A retrospective study of 657 women with vaginal intraepithelial neoplasia (VaIN)
1Department of Gynecologic Oncology, the International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, 200030 Shanghai, China
2Shanghai Municipal Key Clinical Specialty, Female Tumor Reproductive Specialty, 200030 Shanghai, China
3Department of Ultrasound, the International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, 200030 Shanghai, China
DOI: 10.22514/ejgo.2022.041 Vol.43,Issue 5,October 2022 pp.42-46
Submitted: 21 May 2022 Accepted: 01 July 2022
Published: 15 October 2022
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.
Carcinoma in situ; Human papilloma viruses; Hysterectomy; Vaginal neoplasms
Fanhui Meng,Yunyun Cao,Yudong Wang. A retrospective study of 657 women with vaginal intraepithelial neoplasia (VaIN). European Journal of Gynaecological Oncology. 2022. 43(5);42-46.
 Adhikari P, Vietje P, Mount S. Premalignant and malignant lesions of the vagina. Diagnostic Histopathology. 2017; 23: 28–34.
 Alfonzo E, Holmberg E, Sparén P, Milsom I, Strander B. Risk of vaginal cancer among hysterectomised women with cervical intraepithelial neoplasia: a population-based national cohort study. BJOG. 2020; 127: 448–454.
 Cao D, Wu D, Xu Y. Vaginal intraepithelial neoplasia in patients after total hysterectomy. Current Problems in Cancer. 2021; 45: 100687.
 Chao A, Jao M, Huang C, Huang H, Cheng H, Yang J, et al. Human papillomavirus genotype in cervical intraepithelial neoplasia grades 2 and 3 of Taiwanese women. International Journal of Cancer. 2011; 128: 653–659.
 Smith JS, Backes DM, Hoots BE, Kurman RJ, Pimenta JM. Human papillomavirus type-distribution in vulvar and vaginal cancers and their associated precursors. Obstetrics & Gynecology. 2009; 113: 917–924.
 De Vuyst H, Clifford GM, Nascimento MC, Madeleine MM, Franceschi S. Prevalence and type distribution of human papillomavirus in carcinoma and intraepithelial neoplasia of the vulva, vagina and anus: a meta-analysis. International Journal of Cancer. 2009; 124: 1626–1636.
 Sopracordevole F, Barbero M, Clemente N, Fallani MG, Cattani P, Agarossi A, et al. High-grade vaginal intraepithelial neoplasia and risk of progression to vaginal cancer: a multicentre study of the Italian society of colposcopy and cervico-vaginal pathology (SICPCV). European Review for Medical and Pharmacological Sciences. 2016; 20: 818–824.
 Cong Q, Song Y, Wang Q, Zhang H, Gao S, Sui L. A retrospective study of cytology, high-risk HPV, and colposcopy results of vaginal intraepithelial neoplasia patients. BioMed Research International. 2018; 2018: 1–6.
 Gurumurthy M, Leeson S, Tidy J, Cruickshank ME. UK national survey of the management of vaginal intraepithelial neoplasia. Journal of Obstetrics and Gynaecology. 2020; 40: 694–698.
 Dodge JA, Eltabbakh GH, Mount SL, Walker RP, Morgan A. Clinical features and risk of recurrence among patients with vaginal intraepithelial neoplasia. Gynecologic Oncology. 2001; 83: 363–369.
 Ao M, Zheng D, Wang J, Gu X, Xi M. A retrospective study of cytology and HPV genotypes results of 3229 vaginal intraepithelial neoplasia patients. Journal of Medical Virology. 2022; 94: 737–744.
 Braaten KP, Laufer MR. Human papillomavirus (HPV), HPV-related disease, and the HPV vaccine. Reviews in Obstetrics & Gynecology. 2008; 1: 2–10.
 Alemany L, Saunier M, Tinoco L, Quirós B, Alvarado-Cabrero I, Alejo M, et al. Large contribution of human papillomavirus in vaginal neoplastic lesions: a worldwide study in 597 samples. European Journal of Cancer. 2014; 50: 2846–2854.
Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,500 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.
Biological Abstracts Easily discover critical journal coverage of the life sciences with Biological Abstracts, produced by the Web of Science Group, with topics ranging from botany to microbiology to pharmacology. Including BIOSIS indexing and MeSH terms, specialized indexing in Biological Abstracts helps you to discover more accurate, context-sensitive results.
Google Scholar Google Scholar is a freely accessible web search engine that indexes the full text or metadata of scholarly literature across an array of publishing formats and disciplines.
JournalSeek Genamics JournalSeek is the largest completely categorized database of freely available journal information available on the internet. The database presently contains 39226 titles. Journal information includes the description (aims and scope), journal abbreviation, journal homepage link, subject category and ISSN.
Current Contents - Clinical Medicine Current Contents - Clinical Medicine provides easy access to complete tables of contents, abstracts, bibliographic information and all other significant items in recently published issues from over 1,000 leading journals in clinical medicine.
BIOSIS Previews BIOSIS Previews is an English-language, bibliographic database service, with abstracts and citation indexing. It is part of Clarivate Analytics Web of Science suite. BIOSIS Previews indexes data from 1926 to the present.
Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.