title: Smoking increases the risk of high-grade vaginal intraepithelial neoplasia in women with oncogenic human papillomavirus.
abstract: OBJECTIVE
  In a large retrospective study, the association of smoking with human papillomavirus (HPV) genotype and vaginal intraepithelial neoplasia (VAIN) grade was analyzed.
  
  
  METHODS
  A SNOMED search was performed for vaginal biopsy or resection specimens diagnosed as VAIN over an 11-year period. The diagnosis of VAIN grade was confirmed by histological review. HPV genotype was determined by GP5+/6+ PCR and dot blot hybridization with type-specific oligonucleotide probes. Smoking history was obtained by chart review. Statistical analysis was performed using the chi-square test.
  
  
  RESULTS
  We identified specimens from 111 patients (age range 15-84); 64% (n=71) were diagnosed with high-grade VAIN (HGVAIN) and 36% (n=40) with low-grade VAIN (LGVAIN). High-risk (HR) HPV genotypes were identified in 83% of specimens (n=92), other types in 17% (n=19). Twenty-one different HPV genotypes were detected in total. Smoking history was available for 81% (n=90). Forty-one percent (n=37) had a positive smoking history. There was no significant difference in infection with HR vs. other types (p=0.92) among smokers when compared to non-smokers. In patients with HR HPV genotypes, smokers were at an increased risk for HGVAIN lesions when compared to patients who had never smoked (83% vs. 59%, p=0.02).
  
  
  CONCLUSIONS
  These data indicate an increased risk for HGVAIN in HR HPV positive women who smoke compared to HR HPV positive non-smokers.
authors.affiliation: Department of Pathology, Fletcher Allen Health Care, Burlington, VT 05401, USA. Sharon.Mount@vtmednet.org
authors.forename: Jessica F
authors.initials: JF
authors.lastname: Sherman
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Mount
authors.forename: Mark F
authors.initials: MF
authors.lastname: Evans
authors.forename: Joan
authors.initials: J
authors.lastname: Skelly
authors.forename: Linda
authors.initials: L
authors.lastname: Simmons-Arnold
authors.forename: Gamal H
authors.initials: GH
authors.lastname: Eltabbakh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002278:Carcinoma in Situ / Q000453:epidemiology* / Q000473:pathology / Q000821:virology; D004279:DNA, Viral / Q000032:analysis / Q000235:genetics; D005260:Female; D005838:Genotype; D006801:Humans; D008875:Middle Aged; D027383:Papillomaviridae / Q000235:genetics* / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000150:complications / Q000453:epidemiology* / Q000821:virology; D016133:Polymerase Chain Reaction; D012189:Retrospective Studies; D012907:Smoking / Q000009:adverse effects*; D014625:Vaginal Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000821:virology
chemical_list: D004279:DNA, Viral