J Gynecol Oncol.  2009 Dec;20(4):232-237. 10.3802/jgo.2009.20.4.232.

The utility of the human papillomavirus DNA load for the diagnosis and prediction of persistent vaginal intraepithelial neoplasia

• So KA
• Hong JH
• Hwang JH
• Song SH
• Lee JK
• Lee NW
• Lee KW

• KMID: 2288588
• DOI: http://doi.org/10.3802/jgo.2009.20.4.232

Abstract

OBJECTIVE
We evaluated the human papillomavirus (HPV) DNA load for the diagnosis and prediction of persistent vaginal intraepithelial neoplasia (VAIN).
METHODS
A retrospective review of the medical records of patients with a pathological diagnosis of VAIN was performed. Eligible women (N=48) were followed for cytology and HPV DNA test, and colposcopic biopsies were taken at 3- to 6-month intervals. Thirty-seven patients were followed for more than 6 months; their HPV DNA test results were compared to the cytology results for the prediction of disease prognosis.
RESULTS
The degree of VAIN was more severe in patients with a high initial HPV DNA load (p=0.009). Patients with VAIN 2 and VAIN 3 were older than those with VAIN 1 (p=0.005 and 0.008, respectively). In 26 out of 37 patients (70.3%), the VAIN resolved. The other patients had persistent lesions with no progression to invasive vaginal carcinoma. The last follow-up HPV DNA load was significantly higher in the group with persistent VAIN compared to the group with resolved VAIN (p<0.0001). Negative cytology was observed in 25 out of 26 patients in the VAIN resolved group and in nine out of 11 patients in the VAIN persistent group (p=0.205).
CONCLUSION
These results suggest that the HPV DNA test, especially for viral load, was more effective for the diagnosis and prediction of persistent VAIN than cytology.

Keyword

Vaginal intraepithelial neoplasia; Human papillomavirus; Viral load

MeSH Terms

Biopsy
DNA
Female
Follow-Up Studies
Human Papillomavirus DNA Tests
Humans
Medical Records
Prognosis
Retrospective Studies
Viral Load
DNA

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