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 explore the detection trends of vaginal intraepithelial neoplasia (VaIN) under colposcopy from 2020 to 2023, and compare the therapeutic effects of 5-aminolaevulinic acid photodynamic therapy (ALA-PDT) and traditional carbon dioxide (CO2) laser therapy. Methods Retrospectively analyze the histopathological results of colposcopically-guided biopsy from January 1st 2020 to December 31st 2023 in Jiangxi Provincial Maternal and Child Health Hospital and the detection rate was analysed; A total of 150 patients diagnosed with VaIN (including VaIN alone and concurrent cervical intraepithelial neoplasia (CIN)/VaIN) and treated with ALA-PDT or CO2 laser were collected from 2020 to 2023, observed the effect of treatments and the clearance of HPV infection on different types of VaIN by a follow-up test including HPV testing, and colposcopy during 12 months after the treatment. Results (1) The detection rates of the two types of VaIN showed an increasing trend year by year bothly. (2) There was no significant difference in complete remission (CR) rate of VaIN only(6 months follow-up: 66.67% vs 80%, 12 months follow-up: 80.95% vs 77.50%, p>0.05) and concurrent CIN/VaIN (6 month follow-up: 50.00% vs 67.31%, 12 months follow-up: 75.00% vs 75.00%, p>0.05)between the ALA-PDT group and the CO2 laser group .The HPV clearance rate were also similar in the two groups (6 months follow-up: 80.49% vs 79.48% for VaIN alone, and 75.00% vs 62.00% for concurrent CIN/VaIN, 12 months follow-up: 90.24% vs 87.18%for VaIN alone, and 87.50% vs 80.00% for concurrent CIN/VaIN, p>0.05). Conclusion The detection rates of VaIN, concurrent CIN/VaIN increased yearly. There was no significant difference in the efficacy of ALA-PDT compared with CO2 laser therapy for different types of VaIN at 6 months or 12 months follow-up, which is worthy of clinical application.