%0 Journal Article
%T Detection of high-risk human papillomavirus infection and treatment of high-grade vaginal intraepithelial neoplasia: A single-institution study.
%A Cho HW
%A Hong JH
%A Lee JK
%J Int J Gynaecol Obstet
%V 154
%N 2
%D Aug 2021
%M 33411347
%F 4.447
%R 10.1002/ijgo.13583
%X 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).
CONCLUSIONS: 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.