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Application of 2011 International Federation for Cervical Pathology and Colposcopy Terminology on the Detection of Vaginal Intraepithelial Neoplasia

Authors Zhou Q, Zhang F, Sui L, Zhang H, Lin L, Li Y

Received 11 April 2020

Accepted for publication 24 June 2020

Published 17 July 2020 Volume 2020:12 Pages 5987—5995


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Eileen O'Reilly

Qi Zhou,* Feifei Zhang,* Long Sui, Hongwei Zhang, Lin Lin, Yanyun Li

Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Yanyun Li Tel +86 21 33189900
Fax +86 21 63450944

Purpose: To evaluate the colposcopic accuracy of the detection of vaginal intraepithelial neoplasia (VaIN) according to the colposcopic terminology for the vagina from the 2011 International Federation of Cervical Pathology and Colposcopy (IFCPC).
Methods: A total of 467 women who were suspected of having VaIN and underwent colposcopy at Obstetrics and Gynecology Hospital of Fudan University from January to December 2018 were included in this retrospective cohort study. The 2011 IFCPC revised terminology for the vagina was applied, and the agreement between colposcopic diagnosis and vaginal biopsy pathology was analysed.
Results: Agreement between colposcopy and pathology was 69.16% (kappa=0.437, p< 0.001), with 23.34% overestimated and 7.49% underestimated diagnosis for colposcopy. The agreement was the lowest (35.71%) in the high-grade VaIN group, which was significantly different from that of other lesion grade groups (p< 0.01). Among grade 1 findings, thin acetowhite epithelium was the most frequent (80.51%). Grade 2 findings and vascular patterns were rare. The positive predictive values of the micropapillary pattern were 55.98% for low-grade VaIN and 5.98% for high-grade VaIN. The specificity of iodine negativity was 10.92% for low-grade VaIN and 8.30% for high-grade VaIN. There were significant differences in the maximum size of single lesions and in the number of lesions among different grade lesion groups.
Conclusion: The agreement between colposcopy findings utilizing the 2011 IFCPC terminology and vaginal pathology is moderate, and more definite findings for high-grade VaIN may be needed. The micropapillary pattern can be considered an alternative low-grade finding, while iodine staining is nonspecific for all lesions. Scattered and spotty lesions suggest low-grade VaIN, while large single lesions suggest high-grade VaIN.

Keywords: colposcopy, vaginal intraepithelial neoplasia, VaIN, International Federation of Cervical Pathology and Colposcopy, IFCPC, terminology, cytology, human papillomavirus, HPV

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