HPV Genotype Distribution and Its Anatomical Site Specificity in Vaginal Intraepithelial Neoplasia

This study aimed to analyze the human papilloma virus (HPV) genotype distribution in vaginal intraepithelial neoplasia (VaIN) and its relationship with the anatomical location on the vaginal wall. A retrospective study was conducted on patients diagnosed with VaIN at the First Affiliated Hospital of Wenzhou Medical University between January 1, 2021, and December 31, 2024. A total of 1670 patients with low-grade VaIN and 259 patients with high-grade VaIN were included. Single HPV infection was the most prevalent type in VaIN cases. HPV52 was identified as the most common genotype in VaIN1 (25.0%), followed by HPV58 (15.7%), HPV53 (15.6%), and HPV16 (11.4%). In VaIN 2/3, the predominant genotypes were HPV16 (39.0%), HPV58 (22.4%), and HPV52 (15.1%). Multifocal lesions were observed in 34.7% of patients and were associated with both HPV co-infection and high-grade lesions. The diversity of HPV genotype was lower in the middle and lower segments of the vagina compared with the upper third and fornix. HPV16 was frequently and evenly detected across all vaginal segments in the specimen-level HSIL group (33.3%-47.2%). HPV52 was a leading genotype in the specimen-level LSIL group (17.6%-33.3%) and remained prevalent in the specimen-level HSIL group (10.3%-33.3%). HPV58 also accounted for a high proportion of infections. HPV exhibits distinct distribution patterns across different anatomical sites of the vaginal wall.