"[1BB14F79C163]" . . . . "Review of precancerous vulvar lesions"@en . . . "Klasifikace prekancer\u00F3zn\u00EDch l\u00E9z\u00ED vulvy je zalo\u017Eena na konceptu vulv\u00E1rn\u00ED intraepiteli\u00E1ln\u00ED neopl\u00E1zie (VIN) s t\u0159\u00EDstup\u0148ov\u00FDm hodnocen\u00EDm z\u00E1va\u017Enosti dysplastick\u00FDch zm\u011Bn (VIN I, II a III). Na z\u00E1klad\u011B histologick\u00E9ho vzhledu se dyspl\u00E1zie vulvy d\u011Bl\u00ED na VIN obvykl\u00E9ho typu (u-VIN) a VIN diferencovan\u00E9ho typu (d-VIN), kter\u00E9 reprezentuj\u00ED dv\u011B z\u00E1kladn\u00ED cesty patogeneze dla\u017Edicobun\u011B\u010Dn\u00E9ho karcinomu vulvy. Zat\u00EDmco je u-VIN etiologicky spojen\u00E1 s infekc\u00ED lidsk\u00FDm papillomavirem (HPV) a histologick\u00FDm vzhledem odpov\u00EDd\u00E1 cervik\u00E1ln\u00ED intraepiteli\u00E1ln\u00ED neopl\u00E1zii, p\u0159edstavuje d-VIN HPV negativn\u00ED sm\u011Br karcinogeneze spojen\u00FD s vulv\u00E1rn\u00EDmi dermat\u00F3zami typu lichen sclerosus (LS) a lichen simplex chronicus (LSC). u-VIN v\u011Bt\u0161inou postihuje relativn\u011B mlad\u00E9 \u017Eeny s anamn\u00E9zou dal\u0161\u00EDch prekancer\u00F3z d\u011Blo\u017En\u00EDho hrdla, vag\u00EDny nebo vulvy. Typickou pacientkou s d-VIN je naopak postmenopauz\u00E1ln\u00ED \u017Eena bez anamnestick\u00FDch dat ostatn\u00EDch dysplastick\u00FDch l\u00E9z\u00ED doln\u00EDho \u017Eensk\u00E9ho pohlavn\u00EDho syst\u00E9mu. d-VIN p\u0159evy\u0161uje u-VIN v tendenci ke strom\u00E1ln\u00ED invazi a biologick\u00FDm chov\u00E1n\u00EDm odpov\u00EDd\u00E1 karcinomu in situ (VIN III). Paradoxn\u011B se v histologick\u00E9m vy\u0161et\u0159en\u00ED d-VIN jev\u00ED jako nen\u00E1padn\u00E1 l\u00E9ze s atypiemi v bu\u0148k\u00E1ch baz\u00E1ln\u00ED vrstvy a s dob\u0159e zachovanou diferenciac\u00ED povrchov\u00FDch parti\u00ED dla\u017Edicov\u00E9ho epitelu, proto b\u00FDv\u00E1 p\u0159i bioptick\u00E9m vy\u0161et\u0159en\u00ED zam\u011B\u0148ov\u00E1na za u-VIN I, LS anebo LSC. P\u0159edev\u0161\u00EDm z d\u016Fvodu n\u00EDzk\u00E9 diagnostick\u00E9 reproducibility kategorie u-VIN I, pro pochybnosti o jej\u00EDm malign\u00EDm potenci\u00E1lu a tak\u00E9 kv\u016Fli problematick\u00E9mu rozli\u0161en\u00ED u-VIN II a III byla v roce 2004 p\u0159edlo\u017Eena revidovan\u00E1 klasifikace VIN, ve kter\u00E9 bylo od gradingu prekancer\u00F3zn\u00EDch l\u00E9z\u00ED vulvy upu\u0161t\u011Bno - jednotka u-VIN I byla zru\u0161ena a u-VIN II a III byly spojeny do jedin\u00E9 kategorie. Term\u00EDn u-VIN tedy v nov\u00E9m n\u00E1zvoslov\u00ED reprezentuje high grade prekancer\u00F3zn\u00ED l\u00E9ze vulvy asociovan\u00E9 s HPV (d\u0159\u00EDve u-VIN II a III) a d-VIN i nad\u00E1le odpov\u00EDd\u00E1 HPV negativn\u00EDm high grade dyspl\u00E1zi\u00EDm." . "I" . . . "Prekancer\u00F3zn\u00ED l\u00E9ze vulvy" . "1" . "Prekancer\u00F3zn\u00ED l\u00E9ze vulvy" . "RIV/00064203:_____/12:8438" . "CZ - \u010Cesk\u00E1 republika" . "Classification of squamous vulvar precancerous lesions is based on the concept of vulvar intraepithelial neoplasia (VIN) and incorporates a three grade evaluation of the intensity of dysplastic changes (VIN I, II and III). On the basis of histological features, VIN has been subdivided into the usual VIN (u-VIN) and differentiated VIN (d-VIN), which represent the two basic pathways of the pathogenesis of vulvar squamous cell carcinoma. Although u-VIN is etiologically associated with the human papillomavirus (HPV) infection and histologically corresponds to cervical intraepithelial neoplasia, d-VIN represents the HPV-negative sequence of vulvar carcinogenesis, which is linked to lichen sclerosus (LS) and lichen simplex chronicus (LSC). u-VIN preferentially occurs in relatively young women with a history of cervical, vaginal or vulvar premalignant lesions. On the other hand, d-VIN usually affects postmenopausal women without anamnestic data of other dysplastic lesions of the lower female genital tract. d-VIN is characterized by a higher tendency of stromal invasion than u-VIN and its malignant potential is analogous to carcinoma in situ (VIN III). The histological appearance of d-VIN is subtle with basal atypia and a well-preserved differentiation of the superficial parts of the squamous epithelium, therefore it is frequently misdiagnosed for u-VIN I, LS or LSC in vulvar biopsies. Primarily because of the low diagnostic reproducibility of the u-VIN I category and the doubts about its precancerous potential as well as due to the questionable differentiation between u-VIN II and III, a revised VIN classification was proposed in 2004. The grading of vulvar precancerous lesions was abandoned, the u-VIN I category was discontinued and u-VIN II and III were merged. In the revised terminology, the term u-VIN represents HPV-associated high grade precancerous vulvar lesions (formerly u-VIN II and III) and d-VIN encompasses HPV-negative high grade dysplasias."@en . . "161255" . "Prekancer\u00F3zn\u00ED l\u00E9ze vulvy"@cs . "vulvar intraepithelial neoplasia; VIN of the usual type; VIN of the differentiated type; lichen sclerosus; lichen simplex chronicus; HPV"@en . "Prekancer\u00F3zn\u00ED l\u00E9ze vulvy"@cs . . . "4"^^ . "Rob, Luk\u00E1\u0161" . . . "Robov\u00E1, Helena" . "48-57" . . "4"^^ . . . . "Klasifikace prekancer\u00F3zn\u00EDch l\u00E9z\u00ED vulvy je zalo\u017Eena na konceptu vulv\u00E1rn\u00ED intraepiteli\u00E1ln\u00ED neopl\u00E1zie (VIN) s t\u0159\u00EDstup\u0148ov\u00FDm hodnocen\u00EDm z\u00E1va\u017Enosti dysplastick\u00FDch zm\u011Bn (VIN I, II a III). Na z\u00E1klad\u011B histologick\u00E9ho vzhledu se dyspl\u00E1zie vulvy d\u011Bl\u00ED na VIN obvykl\u00E9ho typu (u-VIN) a VIN diferencovan\u00E9ho typu (d-VIN), kter\u00E9 reprezentuj\u00ED dv\u011B z\u00E1kladn\u00ED cesty patogeneze dla\u017Edicobun\u011B\u010Dn\u00E9ho karcinomu vulvy. Zat\u00EDmco je u-VIN etiologicky spojen\u00E1 s infekc\u00ED lidsk\u00FDm papillomavirem (HPV) a histologick\u00FDm vzhledem odpov\u00EDd\u00E1 cervik\u00E1ln\u00ED intraepiteli\u00E1ln\u00ED neopl\u00E1zii, p\u0159edstavuje d-VIN HPV negativn\u00ED sm\u011Br karcinogeneze spojen\u00FD s vulv\u00E1rn\u00EDmi dermat\u00F3zami typu lichen sclerosus (LS) a lichen simplex chronicus (LSC). u-VIN v\u011Bt\u0161inou postihuje relativn\u011B mlad\u00E9 \u017Eeny s anamn\u00E9zou dal\u0161\u00EDch prekancer\u00F3z d\u011Blo\u017En\u00EDho hrdla, vag\u00EDny nebo vulvy. Typickou pacientkou s d-VIN je naopak postmenopauz\u00E1ln\u00ED \u017Eena bez anamnestick\u00FDch dat ostatn\u00EDch dysplastick\u00FDch l\u00E9z\u00ED doln\u00EDho \u017Eensk\u00E9ho pohlavn\u00EDho syst\u00E9mu. d-VIN p\u0159evy\u0161uje u-VIN v tendenci ke strom\u00E1ln\u00ED invazi a biologick\u00FDm chov\u00E1n\u00EDm odpov\u00EDd\u00E1 karcinomu in situ (VIN III). Paradoxn\u011B se v histologick\u00E9m vy\u0161et\u0159en\u00ED d-VIN jev\u00ED jako nen\u00E1padn\u00E1 l\u00E9ze s atypiemi v bu\u0148k\u00E1ch baz\u00E1ln\u00ED vrstvy a s dob\u0159e zachovanou diferenciac\u00ED povrchov\u00FDch parti\u00ED dla\u017Edicov\u00E9ho epitelu, proto b\u00FDv\u00E1 p\u0159i bioptick\u00E9m vy\u0161et\u0159en\u00ED zam\u011B\u0148ov\u00E1na za u-VIN I, LS anebo LSC. P\u0159edev\u0161\u00EDm z d\u016Fvodu n\u00EDzk\u00E9 diagnostick\u00E9 reproducibility kategorie u-VIN I, pro pochybnosti o jej\u00EDm malign\u00EDm potenci\u00E1lu a tak\u00E9 kv\u016Fli problematick\u00E9mu rozli\u0161en\u00ED u-VIN II a III byla v roce 2004 p\u0159edlo\u017Eena revidovan\u00E1 klasifikace VIN, ve kter\u00E9 bylo od gradingu prekancer\u00F3zn\u00EDch l\u00E9z\u00ED vulvy upu\u0161t\u011Bno - jednotka u-VIN I byla zru\u0161ena a u-VIN II a III byly spojeny do jedin\u00E9 kategorie. Term\u00EDn u-VIN tedy v nov\u00E9m n\u00E1zvoslov\u00ED reprezentuje high grade prekancer\u00F3zn\u00ED l\u00E9ze vulvy asociovan\u00E9 s HPV (d\u0159\u00EDve u-VIN II a III) a d-VIN i nad\u00E1le odpov\u00EDd\u00E1 HPV negativn\u00EDm high grade dyspl\u00E1zi\u00EDm."@cs . "\u0160kapa, Petr" . "Review of precancerous vulvar lesions"@en . "7"^^ . . . "http://www.prolekare.cz/cesko-slovenska-patologie-clanek/prekancerozni-leze-vulvy-37450" . "RIV/00064203:_____/12:8438!RIV13-MZ0-00064203" . . . "\u010Cesko-slovensk\u00E1 patologie a soudn\u00ED l\u00E9ka\u0159stv\u00ED" . "1210-7875" . "Z\u00E1me\u010Dn\u00EDk, Josef" . .