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Vaginal Intraepithelial Neoplasia

MedGen UID:
87546
•Concept ID:
C0346208
•
Neoplastic Process
Synonyms: Intraepithelial Neoplasia of the Vagina; Intraepithelial Neoplasia of Vagina; Intraepithelial Neoplasm of the Vagina; Intraepithelial Neoplasm of Vagina; Intraepithelial Tumor of the Vagina; Intraepithelial Tumor of Vagina; Vaginal intraepithelial neoplasia; Vaginal Intraepithelial Neoplasm; Vaginal Intraepithelial Tumor; Vaginal SIL; Vaginal Squamous Intraepithelial Lesion; VAIN - Vaginal intraepithelial neoplasia
SNOMED CT: Vaginal intraepithelial neoplasia (254894004); VAIN - Vaginal intraepithelial neoplasia (254894004)

Definition

A superficial neoplastic process involving exclusively the vaginal squamous epithelium without extension to underlying tissue. It is classified as low- or high-grade intraepithelial neoplasia. [from NCI]

Professional guidelines

PubMed

The European Society of Gynaecological Oncology (ESGO), the International Society for the Study of Vulvovaginal Disease (ISSVD), the European College for the Study of Vulval Disease (ECSVD), and the European Federation for Colposcopy (EFC) consensus statement on the management of vaginal intraepithelial neoplasia.
Kesic V, Carcopino X, Preti M, Vieira-Baptista P, Bevilacqua F, Bornstein J, Chargari C, Cruickshank M, Erzeneoglu E, Gallio N, Gultekin M, Heller D, Joura E, Kyrgiou M, Madić T, Planchamp F, Regauer S, Reich O, Esat Temiz B, Woelber L, Zodzika J, Stockdale C
Int J Gynecol Cancer 2023 Apr 3;33(4):446-461. doi: 10.1136/ijgc-2022-004213. PMID: 36958755Free PMC Article
Management options for vaginal intraepithelial neoplasia.
Rountis A, Pergialiotis V, Tsetsa P, Rodolakis A, Haidopoulos D
Int J Clin Pract 2020 Nov;74(11):e13598. Epub 2020 Aug 4 doi: 10.1111/ijcp.13598. PMID: 32602195
Management of vaginal intraepithelial neoplasia.
Gurumurthy M, Cruickshank ME
J Low Genit Tract Dis 2012 Jul;16(3):306-12. doi: 10.1097/LGT.0b013e31823da7fb. PMID: 22460272

Recent clinical studies

Etiology

Imiquimod for Cervical and Vaginal Intraepithelial Neoplasia: A Systematic Review and Meta-analysis.
Inayama Y, Takamatsu S, Hamanishi J, Mizuno K, Horinouchi N, Yamanoi K, Taki M, Murakami R, Yamaguchi K, Kosaka K, Efthimiou O, Kawakami K, Furukawa TA, Mandai M
Obstet Gynecol 2023 Aug 1;142(2):307-318. Epub 2023 Jul 5 doi: 10.1097/AOG.0000000000005256. PMID: 37411024
The European Society of Gynaecological Oncology (ESGO), the International Society for the Study of Vulvovaginal Disease (ISSVD), the European College for the Study of Vulval Disease (ECSVD), and the European Federation for Colposcopy (EFC) consensus statement on the management of vaginal intraepithelial neoplasia.
Kesic V, Carcopino X, Preti M, Vieira-Baptista P, Bevilacqua F, Bornstein J, Chargari C, Cruickshank M, Erzeneoglu E, Gallio N, Gultekin M, Heller D, Joura E, Kyrgiou M, Madić T, Planchamp F, Regauer S, Reich O, Esat Temiz B, Woelber L, Zodzika J, Stockdale C
Int J Gynecol Cancer 2023 Apr 3;33(4):446-461. doi: 10.1136/ijgc-2022-004213. PMID: 36958755Free PMC Article
Management options for vaginal intraepithelial neoplasia.
Rountis A, Pergialiotis V, Tsetsa P, Rodolakis A, Haidopoulos D
Int J Clin Pract 2020 Nov;74(11):e13598. Epub 2020 Aug 4 doi: 10.1111/ijcp.13598. PMID: 32602195
Final efficacy, immunogenicity, and safety analyses of a nine-valent human papillomavirus vaccine in women aged 16-26 years: a randomised, double-blind trial.
Huh WK, Joura EA, Giuliano AR, Iversen OE, de Andrade RP, Ault KA, Bartholomew D, Cestero RM, Fedrizzi EN, Hirschberg AL, Mayrand MH, Ruiz-Sternberg AM, Stapleton JT, Wiley DJ, Ferenczy A, Kurman R, Ronnett BM, Stoler MH, Cuzick J, Garland SM, Kjaer SK, Bautista OM, Haupt R, Moeller E, Ritter M, Roberts CC, Shields C, Luxembourg A
Lancet 2017 Nov 11;390(10108):2143-2159. Epub 2017 Sep 5 doi: 10.1016/S0140-6736(17)31821-4. PMID: 28886907
Effect of the human papillomavirus (HPV) quadrivalent vaccine in a subgroup of women with cervical and vulvar disease: retrospective pooled analysis of trial data.
Joura EA, Garland SM, Paavonen J, Ferris DG, Perez G, Ault KA, Huh WK, Sings HL, James MK, Haupt RM; FUTURE I and II Study Group
BMJ 2012 Mar 27;344:e1401. doi: 10.1136/bmj.e1401. PMID: 22454089Free PMC Article

Diagnosis

Final efficacy, immunogenicity, and safety analyses of a nine-valent human papillomavirus vaccine in women aged 16-26 years: a randomised, double-blind trial.
Huh WK, Joura EA, Giuliano AR, Iversen OE, de Andrade RP, Ault KA, Bartholomew D, Cestero RM, Fedrizzi EN, Hirschberg AL, Mayrand MH, Ruiz-Sternberg AM, Stapleton JT, Wiley DJ, Ferenczy A, Kurman R, Ronnett BM, Stoler MH, Cuzick J, Garland SM, Kjaer SK, Bautista OM, Haupt R, Moeller E, Ritter M, Roberts CC, Shields C, Luxembourg A
Lancet 2017 Nov 11;390(10108):2143-2159. Epub 2017 Sep 5 doi: 10.1016/S0140-6736(17)31821-4. PMID: 28886907
Vaginal intraepithelial neoplasia: a therapeutical dilemma.
Frega A, Sopracordevole F, Assorgi C, Lombardi D, DE Sanctis V, Catalano A, Matteucci E, Milazzo GN, Ricciardi E, Moscarini M
Anticancer Res 2013 Jan;33(1):29-38. PMID: 23267125
Effect of the human papillomavirus (HPV) quadrivalent vaccine in a subgroup of women with cervical and vulvar disease: retrospective pooled analysis of trial data.
Joura EA, Garland SM, Paavonen J, Ferris DG, Perez G, Ault KA, Huh WK, Sings HL, James MK, Haupt RM; FUTURE I and II Study Group
BMJ 2012 Mar 27;344:e1401. doi: 10.1136/bmj.e1401. PMID: 22454089Free PMC Article
Vaginal intraepithelial neoplasia and vaginal cancer.
Wharton JT, Tortolero-Luna G, Linares AC, Malpica A, Baker VV, Cook E, Johnson E, Follen Mitchell M
Obstet Gynecol Clin North Am 1996 Jun;23(2):325-45. PMID: 8784884
Vaginal intraepithelial neoplasia.
Audet-Lapointe P, Body G, Vauclair R, Drouin P, Ayoub J
Gynecol Oncol 1990 Feb;36(2):232-9. doi: 10.1016/0090-8258(90)90180-s. PMID: 2404839

Therapy

Imiquimod for Cervical and Vaginal Intraepithelial Neoplasia: A Systematic Review and Meta-analysis.
Inayama Y, Takamatsu S, Hamanishi J, Mizuno K, Horinouchi N, Yamanoi K, Taki M, Murakami R, Yamaguchi K, Kosaka K, Efthimiou O, Kawakami K, Furukawa TA, Mandai M
Obstet Gynecol 2023 Aug 1;142(2):307-318. Epub 2023 Jul 5 doi: 10.1097/AOG.0000000000005256. PMID: 37411024
The European Society of Gynaecological Oncology (ESGO), the International Society for the Study of Vulvovaginal Disease (ISSVD), the European College for the Study of Vulval Disease (ECSVD), and the European Federation for Colposcopy (EFC) consensus statement on the management of vaginal intraepithelial neoplasia.
Kesic V, Carcopino X, Preti M, Vieira-Baptista P, Bevilacqua F, Bornstein J, Chargari C, Cruickshank M, Erzeneoglu E, Gallio N, Gultekin M, Heller D, Joura E, Kyrgiou M, Madić T, Planchamp F, Regauer S, Reich O, Esat Temiz B, Woelber L, Zodzika J, Stockdale C
Int J Gynecol Cancer 2023 Apr 3;33(4):446-461. doi: 10.1136/ijgc-2022-004213. PMID: 36958755Free PMC Article
Management options for vaginal intraepithelial neoplasia.
Rountis A, Pergialiotis V, Tsetsa P, Rodolakis A, Haidopoulos D
Int J Clin Pract 2020 Nov;74(11):e13598. Epub 2020 Aug 4 doi: 10.1111/ijcp.13598. PMID: 32602195
Final efficacy, immunogenicity, and safety analyses of a nine-valent human papillomavirus vaccine in women aged 16-26 years: a randomised, double-blind trial.
Huh WK, Joura EA, Giuliano AR, Iversen OE, de Andrade RP, Ault KA, Bartholomew D, Cestero RM, Fedrizzi EN, Hirschberg AL, Mayrand MH, Ruiz-Sternberg AM, Stapleton JT, Wiley DJ, Ferenczy A, Kurman R, Ronnett BM, Stoler MH, Cuzick J, Garland SM, Kjaer SK, Bautista OM, Haupt R, Moeller E, Ritter M, Roberts CC, Shields C, Luxembourg A
Lancet 2017 Nov 11;390(10108):2143-2159. Epub 2017 Sep 5 doi: 10.1016/S0140-6736(17)31821-4. PMID: 28886907
Effect of the human papillomavirus (HPV) quadrivalent vaccine in a subgroup of women with cervical and vulvar disease: retrospective pooled analysis of trial data.
Joura EA, Garland SM, Paavonen J, Ferris DG, Perez G, Ault KA, Huh WK, Sings HL, James MK, Haupt RM; FUTURE I and II Study Group
BMJ 2012 Mar 27;344:e1401. doi: 10.1136/bmj.e1401. PMID: 22454089Free PMC Article

Prognosis

Recent advances in treating female genital human papillomavirus related neoplasms with topical imiquimod.
Borella F, Gallio N, Mangherini L, Cassoni P, Bertero L, Benedetto C, Preti M
J Med Virol 2023 Nov;95(11):e29238. doi: 10.1002/jmv.29238. PMID: 38009696
Final efficacy, immunogenicity, and safety analyses of a nine-valent human papillomavirus vaccine in women aged 16-26 years: a randomised, double-blind trial.
Huh WK, Joura EA, Giuliano AR, Iversen OE, de Andrade RP, Ault KA, Bartholomew D, Cestero RM, Fedrizzi EN, Hirschberg AL, Mayrand MH, Ruiz-Sternberg AM, Stapleton JT, Wiley DJ, Ferenczy A, Kurman R, Ronnett BM, Stoler MH, Cuzick J, Garland SM, Kjaer SK, Bautista OM, Haupt R, Moeller E, Ritter M, Roberts CC, Shields C, Luxembourg A
Lancet 2017 Nov 11;390(10108):2143-2159. Epub 2017 Sep 5 doi: 10.1016/S0140-6736(17)31821-4. PMID: 28886907
Management of vaginal intraepithelial neoplasia.
Gurumurthy M, Cruickshank ME
J Low Genit Tract Dis 2012 Jul;16(3):306-12. doi: 10.1097/LGT.0b013e31823da7fb. PMID: 22460272
Effect of the human papillomavirus (HPV) quadrivalent vaccine in a subgroup of women with cervical and vulvar disease: retrospective pooled analysis of trial data.
Joura EA, Garland SM, Paavonen J, Ferris DG, Perez G, Ault KA, Huh WK, Sings HL, James MK, Haupt RM; FUTURE I and II Study Group
BMJ 2012 Mar 27;344:e1401. doi: 10.1136/bmj.e1401. PMID: 22454089Free PMC Article
Vaginal intraepithelial neoplasia.
Audet-Lapointe P, Body G, Vauclair R, Drouin P, Ayoub J
Gynecol Oncol 1990 Feb;36(2):232-9. doi: 10.1016/0090-8258(90)90180-s. PMID: 2404839

Clinical prediction guides

Recent advances in treating female genital human papillomavirus related neoplasms with topical imiquimod.
Borella F, Gallio N, Mangherini L, Cassoni P, Bertero L, Benedetto C, Preti M
J Med Virol 2023 Nov;95(11):e29238. doi: 10.1002/jmv.29238. PMID: 38009696
Non-Excisional therapeutic modalities in vaginal intraepithelial neoplasia.
Freitas G, Costa A
Eur J Obstet Gynecol Reprod Biol 2023 May;284:175-179. Epub 2023 Mar 20 doi: 10.1016/j.ejogrb.2023.03.014. PMID: 37004357
Recurrence of high-grade vaginal intraepithelial neoplasia after various treatments.
Boonlikit S
Curr Probl Cancer 2022 Apr;46(2):100792. Epub 2021 Sep 20 doi: 10.1016/j.currproblcancer.2021.100792. PMID: 34579973
Vaginal Intraepithelial Neoplasia: Clinical Presentation, Management, and Outcomes in Relation to HIV Infection Status.
Bradbury M, Xercavins N, García-Jiménez Á, Pérez-Benavente A, Franco-Camps S, Cabrera S, Sánchez-Iglesias JL, De La Torre J, Díaz-Feijoo B, Gil-Moreno A, Centeno-Mediavilla C
J Low Genit Tract Dis 2019 Jan;23(1):7-12. doi: 10.1097/LGT.0000000000000431. PMID: 30161052
Brachytherapy for vaginal intraepithelial neoplasia.
Zolciak-Siwinska A, Gruszczynska E, Jonska-Gmyrek J, Kulik A, Michalski W
Eur J Obstet Gynecol Reprod Biol 2015 Nov;194:73-7. Epub 2015 Aug 22 doi: 10.1016/j.ejogrb.2015.08.018. PMID: 26334358

Recent systematic reviews

Imiquimod for Cervical and Vaginal Intraepithelial Neoplasia: A Systematic Review and Meta-analysis.
Inayama Y, Takamatsu S, Hamanishi J, Mizuno K, Horinouchi N, Yamanoi K, Taki M, Murakami R, Yamaguchi K, Kosaka K, Efthimiou O, Kawakami K, Furukawa TA, Mandai M
Obstet Gynecol 2023 Aug 1;142(2):307-318. Epub 2023 Jul 5 doi: 10.1097/AOG.0000000000005256. PMID: 37411024
Imiquimod for vaginal intraepithelial neoplasia 2-3: A systematic review and meta-analysis.
Inayama Y, Yamanishi Y, Nakatani E, Aratake J, Sasagasako N, Yamada K, Gou R, Kawamura A, Yamanishi M, Kosaka K
Gynecol Oncol 2021 Jan;160(1):140-147. Epub 2020 Oct 1 doi: 10.1016/j.ygyno.2020.09.031. PMID: 33010966
Human papillomavirus and p16 in squamous cell carcinoma and intraepithelial neoplasia of the vagina.
Bertoli HK, Rasmussen CL, Sand FL, Albieri V, Norrild B, Verdoodt F, Kjaer SK
Int J Cancer 2019 Jul 1;145(1):78-86. Epub 2019 Jan 11 doi: 10.1002/ijc.32078. PMID: 30561092
Efficacy of 5% imiquimod for the treatment of Vaginal intraepithelial neoplasia-A systematic review of the literature and a meta-analysis.
Tranoulis A, Laios A, Mitsopoulos V, Lutchman-Singh K, Thomakos N
Eur J Obstet Gynecol Reprod Biol 2017 Nov;218:129-136. Epub 2017 Sep 27 doi: 10.1016/j.ejogrb.2017.09.020. PMID: 28985547
Human papillomavirus type-distribution in vulvar and vaginal cancers and their associated precursors.
Smith JS, Backes DM, Hoots BE, Kurman RJ, Pimenta JM
Obstet Gynecol 2009 Apr;113(4):917-924. doi: 10.1097/AOG.0b013e31819bd6e0. PMID: 19305339

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