Clinical analysis of 20 patients with vaginal intraepithelial neoplasia

Abstract

Objective To explore the clinical-pathologic characteristics, treatment modalities and prognosis of patients with vaginal intracpithelial neoplasia ( VAIN ). Methods The clinical, pathologic and follow-up data of 20 cases with vaginal intraepithelial neoplasia treated primarily in Cancer Hospital of Chinese Academy of Medical Sciences from Jan. 1999 to Dec. 2007, were reviewed and analyzed retrospectively. Results There were not any of symptoms on diagnosis in all patients, and most of them ( 17 cases, 85% ) were frequently detected VAIN for the abnormal pap smears or pelvic examination from cervical carcinoma patients and under the colposcopy as well as colposcopic biopsies. There were 3 cases (15%) with cervical cancer were diagnosed as VAIN during the postoperative follow up, while 17 cases (85%) of patients were accompanied with cervical cancer( 12 eases) or cervical intraepithelial neoplasia (CIN, 5 cases ) concomitantly or antecedently. Ninety percent of patients were diagnosed as VAIN Ⅲ,17 cases (85%) were mainly localized in the upper third of vagina, and 13 cases (65%) affected to the multiple vaginal walls. Thirteen cases were performed surgery, and 7 cases were treated by irradiation. The local control rate was achieved to 100% in all of patients. Three cases ( included 1 post-irradiated and 2 post-operative) were relapsed after treatment, but still be controlled completely by radiotherapy or surgery. Conclusions VAIN was difficult to be diagnosed independently, which was frequently accompanied by cervical cancer or CIN, significantly localized in the upper third of vagina involving the multiple walls of vagina, and treated synchronously with cervical carcinoma and CIN accompanying. Surgery and radiotherapy was equally effective to control VAIN, and then follow-up post-treatment should be closely to detect, diagnose and treat recurrent VAIN as soon as possible after treatment. Key words: Vaginal neoplasms; Precancerous conditions; Biopsy