Retrospective analysis of 274 cases suspected vaginal intraepithelial neoplasia

Vaginal intraepithelial neoplasia (VaIN) is a precancerous lesion for invasive vaginal cancer, which is highly malignant and difficult to treat. This study aimed to identify the risk factors for VaIN and emphasize the importance of screening and monitoring patients with a history of cervical intraepithelial neoplasia and ongoing human papillomavirus (HPV) infection. Patients suspected of having VaIN were admitted to the Department of Gynecology and Obstetrics at the Affiliated Suzhou Hospital of Nanjing Medical University between February 2014 and August 2022. Medical records of these patients were retrospectively reviewed. A total of 274 patients underwent colposcopy due to suspected VaIN, and the diagnosis was confirmed in 167 patients based on biopsy pathology reports. Multivariate analysis in which odds ratios (ORs) with a 95% confidence interval (95% CI) were calculated revealed that vaccine-related HPV-infected patients (OR = 4.30, 95% CI: 1.75-10.58), and postmenopausal patients (OR = 5.94, 95% CI: 1.95-18.09), had a significantly increased risk of developing high-grade VaIN. However, patients with prior surgical treatment had a reduced risk (OR = 0.58, 95% CI: 0.34-0.99), which may be attributed to regular monitoring. HPV16, 58, 52, and 33 were among the most prevalent HPV types, with HPV16 positivity associated with higher-grade VaIN. Patients with concurrent cervical high-grade squamous epithelial lesions also exhibited high-grade VaIN, indicating a potential link between cervical and vaginal intraepithelial lesions. Our study highlights the complex interplay between risk factors such as prior surgical treatment, human papillomavirus infection, and menstrual status in the progression of VaIN. This underscores the importance of comprehensive evaluation and management strategies for VaIN.