Retrospective Analysis Of 166 Cases Of Vaginal Intraepithelial Neoplasia

Objective:By exploring the clinical characteristics of vaginal intraepithelial neoplasia(Va IN)and the related risk factors,we can provide a basis for the management of Va IN.Methods: Data of Va IN hospitalized patients with biopsy confirmed biopsy in the Affiliated Cancer Hospital of Xinjiang Medical University from January 2018 to January 2022 were collected for retrospective analysis.Results :(1)Va IN mainly occurs in women around 48.The mean age(52 years)in the group with uterine or cervical surgery was greater than the age of initial Va IN patients,with significant differences(P<0.05).(2)97.6% of Va IN patients had HPV infection,and HPV type with high infection rate was mainly: HPV16,HPV52,HPV 52,HPV53,HPV18 and HPV58;HSIL group,HPV16 infection rate was higher than LSIL group(P <0.05).(3)Colposcopy patients with Va IN indicated that the vaginal lesions were mainly distributed in 1 / 3 of the vagina,the fornix and the vaginal stump,and the probability of vaginal HSIL at this site was higher,with the statistically significant difference(P=0.023).(4)The relationship between cervical lesions and vaginal lesions was analyzed by Kendall’s tau-b correlation evaluation,and found that the higher the pathological grade of previous or combined cervical lesions,the higher the pathological grade of Va IN,and there was a positive relationship(Kendall’s tau-b=0.237,P <0.05;initial cervical lesions: Kendall’tau-b=0.066,P <0.05).(5)By binary logistic regression analysis,vaginal HSIL in 1 / 3 of the vagina was 2.143 times that in 2 /3(P=0.043,OR =2.143,95% CI=1.023-4.490),and vaginal HSIL in Va IN and cervical lesions was 2.293 times vaginal HSIL caused by Va IN alone(P=0.022,OR =2.293,95%CI=1.128-4.663).(6)To analyze the interval between postoperative and detection of Va IN in the treatment history group(cervical conization / total hysterectomy).The interval between Va IN in women with a history of cervical lesions was 1-3 years and 3-12 years for non-cervical patients.The interval in the total hysterectomy group was significantly longer than the conical group,and the non-cervical history group was significantly longer than the cervical history group,with a statistically significant difference(P=0.009).Conclusion:(1)For perimenopausal women,high-risk HPV infection,a history of CIN,especially patients with high pathological grade,HPV16 infection and high viral load should pay attention to the early screening of Va IN in the first three years.(2)Multi-point biopsy of high-risk people with suspicious lesions in the upper vagina,vault or vaginal stump under the colposcopy,in order to achieve the early diagnosis and treatment of Va IN.(3)HPV detection and colposcopy biopsy are reliable means to diagnose Va IN.