RESUMO
OBJECTIVE: Our purpose was to profile patients with vaginal intraepithelial neoplasia, evaluate the response to treatment and define risk factors for persistence and progression. STUDY DESIGN: We reviewed records and histopathology slides of 94 patients with vaginal intraepithelial neoplasia diagnosed from 1977 to 1986. For 74 patients with follow-up, we evaluated risk factors by univariate and multivariate analyses. RESULTS: Sixty-four of 94 patients (68%) had prior or concurrent anogenital squamous neoplasia, including 21 with invasive and 43 with intraepithelial. Twenty-three had prior radiotherapy, 10 had anogenital neoplastic syndrome, and 11 were immunosuppressed. In 52 of 74 treated patients (70%), vaginal intraepithelial neoplasia went into remission after a single treatment. In 18 patients (70%) vaginal intraepithelial neoplasia went into remission after a single treatment. In 18 patients (24%) recurrent vaginal intraepithelial neoplasia went into remission after chemosurgery, upper vaginectomy, or other treatments; in 4 (5%) it progressed to invasion. Significant multivariate risk factors for persistence or progression were multifocal lesions and anogenital neoplastic syndrome but not vaginal intraepithelial neoplasia grade, associated cervical neoplasia, or immunosuppression. CONCLUSIONS: Although most vaginal intraepithelial neoplasia goes into remission after treatment, 5% of cases may progress from occult foci to invasion in spite of close follow-up.
Assuntos
Carcinoma in Situ , Neoplasias Vaginais , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma in Situ/epidemiologia , Carcinoma in Situ/patologia , Carcinoma in Situ/terapia , Progressão da Doença , Feminino , Humanos , Pessoa de Meia-Idade , Análise Multivariada , Invasividade Neoplásica , Recidiva Local de Neoplasia/epidemiologia , Indução de Remissão , Fatores de Risco , Neoplasias Vaginais/epidemiologia , Neoplasias Vaginais/patologia , Neoplasias Vaginais/terapiaRESUMO
Application of a programmable terminal and printer to the cataloging task of a small medical library is described. The application is independent of a computer; the terminal is used in "local" mode only. Full sets of catalog cards are produced, following a single typing of descriptive cataloging data and tracings. Books can be cataloged the same day they are received. Actual cost per book is just over a dollar, for equipment rental, card stock, and the cataloger's time at the console, after call number, tracings, and main entry for the book have been determined.
