ABSTRACT
OBJECTIVE: Our purpose was to determine the effectiveness of 5-fluorouracil (5-FU) in the treatment of vaginal intraepithelial neoplasia (VAIN). MATERIALS AND METHODS: The study was performed in 30 patients with a mean age of 54 years and previous diagnoses from reviewed records and histopathology slides selected from a group of 65 patients with VAIN from 1980 to 1998. Patients received intravaginal treatment with 5-FU, 1.5 g once weekly for 10 weeks and all patients were followed up for at least 2-years. Papanicolaou smear and colposcopy were performed, as was biopsy when indicated. RESULTS: Twenty eight (93) patients with VAIN had prior or concurrent anogenital squamous neoplasia, including 5 with invasive cervical carcinoma and 23 with cervical intraepithelial neoplasia. In 23 of 30 treated patients (77), VAIN went into remission after a single treatment; in 3, (10), it went into remission after two treatment; 3 (10) had recurrent VAIN 3; and in 1 (3) it progressed to invasive vaginal cancer. The treatment was well tolerated. CONCLUSIONS: The 5-FU is an option choice for VAIN treatment. It is effective, with minimal slide effects. Its use should be confined to treating extensive or multifocal high-grade VAIN.
Subject(s)
Humans , Female , Adult , Middle Aged , Antimetabolites, Antineoplastic/therapeutic use , Uterine Cervical Dysplasia , Fluorouracil , Vaginal Neoplasms , Aged, 80 and over , Antimetabolites, Antineoplastic/administration & dosage , Uterine Cervical Dysplasia , Fluorouracil , Papilloma , Uterine Cervical Neoplasms , Vaginal Neoplasms , Vaginal SmearsABSTRACT
The objective of this study was to determine high risk human papillomavirus infection (HPV-RH) and factors with cervical intraepithelial neoplasia appears (CIN). MATERIAL AND METHOD: From October 1998 to January 2000, a case-control study, was made; women with benefit package from Mexican Institute of Social Security. The cases were of the colposcopic clinic of the department of the Hospital Obstetrics and Gynecology Luis Castelazo Ayala, women histologically diagnosed with colposcopy and CIN cervical biopsy, and controls patients with negative cervical uterine cytologic study of the Preventive Medicine Department, Unit of Familiar Medicine No. 8, of Mexico City. Trained personnel obtained information about socioeconomic and reproductive factors did the interview. A cytobrush was used to take the cervical sample for HPV-RH to determine HPV-RH utilizing Hybrid Capture II test. Both bivariate analysis and logistic regression analysis were used for the adjustment of variables. RESULTS: We analyzed 102 cases and 192 controls, 79 (44/56) of the cases with CIN I and 89 (37/42) of CIN II-III as 21 of controls, respectively, were positive for HPV-RH. Global risk for HPV-RH association to CIN was OR = 40.6 (95 CI, = 17-96.8). Women age was determinative for HPV-RH association to CIN. We observed a high correlation between HPV positive magnitude and CIN degree. CONCLUSIONS: Frequency of RH-HPV in controls and CIN I is higher than other reports in the literature. HPV was identified as the most important agent associated with this neoplasia, other factors involved and age is an important modifier in HPV-RH and CIN.