Abnormal pap smear and diagnosis of high-grade vaginal intraepithelial neoplasia

Francesco Sopracordevole, Francesca Mancioli, Nicolo Clemente, Giovanni De Piero, Monica Buttignol, Giorgio Giorda, Andrea Ciavattini

Research output: Contribution to journalArticle

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Abstract

The aim of this study was to analyze the correlation between the first diagnosis of high-grade Vaginal Intraepithelial Neoplasia (HGVaIN: VaIN 2-VaIN 3) and the cytological abnormalities on the referral pap smear. All thewomenwith histological diagnosis ofHG-VaINconsecutively referred to the Gynecological Oncology Unit of the Aviano National Cancer Institute (Aviano, Italy) fromJanuary 1991 toApril 2014 and with a pap smear performed in the 3 months before the diagnosis were considered, and an observational cohort study was performed. A total of 87 women with diagnosis of HG-VaIN were identified. Major cytological abnormalities (HSIL and ASC-H) on the referral pap smear were significantly more frequent than lesser abnormalities (ASCUS and LSIL) in postmenopausal women (64.9% vs 36.7%, P=0.02) and in women with a previous diagnosis of HPV-related cervical preinvasive or invasive lesions (70.5% vs 39.5%, P=0.01). Diagnosis of VaIN 3 was preceded by major cytological abnormalities in most of the cases (72.7% vs 27.3%, P0.001). The diagnosis of HG-VaIN can be preceded by different abnormalities on referral pap smear. Major abnormalities are usually reported in postmenopausal women and in women with previous cervical HPVrelated disease. However, ASC-US or LSIL do not exclude HG-VaIN, especially VaIN2. An accurate examination of the whole vaginal walls (or vaginal vault) must be performed in all the women who underwent colposcopy for an abnormal pap smear, and a biopsy of all suspicious areas is mandatory.

Original languageEnglish
Pages (from-to)e1827
JournalMedicine (United States)
Volume94
Issue number42
DOIs
Publication statusPublished - Oct 1 2015

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Papanicolaou Test
Neoplasms
Referral and Consultation
Gynecological Examination
Colposcopy
National Cancer Institute (U.S.)
Italy
Observational Studies
Cohort Studies
Biopsy

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Abnormal pap smear and diagnosis of high-grade vaginal intraepithelial neoplasia. / Sopracordevole, Francesco; Mancioli, Francesca; Clemente, Nicolo; De Piero, Giovanni; Buttignol, Monica; Giorda, Giorgio; Ciavattini, Andrea.

In: Medicine (United States), Vol. 94, No. 42, 01.10.2015, p. e1827.

Research output: Contribution to journalArticle

Sopracordevole, Francesco ; Mancioli, Francesca ; Clemente, Nicolo ; De Piero, Giovanni ; Buttignol, Monica ; Giorda, Giorgio ; Ciavattini, Andrea. / Abnormal pap smear and diagnosis of high-grade vaginal intraepithelial neoplasia. In: Medicine (United States). 2015 ; Vol. 94, No. 42. pp. e1827.
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