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原发性外阴癌是妇科较常见的恶性肿瘤之一。在我院门诊20年间(1964～1983)病例登记中,外阴癌占妇科恶性肿瘤癌的3.(?)9%,居第四位。外阴癌病灶发生于外阴皮肤的鳞状上皮及皮肤附件,约1/3～1/2的病例有癌前病变的病史可查。若能在其癌前病变状态给予诊治,则有利于预防外阴癌的发生。现将外阴癌前病变的诊断和治疗分述如下。一、外阴白色病变是指由各种不同原因引起外阴皮肤营养障碍而产生的表皮组织生长紊乱和真皮组织的变性。病变常继发于外阴的慢性炎症和刺激,好发于40～60岁。以前多与“外阴白斑”混淆,但实际上,外阴白斑只是外阴白色病变的一种表现,而非一独立疾病。1975年国际外阴病研究会决定将外阴皮肤粘膜变白变粗或萎缩的此类病变统称为“慢性外阴营养不良”,据其组织病理的不同分为不同类型。所有外阴白色病变的变化,只有当其上皮发生了明显的非典型增生时,才作为癌前期病变。1.增生型营养不良又分为无非典型增生和非典型增生两种,后者又有轻、中、重度之分。均以角质层增厚和棘层增生为
Primary vulvar cancer is one of the more common gynecological malignancies. In our hospital for 20 years (1964 ~ 1983) case registration, vulva cancer accounted for 3 (?) Gynecological cancer 9%, ranking fourth. Vulvar lesions occur in the vulvar skin squamous epithelium and skin attachment, about 1/3 to 1/2 of the cases have a history of precancerous lesions can be investigated. If in its precancerous lesions to give diagnosis and treatment, is conducive to the prevention of vulvar cancer. Now the diagnosis and treatment of vulvar precancerous lesions are as follows. First, the white lesions of the vulva is caused by a variety of different causes of vulvar skin dystrophy arising from epidermal tissue disorders and degeneration of dermal tissue. Lesions often secondary to chronic inflammation of the vulva and stimulate, occur in 40 to 60 years of age. Before and more with the “vulva leukoplakia” confused, but in fact, leukoplakia genital white lesions only a manifestation, not an independent disease. 1975 International Society of Vulvar Diseases decided to vulvar skin and mucous membrane thickening or atrophy of such lesions collectively referred to as “chronic vulvar dystrophy”, according to their histopathological different divided into different types. All changes in the appearance of white lesions of the vulva, only when the epithelial obvious atypical hyperplasia, before as precancerous lesions. 1. Hyperplastic malnutrition is divided into non-typical hyperplasia and atypical hyperplasia two, the latter has light, moderate and severe points. Both stratum corneum thickening and stratum proliferatum