Association between low-grade cervical cytology and histological cervical intraepithelial neoplasia concurrent vaginal intraepithelial neoplasia among outpatient colposcopy: A retrospective study

Abstract

Background

There is evidence that cytological low-grade squamous intraepithelial lesion (LSIL) is associated with cervical intraepithelial neoplasia (CIN) in colposcopy, but its link to cervical intraepithelial neoplasia concurrent vaginal intraepithelial neoplasia (VaIN) remains unclear.

Methods

A retrospective chart review was performed that encompassed patients who were pathologically diagnosed with CIN at a single center from 2017 to 2021. Demographics, referring cytology, HPV genotype, and histologic information were recorded. The primary outcome was CIN coexisted with VaIN.

Results

Among 5488 patients included in this study (mean age, 37.0 years [SD 10]; 1376 [25.4]) had low-grade cervical cytology positive. A total of 458 participants were classified as having histologically CIN concurrent VaIN. Compared with participants without LSIL cytology, those with LSIL cytology had a higher prevalence of histological CIN concurrent VaIN (38.1% [172] vs. 24.2% [1204]). After adjusting for potential confounders, we found an association between LSIL cytology and histological CIN concurrent VaIN (odds ratio [OR], 3.28; 95% confidence interval [CI], 1.84–5.82). In subgroup analyses, LSIL cytology was associated with histological CIN concurrent VaIN among participants sexual life year 10 to 19 years (OR, 5.35; 95% CI, 1.58–18.04), gravidity 1–2 fetus (OR, 5.49; 95% CI, 1.62–18.61), HPV33 positive (OR, 90.06; 95% CI, 2.27–3579.46), HPV52 positive (OR, 9.09; 95% CI, 1.96–42.12).

Conclusions

In this cross-sectional study, LSIL cytology was associated with histological CIN concurrent VaIN in the outpatient colposcopy in adjusted models. This association may be important to consider in the colposcopy for the early detection of CIN concurrent VaIN.