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vaginal intraepithelial neoplasia

L-C Horn, C E Brambs, R Handzel, G Mehlhorn, D Schmidt, K Schierle
The majority of precancerous lesions of the lower female genital tract (intraepithelial neoplasia, IN) are caused by human papillomavirus (HPV) infections resulting in cellular atypia and in turn an altered tissue architecture. Depending on the pathogenesis, a distinction is made between vulvar intraepithelial neoplasia (VIN) classified as classical VIN associated with high-risk HPV infections (u-VIN) and differentiated VIN (d-VIN), which is associated with lichen sclerosus et atrophicus and p53 alterations...
October 13, 2016: Der Pathologe
Vicki B Benard, Philip E Castle, Steven A Jenison, William C Hunt, Jane J Kim, Jack Cuzick, Ji-Hyun Lee, Ruofei Du, Michael Robertson, Scott Norville, Cosette M Wheeler
Importance: A substantial effect of human papillomavirus (HPV) vaccines on reducing HPV-related cervical disease is essential before modifying clinical practice guidelines in partially vaccinated populations. Objective: To determine the population-based cervical intraepithelial neoplasia (CIN) trends when adjusting for changes in cervical screening practices that overlapped with HPV vaccination implementation. Design, Setting, and Participants: The New Mexico HPV Pap Registry, which captures population-based estimates of both cervical screening prevalence and CIN, was used to compute CIN trends from January 1, 2007, to December 31, 2014...
September 29, 2016: JAMA Oncology
Akiva P Novetsky, Marla J Keller, Ana Gradissimo, Zigui Chen, Stephanie L Morgan, Xiaonan Xue, Howard D Strickler, José A Fernández-Romero, Robert Burk, Mark H Einstein
OBJECTIVE: To assess in vitro efficacy of Divine 9, a carrageenan-based vaginal lubricant that is being studied as a microbicide to inhibit HPV16 pseudovirus (PsV) infection. METHODS: Sexually active US women between 19 and 35years without prior HPV vaccination or cervical intraepithelial neoplasia were instructed to use Divine 9 vaginally with an applicator either before sex only or before and after intercourse. Women who applied a single dose of gel returned for cervicovaginal lavage (CVL) collection 1, 4 or 8-12h after intercourse versus those who applied gel before and after intercourse returned 1, 4 or 8-12h after the second gel dose...
September 10, 2016: Gynecologic Oncology
Suzanne M Garland, Jorma Paavonen, Unnop Jaisamrarn, Paulo Naud, Jorge Salmerón, Song-Nan Chow, Dan Apter, Xavier Castellsagué, Júlio C Teixeira, S Rachel Skinner, James Hedrick, Genara Limson, Tino F Schwarz, Willy A J Poppe, F Xavier Bosch, Newton S de Carvalho, Maria Julieta V Germar, Klaus Peters, M Rowena Del Rosario-Raymundo, Grégory Catteau, Dominique Descamps, Frank Struyf, Matti Lehtinen, Gary Dubin
We evaluated the efficacy of the human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine in preventing HPV-related disease after surgery for cervical lesions in a post-hoc analysis of the PApilloma TRIal against Cancer In young Adults (PATRICIA; NCT00122681). Healthy women aged 15-25 years were randomized (1:1) to receive vaccine or control at months 0, 1 and 6 and followed for 4 years. Women were enrolled regardless of their baseline HPV DNA status, HPV-16/18 serostatus, or cytology, but excluded if they had previous or planned colposcopy...
December 15, 2016: International Journal of Cancer. Journal International du Cancer
Antonio Placidi, Paola Capparucci, Antonella Di Luzio, Gabriella Manca, Eloisa Mania, Tommaso Filippini, Paolo Giorgi Rossi
AIM: In 2013, the Local Health Unit Roma 2 ex C screening laboratory introduced a new set of indicators for quality assurance. We compare 2 sets of indicators based on routine multiple readings (peer review) for their ability to identify problems in single-reader accuracy. METHODS: All suspect slides were blindly reviewed by all the cytologists of the laboratory. The standard set of indicators includes interreader Cohen's kappa, positivity rate and atypical squamous cell of undetermined significance/squamous intraepithelial lesion (ASC-US/SIL) ratio...
August 10, 2016: Acta Cytologica
Maria Kyrgiou, Anita Mitra, Anna-Barbara Moscicki
Persistent infection with oncogenic human papillomavirus (HPV) is necessary but not sufficient for the development of cervical cancer. The factors promoting persistence as well those triggering carcinogenetic pathways are incompletely understood. Rapidly evolving evidence indicates that the vaginal microbiome (VM) may play a functional role (both protective and harmful) in the acquisition and persistence of HPV, and subsequent development of cervical cancer. The first studies examining the VM and the presence of an HPV infection using next-generation sequencing techniques identified higher microbial diversity in HPV-positive as opposed to HPV-negative women...
July 15, 2016: Translational Research: the Journal of Laboratory and Clinical Medicine
M Jentschke, K Chen, M Arbyn, B Hertel, M Noskowicz, P Soergel, P Hillemanns
BACKGROUND AND OBJECTIVES: Two devices for vaginal self-sampling of dry cell material (Evalyn Brush, Rovers Medical Devices; Qvintip, Aprovix) were compared using the Abbott RealTime High Risk HPV test. STUDY DESIGN: Both self-sampling devices (change of order with every patient) including instructions for use and a questionnaire were handed to 146 patients in a colposcopy clinic prior to scheduled colposcopies with collection of cervical reference specimens by gynaecologists using a broom-like device...
September 2016: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
Efraim Siegler, Yakir Segev, Lena Mackuli, Ron Auslender, Mayan Shiner, Ofer Lavie
BACKGROUND: Vulvar and vaginal malignant and premalignant lesions are uncommon and are clinically heterogeneous diseases with two pathways of carcinogenesis: human papillomavirus (HPV) induced or non-HPV induced. OBJECTIVES: To evaluate the demographic and clinical characteristics associated with vulvar or vaginal cancer and vulvar and vaginal intraepithelial neoplasia 3 (VIN3, VAIN3). METHODS: We conducted a retrospective chart review of 148 women with vulvar and vaginal malignancy and pre-malignancy for the period October 2004 to October 2012, and identified 59 and 19 patients with vulvar and vaginal cancer respectively, and 57 and 13 patients with VIN3 and VAIN3 respectively RESULTS: The median age of vulvar cancer patients was 30 years older than that of VIN3 patients...
May 2016: Israel Medical Association Journal: IMAJ
Karoliina Tainio, Maija Jakobsson, Karolina Louvanto, Ilkka Kalliala, Jorma Paavonen, Pekka Nieminen, Annika Riska
Vaginal intraepithelial neoplasia (VAIN) is associated with human papillomavirus (HPV) infection. The most common treatment modality is laser vaporisation, but recurrences are common. Imiquimod is an immune response modulator which is used for the treatment of external condylomas and other HPV-related genital neoplasias. The aim of the study was to evaluate the efficacy and tolerability of vaginally administered imiquimod in comparison with laser vaporisation and expectant management of high-grade VAIN. This proof of principle pilot study was a prospective 16-week randomised trial...
November 15, 2016: International Journal of Cancer. Journal International du Cancer
Francesco Sopracordevole, Maggiorino Barbero, Nicolò Clemente, Maria G Fallani, Paolo Cattani, Alberto Agarossi, Giovanni de Piero, Alberto Parin, Antonio Frega, Fausto Boselli, Francesca Mancioli, Monica Buttignol, Francesca Currado, Annalisa Pieralli, Andrea Ciavattini
The aim of this study was to evaluate the colposcopic patterns observed in women with a histopathological diagnosis of vaginal intraepithelial neoplasia (VaIN). The medical charts and the colposcopy records of women diagnosed with VaIN from January 1995 to December 2013 were analysed in a multicentre retrospective case series. The abnormal colposcopic patterns observed in women with VaIN1, VaIN2 and VaIN3 were compared. The vascular patterns and micropapillary pattern were considered separately. A grade II abnormal colposcopic pattern was more commonly observed in women with a biopsy diagnosis of VaIN3 rather than with VaIN1 or VaIN2 (P<0...
July 15, 2016: European Journal of Cancer Prevention
Freja Lærke Sand, Christian Munk, Signe Marie Jensen, Malene Frøsig Svahn, Kirsten Frederiksen, Susanne K Kjær
BACKGROUND: High-risk human papillomavirus (HPV) is essential for developing high-grade cervical intraepithelial neoplasia (CIN2 and CIN3) and has also been associated with noncervical anogenital cancers. However, limited knowledge exists about the long-term risk for anal, vulvar, and vaginal cancer following CIN2 or CIN3 diagnosis. METHODS: In a nationwide cohort study, we followed nearly 2.8 million women born in 1918-1990 who were recorded as living in Denmark between January 1, 1978 and December 31, 2012...
July 2016: Cancer Epidemiology, Biomarkers & Prevention
Claire Grace Scrivener, Robert Gornall, Philip Rolland
A 34-year-old nullipara, wishing to start a family, presented to colposcopy clinic. Her most recent cervical cytology result showed high-grade dyskaryosis. Having undergone four large loop excisions of the transformation zone during the past 6 years, this woman had no remaining vaginal cervix. In order to excise presumed high-grade cervical intraepithelial neoplasia while mitigating obstetric risk, she underwent a simple vaginal trachelectomy and isthmic cerclage. 6 months later, the patient had a negative test of cure...
2016: BMJ Case Reports
Stephanie Smeltzer, Xiaoying Yu, Kathleen Schmeler, Judy Levison
OBJECTIVE: To evaluate the prevalence of abnormal vaginal cytology and vaginal intraepithelial neoplasia (VAIN) and vaginal cancer in human immunodeficiency virus (HIV)-infected women with no history of abnormal cytologic screening who had a hysterectomy for conditions other than cervical dysplasia and cancer and to explore the risk factors associated with VAIN and vaginal cancer. METHODS: A retrospective cohort study was performed identifying 238 women between January 2000 and January 2015 with a history of HIV, previous hysterectomy, and no previous abnormal Pap test results...
July 2016: Obstetrics and Gynecology
Stephanie Smeltzer, Xioying Yu, Kathleen M Schmeler, Yvette Peters, Judy Levison
INTRODUCTION: Current guidelines for HIV-uninfected women do not advocate for continued vaginal pap smears for screening of vaginal intraepithelial neoplasia (VAIN) and vaginal cancer post-hysterectomy. Little data exists to propose the same guidelines for HIV-infected women that maybe at an increased risk. Our objective was to evaluate the prevalence of VAIN or vaginal cancer in HIV infected women with no history of abnormal cytologic screening who had hysterectomy for conditions other than cervical dysplasia/cancer...
May 2016: Obstetrics and Gynecology
Ana Catarina Ferreira Policiano, João Pedro Mendes Lopes, Sónia Alexandra Martins Barata, Anabela Mendes Colaço, Carlos Calhaz-Jorge
No abstract text is available yet for this article.
July 2016: Journal of Lower Genital Tract Disease
Grazyna Stanczuk, Gwendoline Baxter, Heather Currie, James Lawrence, Kate Cuschieri, Allan Wilson, Marc Arbyn
OBJECTIVES: Papillomavirus Dumfries and Galloway (PaVDaG) assessed the performance of a high-risk human papillomavirus (hrHPV) PCR-based assay to detect high-grade cervical intraepithelial neoplasia (CIN2+) in self-collected vaginal and urine samples. SETTING: Women attending routine cervical screening in primary care. PARTICIPANTS: 5318 women aged 20-60 years provided self-collected random urine and vaginal samples for hrHPV testing and a clinician-collected liquid-based cytology (LBC) sample for cytology and hrHPV testing...
2016: BMJ Open
Beth Cronin, Amy Bregar, Christine Luis, Steven Schechter, Paul Disilvestro, Latha Pisharodi, C James Sung, Christina Raker, Melissa Clark, Katina Robison
OBJECTIVE: To compare the prevalence of abnormal anal cytology, high-risk anal HPV and biopsy proven anal dysplasia among women with a history of lower genital tract malignancy compared to those with dysplasia. METHODS: A prospective cohort study was performed from December 2012 to February 2014 at outpatient clinics at an academic medical center. Women with a history of high-grade cervical, vulvar, or vaginal dysplasia, or malignancy were recruited. Anal cytology and HPV genotyping were performed...
June 2016: Gynecologic Oncology
Melissa Hodeib, Joshua G Cohen, Sukrant Mehta, B J Rimel, Christine S Walsh, Andrew J Li, Beth Y Karlan, Ilana Cass
OBJECTIVE: High-grade vaginal intraepithelial neoplasia (VAIN) II-III has a variable clinical course. Due to the rarity of VAIN, existing data on the efficacy of treatment, risk of recurrence and progression to carcinoma is limited. Our objective was to evaluate predictors of recurrent disease and describe the risk of progression to carcinoma. METHODS: Under an IRB-approved protocol 42 patients with biopsy-proven VAIN II-III from 1995 to 2015 were retrospectively identified...
June 2016: Gynecologic Oncology
F Sopracordevole, M Barbero, N Clemente, M G Fallani, P Cattani, A Agarossi, G De Piero, A Parin, A Frega, F Boselli, F Mancioli, M Buttignol, F Currado, A Pieralli, A Ciavattini
OBJECTIVE: The aim of this study was to analyse the women with high grade vaginal intraepithelial neoplasia (HG-VaIN), in order to identify a subset of women at higher risk of progression to invasive vaginal cancer. MATERIALS AND METHODS: The medical records of all the women diagnosed with HG-VaIN, and subsequently treated, from January 1995 to December 2013 were analyzed in a multicentre retrospective case series. The rate of progression to invasive vaginal cancer and the potential risk factors were evaluated...
March 2016: European Review for Medical and Pharmacological Sciences
Janine T Bryan, Barry Buckland, Jennifer Hammond, Kathrin U Jansen
In 2006, the first human papillomavirus (HPV) virus-like particle (VLP) vaccine was licensed. Gardasil(®), the quadrivalent HPV 6, 11, 16 and 18 recombinant VLP vaccine (4vHPV), developed by Merck demonstrated remarkable efficacy in prevention of important clinical pre-cursors to cervical cancer and genital warts. The vaccine was designed to protect against HPV 16 and 18 that cause ∼70% of cervical cancers and HPV 6 and 11 that cause ∼90% of genital warts. Initially, Gardasil(®) was indicated in the United States for women 9-26 years of age for the prevention of HPV 16 and 18-related cervical, vulvar and vaginal cancer, HPV 6, 11, 16 and 18-related genital intraepithelial neoplasia and the prevention of HPV 6 and 11-related genital warts...
June 2016: Current Opinion in Chemical Biology
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