The detection trends of vaginal intraepithelial neoplasia (VaIN) by colposcopic from 2020-2023 and analysis of clinical efficacy of photodynamic and carbondioxide laser in VaIN.

OBJECTIVE: To investigate the detection trends of vaginal intraepithelial neoplasia (VaIN) via colposcopic biopsy from 2020 to 2023, and to compare the therapeutic efficacy of 5-aminolevulinic acid photodynamic therapy (ALA-PDT) and traditional carbon dioxide (CO2) laser therapy. METHODS: A retrospective analysis was conducted on the histopathological results of colposcopy-guided biopsies performed at the Jiangxi Provincial Maternal and Child Health Hospital between January 1, 2020, and December 31, 2023, to analyze the VaIN detection rates. Additionally, 150 patients diagnosed with VaIN (including isolated VaIN and concurrent cervical intraepithelial neoplasia [CIN]/VaIN) who were treated with ALA-PDT or CO2 laser were enrolled. Treatment efficacy and HPV clearance rates for different types of VaIN were evaluated through HPV testing and colposcopy during a 12-month post-treatment follow-up. RESULTS: (1) The detection rates of both isolated VaIN and concurrent CIN/VaIN exhibited a year-by-year increasing trend. (2) No significant differences were observed in the complete remission (CR) rates between the ALA-PDT and CO2 laser groups for either isolated VaIN (at 6 months: 66.67% vs. 80.00%; at 12 months: 80.95% vs. 77.50%; p > 0.05) or concurrent CIN/VaIN (at 6 months: 50.00% vs. 67.31%; at 12 months: 75.00% vs. 75.00%; p > 0.05). Furthermore, HPV clearance rates were comparable between the two groups for isolated VaIN (at 6 months: 80.49% vs. 79.48%; at 12 months: 90.24% vs. 87.18%; p > 0.05) and concurrent CIN/VaIN (at 6 months: 75.00% vs. 62.00%; at 12 months: 87.50% vs. 80.00%; p > 0.05). CONCLUSION: The detection rates of isolated VaIN and concurrent CIN/VaIN have increased annually. ALA-PDT demonstrates comparable efficacy to traditional CO2 laser therapy for different types of VaIN at both 6- and 12-month follow-ups, indicating that both modalities are viable options worthy of clinical application.