ORIGINAL RESEARCH article
Front. Cell. Infect. Microbiol.
Sec. Clinical Infectious Diseases
Volume 15 - 2025 | doi: 10.3389/fcimb.2025.1602216
This article is part of the Research TopicSquamous Cell Carcinomas – HPV, or No HPV, That Is The QuestionView all 3 articles
Human papillomavirus infection and disease recurrence/persistence after treatment for women of high-grade cervical intraepithelial neoplasia with coexisting vaginal intraepithelial neoplasia
Provisionally accepted
- 1Liaoning Cancer Hospital, China Medical University, Shenyang, China
- 2Shengjing Hospital of China Medical University, Shenyang, China
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Background: Coexistent cervical (CIN) and vaginal (VaIN) intraepithelial neoplasia is problematic, posing challenges for patient management. This study focused on clinical characteristics of coexistent CIN 2/3 and VaIN (all degrees), evaluating the proclivity for disease recurrence/persistence at 6 months after treatment.A retrospective case-control study of women treated for coexistent CIN 2/3 and VaIN (CE group) was undertaken between January 2018 and December 2020. During the same period, women with CIN 2/3 only were selected chronologically (1:2 ratio) for comparison (sCIN group). A loop electrosurgical excision procedure (LEEP) was standard treatment for CIN 2/3, performing electrofulguration of VaIN in tandem. First follow-up visits at 6 months thereafter entailed testing for human papillomavirus (HPV). Univariate and multivariate analyses served to assess pertinent risk factors.Results: There were 91 CE group members, each treated for coexistent CIN 2/3 and VaIN (VaIN 1, 35; VaIN 2/3, 56). Age ≥50 years (OR=3.362, 95% CI: 1.421-7.954) emerged as an independent risk factor for coexistent disease. Positive margins and persistent high-risk HPV (HR-HPV) infection after treatment were more common in the CE (vs sCIN) group (p=0.012 and p<0.001, respectively), as was recurrent/persistent high-grade disease (17.6% vs 2.2%; p<0.001). In the CE group, persistent HR-HPV infection 6 months after treatment (OR=21.320, 95% CI: 2.509-181.188) was the sole independent risk factor for disease recurrence/persistence at 6 months.Comprehensive vaginal wall examinations are warranted for women with CIN 2/3, particularly those >50 years old. Close follow-up by HPV test is also indicated if CIN 2/3 and VaIN coexist, given a heightened incidence of recurrent/persistent disease.
Keywords: High-grade cervical intraepithelial neoplasia, Vaginal intraepithelial neoplasia, persistent high-risk human papillomavirus infection, Disease recurrence, Loop electrosurgical excision procedure
Received: 29 Mar 2025; Accepted: 17 Jun 2025.
Copyright: © 2025 Zhang, Wu, Zhu, Liu and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Danbo Wang, Liaoning Cancer Hospital, China Medical University, Shenyang, China
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