda (CIN)
• Vulvar İntraepitelyal Neoplazi (VIN)
• immünhistokimyasal boyanma
• düşük dereceli vulvar intraepitelyal neoplazi (vLSIL)
• yüksek dereceli vulvar intraepitelyal neoplazi (vHSIL)

Retrospective Analysis of Clinical and Pathological Data of Vulvar IntraepitheliaI Neoplasia Cases

Abstract

Aim: This study was designed to retrospectively evaluatethe clinical and pathological data of cases diagnosed with Vulvar Intraepithelial Neoplasia (VIN) in ourclinic. Material and Methods: 68 patients diagnosed with VIN at Pamukkale University between January 2016 and June 2020 were analyzed retrospectively. Pathological slides were examined with a microscope. Socio demographic data, biopsy and histopathological data of the cases were obtained. Cervical Papsmear, HPV and cervical biopsy results taken simultaneously to VIN cases were grouped and evaluated Results: Of the 68 patients included in the study, 48 were low grade (vLSIL) and 20 were high grade (vHSIL). The mean age in the vLSIL group was 48,60±16,02; gravida 2,54±1,92; parity 2,02±1,60 while; 44,80±14,71; 2,40±1,81; 1,70±1,49 in the vHSIL group, respectively. In the vHSIL group; lesion area (p=0,008), Ki-67 (p=0,001), p53 (p=0,036), p16 (p=0,034) immunohistochemistry staining were statistically significantly higher. There was no difference in HPV staining (p>0,05). There was no statistically significant difference between the groups in terms of simultaneous cervical Pap-smear, HPV-pcr and cervical biopsy (p>0,05). Conclusion: In our study, in accordance with the literature, immunohistochemical markers were found to be higher in the vHSIL group, as in cervical intraepithelial lesions (CIN) and VIN studies. Although it contains common risk factors with CIN, population-based screening for VIN is not yet available. Therefore, the gold standard procedure for diagnosis in the investigation of suspicious vulvar lesions is biopsy. Multi center advanced studies are needed to create algorithms for the diagnosis and treatment of VIN patients

Keywords

• Cervical intraepithelial lesions (CIN)
• Vulvar Intraepithelial Neoplasia (VIN)
• immunohistochemical staining
• low grade vulvar intraepithelial neoplasia (vLSIL)
• high grade vulvar intraepithelial neoplasia (vHSIL)

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