Cargando…

Importance of Colposcopy Impression in the Early Diagnosis of Posthysterectomy Vaginal Cancer

OBJECTIVE: The aim of the study was to investigate the value of cytology, high-risk human papillomavirus (hrHPV) status and colposcopy in the early diagnosis of vaginal cancer after hysterectomy. MATERIALS AND METHODS: A retrospective study was performed in the Obstetrics and Gynecology Hospital of...

Descripción completa

Detalles Bibliográficos
Autores principales: Cong, Qing, Fu, Zhongpeng, Zhang, Di, Sui, Long
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6325769/
https://www.ncbi.nlm.nih.gov/pubmed/30418351
http://dx.doi.org/10.1097/LGT.0000000000000446
_version_ 1783386184390541312
author Cong, Qing
Fu, Zhongpeng
Zhang, Di
Sui, Long
author_facet Cong, Qing
Fu, Zhongpeng
Zhang, Di
Sui, Long
author_sort Cong, Qing
collection PubMed
description OBJECTIVE: The aim of the study was to investigate the value of cytology, high-risk human papillomavirus (hrHPV) status and colposcopy in the early diagnosis of vaginal cancer after hysterectomy. MATERIALS AND METHODS: A retrospective study was performed in the Obstetrics and Gynecology Hospital of Fudan University. Posthysterectomy patients who were diagnosed with vaginal high-grade intraepithelial lesion (HSIL) by colposcopy-directed biopsy with colposcopy impression of extensive HSIL or suspicion of cancer and underwent upper or total vaginectomy from January 2009 to December 2017 were included. RESULTS: Eighty-six posthysterectomy vaginal HSIL patients were included. Available abnormal cytology and positive hrHPV were observed in 90.7% (49/54) and 96.2% (51/53) of the patients, respectively. A total of 18.6% (16/86) of the patients were diagnosed with squamous cell cancer by vaginectomy, and the average interval between hysterectomy and vaginectomy was 3.5 years. Among them, 62.5% (10/16) cancers occurred after hysterectomy for cervical cancer, 31.2% (5/16) after hysterectomy for cervical precancer, and 6.3% (1/16) after hysterectomy for myoma. An indication for hysterectomy (cervical cancer vs HSIL, odds ratio = 7.2, 95% CI = 1.9–28.0, p = .004) and colposcopy impression of vaginal cancer (vaginal cancer vs HSIL, odds ratio = 5.9, 95% CI = 1.3–26.8, p = .021) were high-risk factors of cancer confirmed by vaginectomy in colposcopy-directed biopsy vaginal intraepithelial neoplasia 2/3 posthysterectomy in multiple logistic regression analysis. CONCLUSIONS: Colposcopy is pivotal in the evaluation of abnormal cytology/hrHPV tests in follow-up of cervical cancer patients after hysterectomy and decision-making for vaginectomy in detecting early cancer.
format Online
Article
Text
id pubmed-6325769
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher Lippincott Williams & Wilkins
record_format MEDLINE/PubMed
spelling pubmed-63257692019-01-18 Importance of Colposcopy Impression in the Early Diagnosis of Posthysterectomy Vaginal Cancer Cong, Qing Fu, Zhongpeng Zhang, Di Sui, Long J Low Genit Tract Dis Original Research Articles: Cervix and HPV OBJECTIVE: The aim of the study was to investigate the value of cytology, high-risk human papillomavirus (hrHPV) status and colposcopy in the early diagnosis of vaginal cancer after hysterectomy. MATERIALS AND METHODS: A retrospective study was performed in the Obstetrics and Gynecology Hospital of Fudan University. Posthysterectomy patients who were diagnosed with vaginal high-grade intraepithelial lesion (HSIL) by colposcopy-directed biopsy with colposcopy impression of extensive HSIL or suspicion of cancer and underwent upper or total vaginectomy from January 2009 to December 2017 were included. RESULTS: Eighty-six posthysterectomy vaginal HSIL patients were included. Available abnormal cytology and positive hrHPV were observed in 90.7% (49/54) and 96.2% (51/53) of the patients, respectively. A total of 18.6% (16/86) of the patients were diagnosed with squamous cell cancer by vaginectomy, and the average interval between hysterectomy and vaginectomy was 3.5 years. Among them, 62.5% (10/16) cancers occurred after hysterectomy for cervical cancer, 31.2% (5/16) after hysterectomy for cervical precancer, and 6.3% (1/16) after hysterectomy for myoma. An indication for hysterectomy (cervical cancer vs HSIL, odds ratio = 7.2, 95% CI = 1.9–28.0, p = .004) and colposcopy impression of vaginal cancer (vaginal cancer vs HSIL, odds ratio = 5.9, 95% CI = 1.3–26.8, p = .021) were high-risk factors of cancer confirmed by vaginectomy in colposcopy-directed biopsy vaginal intraepithelial neoplasia 2/3 posthysterectomy in multiple logistic regression analysis. CONCLUSIONS: Colposcopy is pivotal in the evaluation of abnormal cytology/hrHPV tests in follow-up of cervical cancer patients after hysterectomy and decision-making for vaginectomy in detecting early cancer. Lippincott Williams & Wilkins 2019-01 2018-11-09 /pmc/articles/PMC6325769/ /pubmed/30418351 http://dx.doi.org/10.1097/LGT.0000000000000446 Text en Copyright © 2018 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the ASCCP. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Original Research Articles: Cervix and HPV
Cong, Qing
Fu, Zhongpeng
Zhang, Di
Sui, Long
Importance of Colposcopy Impression in the Early Diagnosis of Posthysterectomy Vaginal Cancer
title Importance of Colposcopy Impression in the Early Diagnosis of Posthysterectomy Vaginal Cancer
title_full Importance of Colposcopy Impression in the Early Diagnosis of Posthysterectomy Vaginal Cancer
title_fullStr Importance of Colposcopy Impression in the Early Diagnosis of Posthysterectomy Vaginal Cancer
title_full_unstemmed Importance of Colposcopy Impression in the Early Diagnosis of Posthysterectomy Vaginal Cancer
title_short Importance of Colposcopy Impression in the Early Diagnosis of Posthysterectomy Vaginal Cancer
title_sort importance of colposcopy impression in the early diagnosis of posthysterectomy vaginal cancer
topic Original Research Articles: Cervix and HPV
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6325769/
https://www.ncbi.nlm.nih.gov/pubmed/30418351
http://dx.doi.org/10.1097/LGT.0000000000000446
work_keys_str_mv AT congqing importanceofcolposcopyimpressionintheearlydiagnosisofposthysterectomyvaginalcancer
AT fuzhongpeng importanceofcolposcopyimpressionintheearlydiagnosisofposthysterectomyvaginalcancer
AT zhangdi importanceofcolposcopyimpressionintheearlydiagnosisofposthysterectomyvaginalcancer
AT suilong importanceofcolposcopyimpressionintheearlydiagnosisofposthysterectomyvaginalcancer