Riscos de lesões pré-cancerosas
O diagnóstico de patologias vulvares é importante porque algumas são pré-cancerosas. Enquanto o câncer vulvar representa apenas 5% dos cânceres genitais para uma idade média de 65 anos, a incidência de neoplasia intraepitelial vulvar (NIV) aumentou acentuadamente nos últimos dez anos. As mulheres afetadas são cada vez mais jovens.
Esse achado, portanto, torna necessário o diagnóstico precoce dessas pré-cancros, a fim de oferecer o tratamento menos invasivo possível. Para melhor esclarecer essas patologias, foi estabelecida uma classificação de neoplasia intraepitelial vulvar.
Como as lesões de VIN 1 são essencialmente induzidas por uma infecção por HPV de baixo risco, responsável por patologias benignas, passam a ser classificadas sob o termo condiloma plano.
OS VINHOS 2 e 3, em que se identifica o HPV de alto risco, constituem um grupo de risco de desenvolver câncer denominado VIN comum.
Existe um grupo de lesões vulvares não relacionadas à infecção pelo HPV, mas ocorrendo essencialmente no contexto do líquen escleroso e apresentando certo potencial para evoluir para câncer em pacientes mais velhas, são as VIN 3 diferenciadas.
Tabela 1:
Classificação ISSVD (International Society for the Study of Vulvovaginal Disease) da neoplasia intraepitelial vulvar (VIN).
Ancienne terminologie ISSVD | ISSVD 2015 | En relation avec |
---|---|---|
Fri., June 20 | The Academy, L.A | Book It |
Thu., June 19 | Bamboo, Santa Barbara | Book It |
Sat., June 28 | Cheers, Santa Cruz | Book It |
Wed., July 6 | The Roxy, San Francisco | Book It |
VIN 1 | Lésion squameuse intra-épithéliale BG | HPV bas risque |
---|---|---|
Fri., June 20 | The Academy, L.A | Book It |
Thu., June 19 | Bamboo, Santa Barbara | Book It |
Sat., June 28 | Cheers, Santa Cruz | Book It |
Wed., July 6 | The Roxy, San Francisco | Book It |
VIN 1 | Condylome plan | HPV bas risque |
---|---|---|
Fri., June 20 | The Academy, L.A | Book It |
Thu., June 19 | Bamboo, Santa Barbara | Book It |
Sat., June 28 | Cheers, Santa Cruz | Book It |
Wed., July 6 | The Roxy, San Francisco | Book It |
VIN 1 | aspect HPV | HPV bas risque |
---|---|---|
Fri., June 20 | The Academy, L.A | Book It |
Thu., June 19 | Bamboo, Santa Barbara | Book It |
Sat., June 28 | Cheers, Santa Cruz | Book It |
Wed., July 6 | The Roxy, San Francisco | Book It |
VIN 2/3 classique | Lésion squameuse intra-épithéliale HG | HPV haut risque |
---|---|---|
Fri., June 20 | The Academy, L.A | Book It |
Thu., June 19 | Bamboo, Santa Barbara | Book It |
Sat., June 28 | Cheers, Santa Cruz | Book It |
Wed., July 6 | The Roxy, San Francisco | Book It |
VIN 2/3 classique | aspect classique | HPV haut risque |
---|---|---|
Fri., June 20 | The Academy, L.A | Book It |
Thu., June 19 | Bamboo, Santa Barbara | Book It |
Sat., June 28 | Cheers, Santa Cruz | Book It |
Wed., July 6 | The Roxy, San Francisco | Book It |
VIN 3 différenciée | néoplasie vulvaire intra-épithéliale | Lichen scléreux |
---|---|---|
Fri., June 20 | The Academy, L.A | Book It |
Thu., June 19 | Bamboo, Santa Barbara | Book It |
Sat., June 28 | Cheers, Santa Cruz | Book It |
Wed., July 6 | The Roxy, San Francisco | Book It |
1- HPV: vírus do papiloma humano
2- BG/HG: grau baixo/alto grau
Tabela 2: Perfil das pacientes com lesão vulvar em risco de desenvolver câncer
VIN communs | VIN différenciés | |
---|---|---|
Fri., June 20 | The Academy, L.A | Book It |
Thu., June 19 | Bamboo, Santa Barbara | Book It |
Sat., June 28 | Cheers, Santa Cruz | Book It |
Wed., July 6 | The Roxy, San Francisco | Book It |
Base | HPV induit | Lichen scléreux |
---|---|---|
Fri., June 20 | The Academy, L.A | Book It |
Thu., June 19 | Bamboo, Santa Barbara | Book It |
Sat., June 28 | Cheers, Santa Cruz | Book It |
Wed., July 6 | The Roxy, San Francisco | Book It |
Origine des cancers | 30% | Lichen scléreux |
---|---|---|
Fri., June 20 | The Academy, L.A | Book It |
Thu., June 19 | Bamboo, Santa Barbara | Book It |
Sat., June 28 | Cheers, Santa Cruz | Book It |
Wed., July 6 | The Roxy, San Francisco | Book It |
Age | Jeune | Avancé |
---|---|---|
Fri., June 20 | The Academy, L.A | Book It |
Thu., June 19 | Bamboo, Santa Barbara | Book It |
Sat., June 28 | Cheers, Santa Cruz | Book It |
Wed., July 6 | The Roxy, San Francisco | Book It |
Site | Uni, multifocal | Avancé |
---|---|---|
Fri., June 20 | The Academy, L.A | Book It |
Thu., June 19 | Bamboo, Santa Barbara | Book It |
Sat., June 28 | Cheers, Santa Cruz | Book It |
Wed., July 6 | The Roxy, San Francisco | Book It |
Aspect | Varié | Avancé |
---|---|---|
Fri., June 20 | The Academy, L.A | Book It |
Thu., June 19 | Bamboo, Santa Barbara | Book It |
Sat., June 28 | Cheers, Santa Cruz | Book It |
Wed., July 6 | The Roxy, San Francisco | Book It |
Plaintes | Multiples | Récurrentes |
---|---|---|
Fri., June 20 | The Academy, L.A | Book It |
Thu., June 19 | Bamboo, Santa Barbara | Book It |
Sat., June 28 | Cheers, Santa Cruz | Book It |
Wed., July 6 | The Roxy, San Francisco | Book It |
Plainte 1 | prurit 30% | prurit 50% |
---|---|---|
Fri., June 20 | The Academy, L.A | Book It |
Thu., June 19 | Bamboo, Santa Barbara | Book It |
Sat., June 28 | Cheers, Santa Cruz | Book It |
Wed., July 6 | The Roxy, San Francisco | Book It |
Plainte 2 | douleurs 25% | saignement 20% |
---|---|---|
Fri., June 20 | The Academy, L.A | Book It |
Thu., June 19 | Bamboo, Santa Barbara | Book It |
Sat., June 28 | Cheers, Santa Cruz | Book It |
Wed., July 6 | The Roxy, San Francisco | Book It |
Plaintes 3 | gêne 80% | brûlures 80% |
---|---|---|
Fri., June 20 | The Academy, L.A | Book It |
Thu., June 19 | Bamboo, Santa Barbara | Book It |
Sat., June 28 | Cheers, Santa Cruz | Book It |
Wed., July 6 | The Roxy, San Francisco | Book It |