Prognostic factors for the development of vaginal intraepithelial neoplasia
Por:
Gonzalez-Bosquet E, Torres A, Busquets M, Esteva-Afonso C, Munoz-Almagro C and Lailla Vicens JM
Publicada:
1 ene 2008
Resumen:
Objective: To identify risk factors for the appearance of vaginal
intraepithelial neoplasia (VAIN). Material and methods: A total of 485
women with abnormal cytologies were followed over three years
(2003-2006). They underwent cytotology and colposcopy, and testing for
human papillomavirus virus (HPV) infection. If the colposcopy was
atypical, a biopsy was performed. Results: A total of 256 women were
treated: 161 by cone biopsy, 103 by LLETZ, 12 by repeat conization, and
44 by total hysterectomy. In eight cases VAIN was diagnosed following
hysterectomy. The average age at which VAIN appeared was 49.8 years (age
range 39-61). Hysterectomy was indicated in two cases of cervical
cancer, four cases of persistent high-grade cervical SIL, and two cases
of recurrent high-grade cervical SIL. The mean time for the appearance
of VAIN following hysterectomy was 3.8 years (range 1-9 years). Of these
eight women, seven had HPV infections at high risk for carcinogenesis.
Conclusions: Long-term follow-up cytology is necessary for women treated
for high-grade SIL, even after hysterectomy, because of the increased
risk of a primary vaginal VAIN lesion, especially in women with
high-risk HPV infection.
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