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A Journal on Obstetrics and Gynecology

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Minerva Ginecologica 2006 April;58(2):101-8


language: Italian

Vaginal intraepithelial neoplasia and human papillomavirus infection: a report of 75 cases

Indraccolo U. 1, Del Frate E. 1, Cenci S. 1, Ubertosi M. 1, Donati Sarti R. 2, Donati Sarti C. 2, Baldoni A. 1

1 Servizio di Ginecologia Oncologica Preventiva, (Responsabile Dott. A. Baldoni), Italia 2 Centro Menopausa, (Responsabile Dott. C. Donati Sarti), S.C. di Ostetricia e Ginecologia, (Direttore Dott. G. Affronti), Azienda Ospedaliera di Perugia, Perugia, Italia


Aim. Vaginal intraepithelial neoplasia (VaIN) is an uncommon and poorly understood disease. Risk factors other than human papillomavirus (HPV) infection could be linked to the onset and evolution of some VaIN.
Methods. In this paper, the results achieved from the analysis of 75 patients with VaIN are reported. From these cases, women with HIV, previous hysterectomy, autoimmune diseases and radio- and chemotherapy have been excluded. Thus, most of these selected cases should be linked to the HPV infection. They have been examined after a distinction between grade and association with koilocytosis. VaIN preferential localization, mean age of patients and manifestation pattern after vaginal colposcopy have then been examined.
Results. Although the population size cannot allow evidences, it seems that VaIN with koilocytosis and VaIN I without koilocytosis have preferential localization in the upper third of the vagina. It does not appear that mean age of patients for each grade of VaIN differs significativly, both associated and not associated with koilocytosis. Finally, after vaginal colposcopy, the pattern of VaIN for each grade is not typical, and it seems that white thin epithelium or negative Lugol area are often the manifestation of high grades of VaIN too.
Conclusion. These results, if confirmed, could mean that VaIN due to HPV may have a different natural history relating to the site of localization in the vagina and, moreover, that also VaIN of high grade could appear with an innocent vaginal pattern.

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