阴道鳞状上皮内病变的阴道镜诊断特点与临床管理OA

Vaginal squamous intraepithelial lesion,also known as vaginal intraepithelial neoplasia(VaIN),is a precursor lesion of vaginal cancer closely associated with persistent infection by high-risk human papillomavirus(HR-HPV).It has long been underrecognized in clinical practice due to its low incidence.In recent years,with the popularization and standardized application of colposcopy,the detection rate of VaIN has increased significantly.VaIN frequently coexists with cervical squamous intraepithelial lesion and has gradually become a key clinical concern as a major cause of recurrence or residual disease during follow-up after cervical lesion treatment.However,due to the unique anatomical structure of the vagina,VaIN presents diagnostic challenges such as occult lesions,multifocal distribution,and difficult exposure,resulting in a high rate of clinical missed diagnoses and hindering early intervention.This article systematically reviews the epidemiological characteristics of VaIN,its association with cervical lesions and post-treatment follow-up,colposcopic features and identification difficulties,biopsy strategies and risk control of missed diagnoses,as well as clinical management and follow-up principles for different grades of lesions.Based on the latest clinical research and consensus,it provides a reference for clinicians to standardize the diagnosis and management of VaIN.