Vaginal intraepithelial neoplasia: Risk factors for persistence, recurrence, and invasion and its management

Sillman, Frederick H.; Fruchter, Rachel G.; Chen, Yan-Shiun; Camilien, Louis; Sedlis, Alexander; McTigue, E.

doi:10.1016/s0002-9378(97)80018-x

Cited by 138 publications

(128 citation statements)

References 12 publications

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“…Other authors reported an increasing mean patient age with increasing grade of VAIN. 6 As shown in Table 2, among the 28 patients with VAIN 1 that had had a hysterectomy, 21 (75.0%) had the hysterectomy for neoplasia and seven for other reasons. By contrast, among the VAIN 3 patients, those that had a hysterectomy for reasons other than neoplasia were 4-times more common than patients that had a hysterectomy for neoplasia.…”

Section: Discussionmentioning

confidence: 97%

“…In addition, the human papillomavirus (HPV) has been implicated as a causative agent. 4,5 Other risk factors include antecedent or coexistent neoplasia of the lower genital tract, a history of pelvic radiation, 6,7 and immunosuppression. 6 VAIN often accompanies CIN, and is thought to have a similar etiology.…”

Section: Introductionmentioning

confidence: 99%

“…4,5 Other risk factors include antecedent or coexistent neoplasia of the lower genital tract, a history of pelvic radiation, 6,7 and immunosuppression. 6 VAIN often accompanies CIN, and is thought to have a similar etiology. 8 Such lesions may be extensions into the vagina from the CIN, or they may be satellite lesions occurring mainly in the upper vagina.…”

Section: Introductionmentioning

confidence: 99%

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The utility of the human papillomavirus DNA load for the diagnosis and prediction of persistent vaginal intraepithelial neoplasia

Hwang

Song

et al. 2009

J Gynecol Oncol

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Objective: We evaluated the human papillomavirus (HPV) DNA load for the diagnosis and prediction of persistent vaginal intraepithelial neoplasia (VAIN). Methods: A retrospective review of the medical records of patients with a pathological diagnosis of VAIN was performed. Eligible women (N=48) were followed for cytology and HPV DNA test, and colposcopic biopsies were taken at 3-to 6-month intervals. Thirty-seven patients were followed for more than 6 months; their HPV DNA test results were compared to the cytology results for the prediction of disease prognosis. Results: The degree of VAIN was more severe in patients with a high initial HPV DNA load (p=0.009). Patients with VAIN 2 and VAIN 3 were older than those with VAIN 1 (p=0.005 and 0.008, respectively). In 26 out of 37 patients (70.3%), the VAIN resolved. The other patients had persistent lesions with no progression to invasive vaginal carcinoma. The last follow-up HPV DNA load was significantly higher in the group with persistent VAIN compared to the group with resolved VAIN (p＜0.0001). Negative cytology was observed in 25 out of 26 patients in the VAIN resolved group and in nine out of 11 patients in the VAIN persistent group (p=0.205). Conclusion: These results suggest that the HPV DNA test, especially for viral load, was more effective for the diagnosis and prediction of persistent VAIN than cytology.

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The utility of the human papillomavirus DNA load for the diagnosis and prediction of persistent vaginal intraepithelial neoplasia

Hwang

Song

et al. 2009

J Gynecol Oncol

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“…Vaginal neoplasia after hysterectomy is rare and has been reported 5,6,[17][18][19][20][21][22] to develop in up to 7.4% of patients whose hysterectomies followed a premalignant cervical diagnosis, compared with 1.1% in patients who had hysterectomies performed for benign conditions. Therefore, health care organizations generally recommend limited vaginal Pap test screening after most hysterectomies.…”

Section: Commentmentioning

confidence: 99%

Correlation of Histopathologic Follow-up Findings With Vaginal Human Papillomavirus and Low-Grade Squamous Intraepithelial Lesion Papanicolaou Test Results

Bansal

Austin²,

Zhao³

2011

Archives of Pathology &Amp; Laboratory Medicine

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Context.—Data on high-risk human papillomavirus (hrHPV) DNA test results in vaginal, liquid-based cytology (LBC) specimens and corresponding cytologic and histopathologic correlation data are limited. Objective.—To analyze follow-up correlation data associated with vaginal (after hysterectomy) low-grade squamous intraepithelial lesion (LSIL) LBC and hrHPV test results. Design.—Hospital records were searched for vaginal LSIL LBC and hrHPV results between July 1, 2005, and July 30, 2009. Histopathologic and Papanicolaou test follow-up correlation data were analyzed. Results.—During the study period, 2892 patients with test results from both posthysterectomy vaginal LBC and hrHPV were identified: 148 (5.1%) of the patients had vaginal Papanicolaou test results reported as LSIL, with hrHPV detected in 113 of the 148 patients (76.4%). Of 148 patients, 59 of those with vaginal LSIL including 48 (81.4%) with positive HPV testing and 11 (18.6%) with negative HPV testing results had a follow-up vaginal biopsy. Histopathologic vaginal intraepithelial neoplasia (VAIN) 2/3 was diagnosed in 7 of 59 patients (11.9%) with biopsies. In all 7 patients who were diagnosed with VAIN 2/3, hrHPV was detected in the LBC vial. No VAIN 2/3 diagnoses were documented in the biopsy specimens from the 11 patients with hrHPV− LSIL Papanicolaou test results. Histopathologic VAIN 2/3 was diagnosed from vaginal biopsies in 7 of the 48 patients (14.6%) with vaginal hrHPV+ LSIL test results. Conclusions.—Sensitivity and specificity of hrHPV test results associated with histopathologic follow-up diagnoses of VAIN 2/3 in patients with vaginal LSIL results were 100% and 21.2%, respectively. The positive predictive value of a vaginal hrHPV+ LSIL result for a subsequent histopathologic VAIN 2/3 diagnosis was 14.6%. No cases of VAIN 2/3 were diagnosed in the 11 patients with vaginal hrHPV− LSIL results. Correlations of vaginal cytologic, histopathologic, and human papillomavirus findings were quite similar to correlation findings previously reported in older women with cervical LSIL test results.

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“…La hipótesis es que su historia natural es semejante al de la neoplasia intraepitelial de cuello uterino, con el riesgo de progresión a carcinoma invasor. Sin embargo, esta eventualidad parece ser 100 veces menor que la situación aná-loga del cuello uterino (3).…”

Section: Introductionunclassified

Laser en El Tratamiento De La Neoplasia Intraepitelial De Vagina

Yazigi

2006

Rev. chil. obstet. ginecol.

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Vaginal intraepithelial neoplasia: Risk factors for persistence, recurrence, and invasion and its management

Cited by 138 publications

References 12 publications

The utility of the human papillomavirus DNA load for the diagnosis and prediction of persistent vaginal intraepithelial neoplasia

The utility of the human papillomavirus DNA load for the diagnosis and prediction of persistent vaginal intraepithelial neoplasia

Correlation of Histopathologic Follow-up Findings With Vaginal Human Papillomavirus and Low-Grade Squamous Intraepithelial Lesion Papanicolaou Test Results

Laser en El Tratamiento De La Neoplasia Intraepitelial De Vagina

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