AUTHOR=Zhang Jing , Wu Lina , Zhu Yanmei , Liu Guangcong , Wang Danbo 

TITLE=Human papillomavirus infection and disease recurrence/persistence after treatment for women of high-grade cervical intraepithelial neoplasia with coexisting vaginal intraepithelial neoplasia

JOURNAL=Frontiers in Cellular and Infection Microbiology

VOLUME=Volume 15 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/cellular-and-infection-microbiology/articles/10.3389/fcimb.2025.1602216

DOI=10.3389/fcimb.2025.1602216

ISSN=2235-2988

ABSTRACT=BackgroundCoexistent cervical intraepithelial neoplasia (CIN) and vaginal intraepithelial neoplasia (VaIN) is problematic, posing challenges for patient management. This study focused on the clinical characteristics of coexistent CIN 2/3 and VaIN (all degrees), evaluating the proclivity for disease recurrence/persistence at 6 months after treatment.MethodsA 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 the 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.ResultsThere 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.ConclusionsComprehensive 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.