A Retrospective Study of 657 Women With Vaginal Intraepithelial Neoplasia (VaIN)

Objective: The aim of this study was to explore the clinical characteristics of patients with VaIN and identify more sensitive diagnostic methods.Methods: This study retrospectively analyzed 657 patients with VaIN from the International Peace Maternal and Child Health Hospital in Shanghai during a ten-year period. Results: 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 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 hrHPV 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 who did not undergo hysterectomy, HPV16 was detected in 9.5% of VaIN 1 lesions among the HPV DNA-positive patients, while the other 12 types of HPV were detected in 62.6% of VaIN 1 lesions. In patients who underwent hysterectomy, HPV16 was detected in 2.1% of VaIN 1 lesions, and the other 12 types of HPV were detected in 54.2% of VaIN 1 lesions.Conclusions: A combination of cytology and colposcopy could increase the sensitivity of the diagnosis of VaIN. The other 12 high-risk types of HPV positive may be more closely related to VAIN 1, more attention should be paid.