Vaginal Intraepithelial Neoplasia Detected with Cervical Liquid-Based Cytology: Old Concerns or New Facilities?


Background: The detection of vaginal intraepithelial neoplasia (VAIN) in cervical samples is not a common finding. Therefore, we aimed to report VAINs detected in liquid-based cytology (LBC) from women examined at Hospital das Clínicas of Faculty of Medicine, Sao Paulo State University. Materials and Methods: We evaluated LBC samples from women referred to gynecology examination for different reasons (previous abnormal PapTest, follow up of treated cervical lesion, ecc) and women examined for regular screening proposals, and compared with biopsy diagnoses, including the controversial diagnoses of vaginal intraepithelial neoplasia (VAIN). Results: From 1866 patients, 1423 (76.3%) cases were negative and 443 (23.7%) were positive for any cellular alteration. Age of patients ranged from 12 to 86 years. We detected 25 histologically confirmed VAIN (1.3% p = 0.0002 by Fisher’s exact test IC 95% 0.0090 - 0.0198) and 1.1% VAIN (p = 0.0031 by Fisher’s exact test IC 95% 0.0077 - 0.0179). Conclusion: The identification of VAIN in routine is feasible; the professionals involved with cytological examination should be aware of these lesions in Pap test samples.

Share and Cite:

Beldi, M. , Tacla, M. , Kamilos, M. , Sarmanho, F. , Ab’Saber, A. , Siqueira, S. , Alves, V. , Baracat, E. and Longatto-Filho, A. (2015) Vaginal Intraepithelial Neoplasia Detected with Cervical Liquid-Based Cytology: Old Concerns or New Facilities?. Open Journal of Obstetrics and Gynecology, 5, 580-587. doi: 10.4236/ojog.2015.511082.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Sillman, F.H., Fruchter, R.G., Chen, Y.S., et al. (1997) Vaginal Intraepithelial Neoplasia: Risk Factors for Persistence, Recurrence, and Invasion and Its Management. American Journal of Obstetrics & Gynecology, 176, 93-99.
[2] Aho, M., Vesterinen, E., Meyer, B., et al. (1991) Natural History of Vaginal Intraepithelial Neoplasia. Cancer, 68, 195-197.<195::AID-CNCR2820680135>3.0.CO;2-L
[3] Indermaur, M.D., Martino, M.A., Fiorica, J.V., et al. (2005) Upper Vaginectomy for the Treatment of Vaginal Intraepithelial Neoplasia. American Journal of Obstetrics & Gynecology, 193, 577-580, Discussion 580-581.
[4] Boonlikit, S. and Noinual, N. (2010) Vaginal Intraepithelial Neoplasia: A Retrospective Analysis of Clinical Features and Colpohistology. Journal of Obstetrics and Gynaecology Research, 36, 94-100.
[5] Minucci, D., et al. (1995) Epidemiological Aspects of Vaginal Intraepithelial Neoplasia (VAIN). Clinical & Experimental Obstetrics & Gynecology, 22, 36-42.
[6] Siebers, A.G., et al. (2008) Cytologic Detection of Cervical Abnormalities Using Liquid-Based Compared with Conventional Cytology: A Randomized Controlled Trial. Obstetrics & Gynecology, 112, 1327-1334.
[7] Sykes, P.H., Harker, D.Y., Miller, A., et al. (2008) A Randomised Comparison of Sure Path Liquid-Based Cytology and Conventional Smear Cytology in a Colposcopy Clinic Setting. BJOG, 115, 1375-1381.
[8] Arbyn, M., et al. (2008) Liquid Compared with Conventional Cervical Cytology: A Systematic Review and Meta-Analysis. Obstetrics & Gynecology, 111, 167-77.
[9] Scapulatempo, C., Fregnani, J.H, Campacci, N., Possati-Resende, J.C., Longatto-Filho, A. and Rodeo Study Team (2013) The Significance of Augmented High-Grade Squamous Intraepithelial Lesion Detection on Pap Test Examination: Partial Results from the RODEO Study Team. Acta Cytologica, 57, 489-494.
[10] Ronco, G., Cuzick, J., Pierotti, P., et al. (2007) Accuracy of Liquid Based versus Conventional Cytology: Overall Results of New Technologies for Cervical Cancer Screening: Randomised Controlled Trial. BMJ, 335, 28.
[11] Colgan, T.J., McLachlin, C.M., Cotterchio, M., Howlett, R., Seidenfeld, A.M. and Mai, V.M. (2004) Results of the Implementation of Liquid-Based Cytology-SurePath in the Ontario Screening Program. Cancer Cytopathology, 102, 362-367.
[12] Fremont-Smith, M., Marino, J., Griffin, B., Spencer, L. and Bolick, D. (2004) Comparison of the SurePath? Liquid-Based Papanicolaou Smear with the Conventional Papanicolaou Smear in a Multisite Direct-to-Vial Study. Cancer Cytopathology, 102, 269-279.
[13] Blanks, R.G. and Kelly, R.S. (2010) Comparison of Cytology and Histology Results in English Cervical Screening Laboratories before and after Liquid-Based Cytology Conversion: Do the Data Provide Evidence for a Single Category of High-Grade Dyskaryosis? Cytopathology, 21, 368-373.
[14] Yalcin, O.T., Rutherford, T.J., Chambers, S.K., Chambers, J.T. and Schwartz, P.E. (2003) Vaginal Intraepithelial Neoplasia: Treatment by Carbon Dioxide Laser and Risk Factors for Failure. European Journal of Obstetrics & Gynecology and Reproductive Biology, 106, 64-68.
[15] Bansal, M., Austin, R.M. and Zhao, C.Q. (2011) Correlation of Histopathologic Follow-Up Findings with Vaginal Human Papillomavirus and Low-Grade Squamous Intraepithelial Lesion Papanicolaou Test Results. Archives of Pathology & Laboratory Medicine, 135, 1545-1549.
[16] Indraccolo, U., Chiocci, L. and Baldoni, A. (2008) Does Vaginal Intraepithelial Neoplasia Have the Same Evolution as Cervical Intraepithelial Neoplasia? European Journal of Gynaecological Oncology, 29, 371-373.
[17] Frega, A., French, D., Piazze, J., Cerekja, A., Vetrano, G. and Moscarini, M. (2007) Prediction of Persistent Vaginal Intraepithelial Neoplasia in Previously Hysterectomized Women by High-Risk HPV DNA Detection. Cancer Letters, 249, 235-241.
[18] Herrington, C.S. (1995) Human Papillomaviruses and Cervical Neoplasia. II. Interaction of HPV with Other Factors. Journal of Clinical Pathology, 48, 1-6.
[19] van der Burg, S.H. and Palefsky, J.M. (2009) Human Immunodeficiency Virus and Human Papilloma Virus—Why HPV-Induced Lesions Do Not Spontaneously Resolve and Why Therapeutic Vaccination Can Be Successful. Journal of Translational Medicine, 7, 108.
[20] Massad, L.S., Xie, X.H., Greenblatt, R.M., Minkoff, H., Sanchez-Keeland, L., Watts, D.H., et al. (2012) Effect of Human Immunodeficiency Virus Infection on the Prevalence and Incidence of Vaginal Intraepithelial Neoplasia. Obstetrics & Gynecology, 119, 582-589.

Copyright © 2023 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.