Bloss JD, Liao SY, Wilczynski SP, et al. Clinical and histologic features of vulvar carcinomas analyzed for human papillomavirus status: evidence that squamous cell carcinoma of the vulva has more than one etiology
The association between the human papillomavirus (HPV) and malignant neoplasms of the uterine cervix is well established; however, its role in the pathogenesis of vulvar cancer has not been well defined. This study correlates the clinical and histopathologic features of 21 invasive carcinomas of the vulva with the presence of HPV DNA as detected by Southern blot and polymerase chain reaction (PCR) analysis. By one or both techniques, HPV DNA was detected in 10 of the 21 tumors analyzed; all HPVs containing tumors hybridized with HPV-16 probes, although PCR also detected HPV-6 in two of the HPV-16-containing tumors. No HPV-18 DNA was detected in any tumor by PCR or Southern blot hybridization. Both the invasive cancer and the surrounding intraepithelial disease tended to display histopathologic features that usually could distinguish HPV-associated cancers from those without HPV DNA. The intraepithelial lesions associated with HPV-containing tumors were of the bowenoid type with koilocytosis, while tumors lacking HPV generally demonstrated a simplex type of intraepithelial lesion. Invasive tumors with no viral DNA were more frequently keratinizing than the HPV-containing cancers. Race, parity, hormonal therapy, and alcohol use did not affect the HPV status; however, HPV DNA was more prevalent in the tumors of younger women and in those with a history of tobacco use. Human papillomavirus status had no impact on the stage of disease or its prognosis. These findings identify two subsets of vulvar carcinoma cases based on HPV hybridization data and the histopathologic characteristics of the tumor.
[Show abstract][Hide abstract] ABSTRACT: The human papillomavirus (HPV) has been implicated in the development of an estimated 10% of cancers worldwide. Both epidemiologic and molecular evidence have conclusively demonstrated that oncogenic HPV is the central causal agent of cervical cancer and of a substantial proportion of many other anogenital neoplasms. In fact, it is believed that HPV is the necessary cause of cervical cancer, which has implications for the prevention, screening, and treatment of this disease, especially for its precursor lesions.
This has led to the possibility of using HPV DNA testing in screening and as a method of triaging abnormal Papanicolaou (Pap) tests. Research into the development of vaccines is also currently very active. HPV has been implicated in the genesis of several other cancers, such as oral and non-melanoma skin malignancies. However, research is yet to provide a consistent body of unequivocal evidence for a causal role that could lead to public health policy.
American Journal of Cancer 02/1987; 4(1). DOI:10.2165/00024669-200504010-00004
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