Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea.
J Gynecol Oncol. 2009 Dec;20(4):232-7. doi: 10.3802/jgo.2009.20.4.232. Epub 2009 Dec 28.
We evaluated the human papillomavirus (HPV) DNA load for the diagnosis and prediction of persistent vaginal intraepithelial neoplasia (VAIN).
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.
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).
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.
评估人乳头瘤病毒（HPV）DNA 载量在阴道上皮内瘤变（VAIN）持续性诊断和预测中的作用。
对经病理学诊断为 VAIN 的患者的病历进行回顾性分析。符合条件的女性（N=48）接受细胞学和 HPV DNA 检测，并在 3-6 个月的间隔时间内行阴道镜活检。37 例患者的随访时间超过 6 个月；将其 HPV DNA 检测结果与细胞学结果进行比较，以预测疾病预后。
HPV DNA 初始载量高的患者 VAIN 程度更严重（p=0.009）。VAIN 2 级和 VAIN 3 级患者的年龄大于 VAIN 1 级患者（p=0.005 和 0.008）。在 37 例患者中的 26 例（70.3%）中，VAIN 得到缓解。其他患者存在持续性病变，但未进展为浸润性阴道癌。与 VAIN 缓解组相比，VAIN 持续组的最后一次随访 HPV DNA 载量显著更高（p<0.0001）。VAIN 缓解组的 26 例患者中的 25 例和 VAIN 持续组的 11 例患者中的 9 例的细胞学检查结果为阴性（p=0.205）。
这些结果表明，HPV DNA 检测，尤其是病毒载量，在 VAIN 的诊断和持续性预测方面比细胞学检查更有效。
