Riesgos de lesiones precancerosas
El diagnóstico de patologías vulvares es importante porque algunas son precancerosas. Mientras que el cáncer de vulva representa solo el 5% de los cánceres genitales para una edad promedio de 65 años, la incidencia de neoplasia intraepitelial vulvar (VIN) ha aumentado considerablemente en los últimos diez años. Las mujeres afectadas son cada vez más jóvenes.
Esta observación, por tanto, hace necesario un diagnóstico más temprano de estas precancerosas, para ofrecer un tratamiento lo menos invasivo posible. Para esclarecer mejor estas patologías se ha establecido una clasificación de neoplasia intraepitelial vulvar.
Dado que las lesiones VIN 1 son esencialmente inducidas por una infección por VPH de bajo riesgo, responsable de patologías benignas, ahora se clasifican bajo el término de condiloma plano.
Los VINOS 2 y 3, en los que se identifican VPH de alto riesgo, constituyen un grupo de riesgo de desarrollar cáncer denominado VIN común.
Hay un grupo de lesiones vulvares no relacionadas con la infección por VPH, pero que ocurren principalmente en el contexto del liquen escleroso y que muestran un claro potencial para progresar a cáncer en pacientes mayores, estas son las VIN 3 diferenciadas.
Tabla 1:
Clasificación de la neoplasia intraepitelial vulvar (VIN) de la ISSVD (Sociedad Internacional para el Estudio de la Enfermedad Vulvovaginal).
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- VPH: virus del papiloma humano
2- BG/HG: bajo grado/alto grado
Tabla 2: Perfil de pacientes con lesión vulvar en riesgo de desarrollar cáncer
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 |