Objective: To identify high-risk HPV (hrHPV) genotypes associated with high-grade vaginal intraepithelial neoplasia (VaIN), and evaluate the efficacy of various treatments for high-grade VaIN.
Methods: A retrospective review of outcomes among women diagnosed with VaIN after vaginal punch biopsy conducted due to an abnormal Papanicolaou smear or positive test for hrHPV at a hospital in Seoul, Korea, from 2013 to 2018. Logistic regression was used to identify variables associated with abnormal pathologic outcomes.
Results: Among 389 women included in the study, 58 were diagnosed with high-grade VaIN, including VaIN stage 2 (n = 37), VaIN stage 3 (n = 16), carcinoma in situ of the vagina (n = 3), and squamous carcinoma of the vagina (n = 2). In multivariate logistic regression analysis, risk of high-grade VaIN and cancer was higher among women with abnormal cytology (odds ratio [OR], 1.88; 95% confidence interval [CI], 1.47-2.47), any hrHPV infection (OR, 8.75; 95% CI, 1.14-67.31), HPV16 infection (OR, 5.71; 95% CI, 2.57-12.68), or HPV31 infection (OR, 4.37; 95% CI, 1.45-13.11).
Conclusion: The findings suggest that infection with hrHPV, especially HPV16 and HPV31, is significantly associated with high-grade VaIN. Regarding treatment modalities, ablative or excisional treatments showed good efficacy against pathologic regression of high-grade VaIN.
Keywords: HPV16; HPV31; high-risk HPV; vaginal intraepithelial neoplasia.
© 2021 International Federation of Gynecology and Obstetrics.