Clinical characteristics, HPV involvement, and demographic risk factors in women with cervical intraepithelial neoplasia complicated by vaginal intraepithelial neoplasia.

Cervical intraepithelial neoplasia Human papillomavirus ThinPrep cytologic test Vaginal intraepithelial neoplasia

Journal

BMC women's health
ISSN: 1472-6874
Titre abrégé: BMC Womens Health
Pays: England
ID NLM: 101088690

Informations de publication

Date de publication:
04 Apr 2024
Historique:
received: 28 07 2023
accepted: 16 03 2024
medline: 5 4 2024
pubmed: 5 4 2024
entrez: 4 4 2024
Statut: epublish

Résumé

This study aimed to explore the clinical characteristics and risk factors associated with cervical intraepithelial neoplasia (CIN) when coexisting with vaginal intraepithelial neoplasia (VAIN). We analyzed the clinical data of 212 patients diagnosed with CIN, including 50 patients with concurrent VAIN. The groups were compared to identify distinct clinical features and independent risk factors for the co-occurrence of CIN and VAIN, using logistic regression analysis. Patients with both CIN and VAIN had a median age of 57, significantly older than the 41-year median age of patients with CIN only (P < 0.05). A higher prevalence of HPV infection (98.0%) was observed in the CIN and VAIN group, with a notable rate of multiple HPV infections (67.3%) compared to the CIN-only group (P < 0.05). Educational levels were significantly lower in the combined CIN and VAIN group (P < 0.05). HPV16, 33, and 52 were identified as significant types for single and multiple infections. Multivariate analysis confirmed age as an independent risk factor for CIN with VAIN (P < 0.05). VAIN3 patients were more likely to exhibit HSIL and ASC-H, whereas VAIN1 cases tended to correspond with ASCUS and LSIL diagnoses. The co-occurrence of CIN and VAIN is significantly influenced by patient age and educational level. The findings advocate for more diligent vaginal examination during colposcopy in older patients, particularly those with multiple HPV infections and cytological abnormalities, to enhance the early detection of vaginal lesions and prevent missed diagnoses and treatments. Additionally, the high prevalence of HPV infection, especially with certain types, underscores the importance of HPV monitoring in this patient population.

Identifiants

pubmed: 38575911
doi: 10.1186/s12905-024-03030-1
pii: 10.1186/s12905-024-03030-1
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

220

Informations de copyright

© 2024. The Author(s).

Références

Jhingran A. Updates in the treatment of vaginal cancer. Int J Gynecol Cancer. 2022;32(3):344–51.
doi: 10.1136/ijgc-2021-002517 pubmed: 35256422 pmcid: 8921584
Wharton JT, Tortolero-Luna G, Linares AC, Malpica A, Baker VV, Cook E, Johnson E, Follen Mitchell M. Vaginal intraepithelial neoplasia and vaginal cancer. Obstet Gynecol Clin North Am. 1996;23(2):325–45.
pubmed: 8784884
Zhang YY, Xia R, Chen D, Zhang X. Analysis of related factors of cervical intraepithelial neoplasia complicated with vaginal intraepithelial neoplasia. Clin Transl Oncol. 2022;24(5):902–8.
doi: 10.1007/s12094-021-02739-x pubmed: 35001341
Cui C, Xiao Y, Lin E, Luo L, Sun X, Zeng J, Sui L, Tao X, Cong Q. Precise measurement of the thickness of Vaginal Intraepithelial Neoplasia. J Low Genit Tract Dis. 2022;26(3):245–9.
doi: 10.1097/LGT.0000000000000672 pubmed: 35285456 pmcid: 9232286
Inayama Y, Yamanishi Y, Nakatani E, Aratake J, Sasagasako N, Yamada K, Gou R, Kawamura A, Yamanishi M, Kosaka K. Imiquimod for vaginal intraepithelial neoplasia 2–3: a systematic review and meta-analysis. Gynecol Oncol. 2021;160(1):140–7.
doi: 10.1016/j.ygyno.2020.09.031 pubmed: 33010966
Sillman FH, Fruchter RG, Chen YS, Camilien L, Sedlis A, McTigue E. Vaginal intraepithelial neoplasia: risk factors for persistence, recurrence, and invasion and its management. Am J Obstet Gynecol. 1997;176(1 Pt 1):93–9.
doi: 10.1016/S0002-9378(97)80018-X pubmed: 9024096
Maffini CF, Collaco LM, Sebastiao APM, Zanine RM. Colposcopic findings and diagnosis in low-income Brazilian women with ASC-H pap smear results. Rev Bras Ginecol Obstet. 2022;44(2):178–86.
doi: 10.1055/s-0042-1742289 pubmed: 35213916 pmcid: 9948266
Yamamoto K, Kitai M, Yamamoto K, Sakuma T, Nagao S, Yamaguchi S. Successful endoscopic treatment for high-grade cervical intraepithelial neoplasia with gross lesions of the Vagina. Gynecol Minim Invasive Ther. 2021;10(2):124–6.
doi: 10.4103/GMIT.GMIT_119_19 pubmed: 34040974 pmcid: 8140545
He S, Wang GL, Zhu YY, Wu MH, Ji ZG, Seng J, Ji Y, Zhou JM, Chen L. Application of the CellDetect(R) staining technique in diagnosis of human cervical cancer. Gynecol Oncol. 2014;132(2):383–8.
doi: 10.1016/j.ygyno.2013.12.016 pubmed: 24361533
Bouvard V, Baan R, Straif K, Grosse Y, Secretan B, El Ghissassi F, Benbrahim-Tallaa L, Guha N, Freeman C, Galichet L, Cogliano V, WHO International Agency for Research on Cancer Monograph Working Group. A review of human carcinogens–part B: biological agents. Lancet Oncol. 2009;10(4):321–2.
doi: 10.1016/S1470-2045(09)70096-8 pubmed: 19350698
Kesic V, Carcopino X, Preti M, Vieira-Baptista P, Bevilacqua F, Bornstein J, Chargari C, Cruickshank M, Erzeneoglu E, Gallio N, Gultekin M, Heller D, Joura E, Kyrgiou M, Madic T, Planchamp F, Regauer S, Reich O, Esat Temiz B, Woelber L, Zodzika J, Stockdale C. The European Society of Gynaecological Oncology (ESGO), the International Society for the Study of Vulvovaginal Disease (ISSVD), the European College for the study of Vulval Disease (ECSVD), and the European Federation for Colposcopy (EFC) consensus statement on the management of vaginal intraepithelial neoplasia. Int J Gynecol Cancer. 2023;33(4):446–61.
doi: 10.1136/ijgc-2022-004213 pubmed: 36958755 pmcid: 10086489
Preti M, Joura E, Vieira-Baptista P, Van Beurden M, Bevilacqua F, Bleeker MCG, Bornstein J, Carcopino X, Chargari C, Cruickshank ME, Erzeneoglu BE, Gallio N, Heller D, Kesic V, Reich O, Stockdale CK, Temiz BE, Woelber L, Planchamp F, Zodzika J, Querleu D, Gultekin M. The European Society of Gynaecological Oncology (ESGO), the International Society for the Study of Vulvovaginal Disease (ISSVD), the European College for the study of Vulval Disease (ECSVD) and the European Federation for Colposcopy (EFC) Consensus statements on pre-invasive vulvar lesions. J Low Genit Tract Dis. 2022;26(3):229–44.
doi: 10.1097/LGT.0000000000000683 pubmed: 35763611 pmcid: 9232287
Bizzarri N, Razumova Z, Selcuk I, Taumberger N, Nikolova T, Fotopoulou C, Van der Steen-Banasik E, Ferrero A, Zalewski K. Report from the 21st meeting of the European Society of Gynaecological Oncology (ESGO 2019). Int J Gynecol Cancer. 2020;30(4):441–7.
doi: 10.1136/ijgc-2020-001226 pubmed: 32139437
Ciavattini A, Delli Carpini G, Giannella L, Arbyn M, Kyrgiou M, Joura EA, Sehouli J, Carcopino X, Redman CW, Nieminen P, Cruickshank M, Gultekin M. European Federation for Colposcopy (EFC) and European Society of Gynaecological Oncology (ESGO) joint considerations about human papillomavirus (HPV) vaccination, screening programs, colposcopy, and surgery during and after the COVID-19 pandemic. Int J Gynecol Cancer. 2020;30(8):1097–100.
doi: 10.1136/ijgc-2020-001617 pubmed: 32487685 pmcid: 7418593
Fotopoulou C, Concin N, Planchamp F, Morice P, Vergote I, du Bois A, Querleu D. Quality indicators for advanced ovarian cancer surgery from the European Society of Gynaecological Oncology (ESGO): 2020 update. Int J Gynecol Cancer. 2020;30(4):436–40.
doi: 10.1136/ijgc-2020-001248 pubmed: 32086362
Razumova Z, Bizzarri N, Kacperczyk-Bartnik J, Pletnev A, Gonzalez Martin A, Persson J. Report from the European Society of Gynaecological Oncology (ESGO) 2020 state-of-the-art virtual meeting. Int J Gynecol Cancer. 2021;31(5):658–69.
doi: 10.1136/ijgc-2021-002577 pubmed: 33811109
Chen X, Wang Z, Yan Y, Li P, Yang Z, Qin L, Mo W. XRCC3 C18067T polymorphism contributes a decreased risk to both basal cell carcinoma and squamous cell carcinoma: evidence from a meta-analysis. PLoS ONE. 2014;9(1):e84195.
doi: 10.1371/journal.pone.0084195 pubmed: 24454720 pmcid: 3893120
Qin LY, Chen X, Li P, Yang Z, Mo WN. Association between the XRCC3 Thr241Met polymorphism and cervical cancer risk: a meta-analysis. Asian Pac J Cancer Prev. 2014;14(11):6703–7.
doi: 10.7314/APJCP.2013.14.11.6703 pubmed: 24377592
Wang Z, Chen X, Liu B, Li S, Liu M, Xue H. Quantitative assessment of the associations between DNA repair gene XRCC3 Thr241Met polymorphism and gastric cancer. Tumour Biol. 2014;35(2):1589–98.
doi: 10.1007/s13277-013-1219-8 pubmed: 24197974
Yan Y, Chen X, Li T, Li M, Liang H. Association of OGG1 Ser326Cys polymorphism and pancreatic cancer susceptibility: evidence from a meta-analysis. Tumour Biol. 2014;35(3):2397–402.
doi: 10.1007/s13277-013-1317-7 pubmed: 24186001
Chen X, Yan Y, Li P, Yang Z, Qin L, Mo W. Association of GSTP1 -313A/G polymorphisms and endometriosis risk: a meta-analysis of case-control studies. Eur J Obstet Gynecol Reprod Biol. 2013;171(2):362–7.
doi: 10.1016/j.ejogrb.2013.10.005 pubmed: 24183097
Chen X, Mo W, Peng Q, Su X. Lack of association between Fas rs180082 polymorphism and risk of cervical cancer: an update by meta-analysis. BMC Med Genet. 2013;14:71.
doi: 10.1186/1471-2350-14-71 pubmed: 23865866 pmcid: 3728080
Si D, Yao Y, Chen X, Qiu J. Ethnicity-stratified analysis of the association between P53 rs1042522 polymorphism and women HPV infection: a meta-analysis. Microb Pathog. 2021;161(Pt A):105099.
doi: 10.1016/j.micpath.2021.105099 pubmed: 34284087
Niu K, Chen X, Lu Y. COL3A1 rs1800255 polymorphism is associated with pelvic organ prolapse susceptibility in caucasian individuals: evidence from a meta-analysis. PLoS ONE. 2021;16(4):e0250943.
doi: 10.1371/journal.pone.0250943 pubmed: 33930075 pmcid: 8087080
Jin X, Wu Y, Yin S, Chen X, Zhang Y. Association between the IL-10 and IL-6 polymorphisms and brucellosis susceptibility: a meta-analysis. BMC Med Genet. 2020;21(1):63.
doi: 10.1186/s12881-020-01006-0 pubmed: 32228609 pmcid: 7104517
Jin X, Yin S, Zhang Y, Chen X. Association between TLR2 Arg677Trp polymorphism and tuberculosis susceptibility: a meta-analysis. Microb Pathog. 2020;144:104173.
doi: 10.1016/j.micpath.2020.104173 pubmed: 32224213
Yuanyuan G, Xue Y, Yachao L, Xiao F, Xu C. Association between IL-18 -607 C/A polymorphism and the risk of prostate Cancer: a Meta-analysis of case-control studies. Asian Pac J Cancer Prev. 2019;20(6):1595–602.
doi: 10.31557/APJCP.2019.20.6.1595 pubmed: 31244277 pmcid: 7021598
Jin X, Yin S, Zhang Y, Chen X. Quantitative assessment of the association between IL-10 -592 A/C polymorphism and Kawasaki disease risk in Chinese population: evidence from a meta-analysis. Cardiol Young. 2018;28(6):811–5.
doi: 10.1017/S1047951118000380 pubmed: 29656715
Jin X, Yin S, Zhang Y, Chen X. Association between TLR2 + 2477G/A polymorphism and bacterial meningitis: a meta-analysis. Epidemiol Infect. 2018;146(5):642–7.
doi: 10.1017/S0950268818000298 pubmed: 29457581
Chen X, Jiang M, Zhao RK, Gu GH. Quantitative Assessment of the Association between ABC Polymorphisms and Osteosarcoma Response: a Meta-analysis. Asian Pac J Cancer Prev. 2015;16(11):4659–64.
doi: 10.7314/APJCP.2015.16.11.4659 pubmed: 26107220
Giorgio B, Francesco S, Andrea C, Alessandro G, Enrico V, Paolo V, Jvan C, Ciro P, Fabio G, Rosa DV, Violante DD, Tullio GD, Andrea G, Flavia S, Marco P, Giampiero C, Giuseppe V, Stefano R, Stefano C, Giovanni S, Francesco R. HPV-related lesions after hysterectomy for high-grade cervical intraepithelial neoplasia and early-stage cervical cancer: a focus on the potential role of vaccination. Tumori.2023; 17:3008916231208344.
Kyrgiou M, Mitra A, Arbyn M, Paraskevaidi M, Athanasiou A, Martin-Hirsch PP, Bennett P, Paraskevaidis E. Fertility and early pregnancy outcomes after conservative treatment for cervical intraepithelial neoplasia. Cochrane Database Syst Rev. 2015;2015(9):CD008478.
pubmed: 26417855 pmcid: 6457639
Marco M, Debora D, Annalisa S, Valentina T, Giusi S, Vanessa C, Andrea G, Violante DD, Innocenza P, Giorgia P, Antonella G, Ludovico M, Pierluigi BP. Relationship between cervical excisional treatment for cervical intraepithelial neoplasia and obstetrical outcome. Minerva Obstet Gynecol. 2021;73(2):233–46.
Giorgio B, Francesco S, Andrea C, Enrico V, Paolo V, Fabio G, Giovanni S, Violante DD, Andrea G, Francesco R. HPV persistence after cervical surgical excision of high-grade cervical lesions. Cancer Cytopathol. 2023 Sep;25. https://doi.org/10.1002/cncy.22760 . Online ahead of print.
Giorgio B, Francesco S, Andrea C, Enrico V, Paolo V, Andrea G, Fabio G, Giovanni S, Francesco R, Violante DD. Duration of human papillomavirus persistence and its relationship with recurrent cervical dysplasia. Eur J Cancer Prev. 2023;32(6):525–32.
doi: 10.1097/CEJ.0000000000000822

Auteurs

Mindan Xu (M)

Department of Obstetrics and Gynecology, First affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, Jiangsu, 215000, People's Republic of China.

Yan Wang (Y)

Department of Obstetrics and Gynecology, First affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, Jiangsu, 215000, People's Republic of China. jswangyan126@126.com.

Classifications MeSH