[1047] Histopathologic Follow-Up of Women with Post-Hysterectomy LSIL Vaginal Paps and High Risk HPV Testing

M Bansal, RM Austin, CZ Zhao. University of Pittsburgh Medical Center, Pittsburgh, PA

Background: High risk (hr) HPV infection is now recognized as the dominant etiologic factor responsible in cervical carcinogenesis. Data on the prevalence of hrHPV infection and histopathological follow-up in women with SIL vaginal cytology results are very limited.
Design: A computer-based search was carried for a study period of 49 months between July 1, 2005 and July 30, 2009 to identify women with LSIL vaginal cytology results who also were tested for hrHPV DNA. All study Pap tests were Thin Prep Pap Tests (TPPT) imaged using the ThinPrep Imaging System (TIS). hrHPV DNA detection was by the Hybrid Capture 2 method. hrHPV test and histopathological follow-up results were documented and analyzed.
Results: During the study period, 148 vaginal LSIL TPPT samples had hrHPV testing. 113 of 148 (76.4%) tested HPV positive. 59 post-hysterectomy patients with vaginal LSIL cytology results and hrHPV DNA testing and had at least one follow-up biopsy were included in this study. 14.6% of hrHPV positive women had follow-up VAIN2/3; however none of the 11 patients who were hrHPV negative had VAIN 2/3 (Table 1). The time interval between LSIL cytology results and an initial histopathological diagnosis of VAIN 2/3 or VAIN 1 ranged from 0.2 to 26 months (mean 8.6 months) and 0.2 to 21 months (mean 4.1 months) respectively. Study subjects were an average age of 57 yrs (27-92). There was no statistically significant difference in detection rates of VAIN for women ≤ 54 and ≥ 55 years of age.

Histopathological VAIN Diagnoses in LSIL Vaginal Pap Tests and correlation with hrHPV Test
Total (59)hrHPV Positive (48)hrHPV Negative (11)
7 (11.9%)41 (69.5%)7 (14.6%)34 (70.8%)07 (63.6%)

Conclusions: 1. The prevalence of hrHPV detection in vaginal LSIL Paps is similar to that reported with cervical LSIL Pap results. 2. The incidence of underlying histopathological high grade dysplasia is higher in hrHPV positive LSIL patients than in hrHPV negative LSIL patients; this difference however does not reach statistical significance due to small case numbers. 3. 81% of women with vaginal LSIL Paps had VAIN documented on in histopathological follow-up. 4. Follow-up vaginal colposcopic and tissue examinations are appropriate for women with vaginal LSIL Pap results.
Category: Gynecologic & Obstetrics

Monday, March 22, 2010 11:30 AM

Platform Session: Section D, Monday Morning


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