HPV prevalence and Detection Sensitivity in Vaginal Intraepithelial
Neoplasia: a hospital-based study
Abstract
Vaginal intraepithelial neoplasia (VaIN) always diagnosed through
coloscopy accidentally when the cervical cancer screening was abnormal.
A precise estimate of the detection rate of cervical cancer screening
for VaIN is limited. This study to investigated the characteristics and
screening history of VaIN, and compared the sensitivity of cytology and
human papillomavirus tests on the cervix against vaginal and cervical
high-grade squamous intraepithelial lesion (HSIL) or cancer. A total of
1200 patients with definitive histopathologic diagnoses of VaIN were
included in this study. Among them, 22.5% were diagnosed with VaIN2+,
and 50.4% were concomitant with cervical lesions. The median age of
VaIN2+ patients was 41.5 years old , while VaIN1 reported a median age
of 53 years old , p<0.001. This study reported that VaIN was
significantly and positively correlated with cervical lesions (r=0.387).
The high-risk human papillomavirus (hr-HPV) detection rate was 88.5%
(883/998) in VaIN and 95.4% in VaIN2+. HPV 16 was the most prevalent
HPV type in VaIN2+, which accounted for 54.5%, followed by HPV58
(17.0%), HPV52 (14.8%), HPV51 (11.4%), and HPV18 (10.2%). The
sensitivity of hr-HPV and cytology tests on the cervix for detecting
VaIN2+ was 95.0% and 84.9%, respectively. Both tests were not
significantly different from detecting CIN2+. When the cervical cancer
screening is abnormal and referring to colposcopy, acetic acid and
Lugol’s iodine need to cover the whole vaginal mucosa as well as the
fornix, attention need to be paid for the abnormal images of vagina in
order to find VaIN.