[Clinical analysis of 13 cases with vaginal intraepithelial neoplasia].
OBJECTIVE
To investigate the pathogenesis, high risk factors, clinical characteristics, methods of diagnosis and treatment, and prognosis of vaginal intraepithelial neoplasia (VAIN).


METHODS
The clinical data of thirteen cases of VAIN treated in Zhejiang Provincial Cancer Hospital dated Mar. 2002 through Dec. 2008 were reviewed and analyzed retrospectively.


RESULTS
Twelve of 13 VAIN cases were performed the human papillomavirus (HPV) detection with 92% (11/12) HPV positive rate. None of the cases shown specific clinical manifestation. Among the 13 cases, 6 of them accompanied with cervical cancer, 4 cases with cervical intraepithelial neoplasia (CIN), and 3 cases with vulvar intraepithelial neoplasma (VIN). Five cases synchronously diagnosed with cervical lesion and 3 with vulva lesion were underwent surgery, while the other 5 cases were diagnosed metachronously. Among 8 cases underwent surgery, 1 case with CIN underwent argon plasma coagulation (APC) after surgery, 1 case with the positive edge of VIN underwent APC. During follow up, 1 case with locally advanced cervical cancer underwent radiotherapy again, 3 cases with VAIN received APC, while 1 cervical cancer cases with VAIN received no treatment. The average follow-up time was 25.6 months (range 6-87 months). Two cases died of cervical cancer metastasis. The other 11 cases were normal and still alive. None of them progressed to invasive carcinoma.


CONCLUSIONS
The main reason of VAIN is HPV infection. There are not specific clinical manifestations, usually diagnosed when reviewing cervical or vulva lesions and rarely progressed to invasive carcinoma. The main treatment of VAIN is surgery with the adjuvant treatment of APC.
Yang
Yue
Y
Department of Gynecology Oncology, Zhejiang Provincial Cancer Hospital, Hangzhou 310022, China. yangyue85170208@163.com
Gao
Yong-liang
YL
Yu
Ai-jun
AJ
Zhang
Jie-jie
JJ
D000328:Adult; D002278:Carcinoma in Situ / Q000209:etiology / Q000473:pathology* / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D027383:Papillomaviridae / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000150:complications*; D011230:Precancerous Conditions / Q000209:etiology / Q000473:pathology / Q000628:therapy; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D002583:Uterine Cervical Neoplasms / Q000209:etiology / Q000473:pathology / Q000628:therapy; D014621:Vagina / Q000601:surgery; D014625:Vaginal Neoplasms / Q000209:etiology / Q000473:pathology* / Q000628:therapy*; D014626:Vaginal Smears; D014846:Vulvar Neoplasms / Q000209:etiology / Q000473:pathology / Q000628:therapy