A retrospective study of 657 women with vaginal intraepithelial neoplasia (VaIN)

Abstract

Vaginal intraepithelial neoplasia (VaIN) is frequently underdiagnosed. The aim of this study was to explore the clinical characteristics of patients with VaIN and identify more sensitive diagnostic methods. This study retrospectively analyzed 657 patients with VaIN from the International Peace Maternal and Child Health Hospital during a ten-year period. Among the 657 patients, 26.5% were diagnosed with VaIN 2/3. The proportions of patients with VaIN 2/3 among those who did and did not undergo hysterectomy were 39.5% and 24.7%, respectively. The sensitivity of cytology testing for VaIN in those with only VaIN, VaIN concomitant with cervical or vulvar lesions, and posthysterectomy VaIN was 56.7%, 66.5%, and 72.3%, respectively. The sensitivity of high-risk human papillomavirus (hrHPV) testing for VaIN in the same categories was 87.7%, 86.5%, and 74.3%, respectively. The sensitivity of cytology and hrHPV cotesting for VaIN in the same categories was 95.2%, 95.6%, and 95.0%, respectively. In patients with VaIN 2/3, the incidence of HPV 16/18 was 50.6%. However, in patients with VaIN 1, the incidence of HPV 16/18 was only 22.6 %. The severity of VaIN was associated with HPV genotyping and hysterectomy, but not with concomitant cervical or vulvar lesions. A combination of cytology and hrHPV could increase the sensitivity of the diagnosis of VaIN. HPV 16 and 18 are the most frequent HPV-types in VaIN 2/3. Twelve specific hrHPV subtypes were the main virus types associated with the development of VaIN 1.