Geburtshilfe Frauenheilkd 2020; 80(10): e86
DOI: 10.1055/s-0040-1717195
Fetale Therapie
Vulvakarzinom: aktuelle Kontroversen der Therapie

Accuracy of vulvoscopic findings in detecting early vulvar neoplasia

FA Stübs
1   Universitätsklinikum Erlangen, Frauenklinik, Erlangen, Deutschland
,
G Mehlhorn
1   Universitätsklinikum Erlangen, Frauenklinik, Erlangen, Deutschland
,
P Gass
1   Universitätsklinikum Erlangen, Frauenklinik, Erlangen, Deutschland
,
CE Schulmeyer
1   Universitätsklinikum Erlangen, Frauenklinik, Erlangen, Deutschland
,
W Adler
2   Friedrich-Alexander-Universität Erlangen-Nürnberg, Institut für Medizininformatik, Biometrie und Epidemiologie (IMBE), Erlangen, Deutschland
,
J Strehl
3   Klinikum Fürth, Frauenklinik, Fürth, Deutschland
,
A Hartmann
4   Universitätsklinikum Erlangen, Pathologie, Erlangen, Deutschland
,
MW Beckmann
1   Universitätsklinikum Erlangen, Frauenklinik, Erlangen, Deutschland
,
SK Renner
5   Kliniken Böblingen, Frauenklinik, Böblingen, Deutschland
,
MC Koch
1   Universitätsklinikum Erlangen, Frauenklinik, Erlangen, Deutschland
› Author Affiliations
 

Purpose Vulvoscopy-guided punch biopsy is a cornerstone method for diagnosing vulvar diseases. The aim of this study was to evaluate the accuracy of clinical findings in vulvar diseases during examinations, in comparison with vulvoscopy -directed punch biopsy. We also developed a new classification to simplify the categorization of vulvoscopic findings.

Methods The accuracy of the clinical findings was compared with the final histology results from punch biopsies. The data were collected between January 2014 and May.

Results A total of 482 vulvoscopy -directed punch biopsies of the vulva were obtained in 420 women. The overall accuracy of the clinical findings in comparison with the histological vulvar punch-biopsy findings was 53.9 % for all entities — benign lesions, lichen, low- and high-grade squamous intraepithelial lesions (LSIL/HSILs), and vulvar carcinoma. The accuracy for detecting LSILs was 64.3 % (45/70). The accuracy for detecting HSILs was 62.3 %. and for Vulvar carcinoma 65.2 %.

Conclusions Punch biopsy of suspicious lesions continues to be a cornerstone in diagnosing HSILs and carcinoma of the vulva. Careful work-up of the vulva is recommended when patients have symptoms such as pruritus or pain. The new classification is more specific for diagnosing lesions in the vulva.



Publication History

Article published online:
07 October 2020

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