Prediction of persistent vaginal intraepithelial neoplasia in previously hysterectomized women by high-risk HPV DNA detection

Abstract Aim: To estimate the incidence and latency of Vaginal Intraepithelial Neoplasia (VAIN) in women previously hysterectomized for benign/malign pathology and to evaluate the role of high risk HPVs in the prediction of persistent or recurrent disease. Subjects and methods: 830 women with prior...

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Bibliographic Details
Published in:Cancer letters 2007-05, Vol.249 (2), p.235-241
Main Authors: Frega, A, French, D, Piazze, J, Cerekja, A, Vetrano, G, Moscarini, M
Format: Article
Language:English
Subjects:
Adult
Age
Aged
Carcinoma in Situ - epidemiology
Carcinoma in Situ - virology
Cellular biology
Cervical cancer
Deoxyribonucleic acid
DNA
DNA, Viral - analysis
Female
Follow-up
Genetic testing
Hematology, Oncology and Palliative Medicine
HPV
Human papillomavirus
Human papillomavirus 16 - genetics
Human papillomavirus 18 - genetics
Humans
Hysterectomy
Lasers
Middle Aged
Papillomavirus Infections - epidemiology
Papillomavirus Infections - virology
Pathology
Predictive Value of Tests
Recurrence
Statistical analysis
Vaginal intraepithelial neoplasia
Vaginal Neoplasms - epidemiology
Vaginal Neoplasms - virology
Womens health
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Summary:Abstract Aim: To estimate the incidence and latency of Vaginal Intraepithelial Neoplasia (VAIN) in women previously hysterectomized for benign/malign pathology and to evaluate the role of high risk HPVs in the prediction of persistent or recurrent disease. Subjects and methods: 830 women with prior hysterectomy for benign/malign pathologies followed by cytological scraping and vaginal colposcopy. Forty-four patients presented VAIN lesions confirmed by histopathological diagnosis. HPV DNA test was performed at the time of diagnosis. Patients were treated by Laser CO2 vaporization and underwent follow-up by cytology, colposcopy for a mean period of 3 years. HPV DNA test was performed at 6 months after treatment and every years. Persistent or relapsed disease was confirmed by histopathology. Results: Incidence of VAIN in women hysterectomized for benign pathologies did not differ significantly from the malign group. VAIN degree was more severe in the hysterectomized patients with cervical malignancy and subsequently radiated respect to non-radiated patients. The HPV DNA test at 6 months after VAIN treatment showed fifteen positive cases: twelve HPV 16 (80%) and three HPV 18 (20%). In five cases HPV DNA test was positive with a persistent negative cytological smear during the years. Positivity to high-risk HPV (either 16 or 18) was significantly higher in the patients with relapse to VAIN (10/44, p < 0.002). Conclusions: We suggest to include HPV DNA test in addition to cytology in the follow-up of patients previously treated for VAIN, in order to predict VAIN persistence or progression in vaginal carcinoma before cytology becomes abnormal.
ISSN:0304-3835
1872-7980
DOI:10.1016/j.canlet.2006.09.003