Traiman P, Bacchi C E, De Luca L A, Uemura G, Nahás Neto J, Nahás E A, Pontes A
Department of Gynecology and Obstetrics, State University of São Paulo-Botucatu, Brazil.
Eur J Gynaecol Oncol. 1999;20(3):191-4.
We report the occurrence of aggressive vulvar carcinoma associated with condyloma acuminata in three patients under 33 years old. Discussion of the role of the human papilloma virus (HPV) in the development of vulvar cancer is also presented. Three patients with condyloma associated with aggressive vulvar squamous cell carcinoma, in situ (1 case) and invasive (2 cases), documented by biopsy and/or vulvectomy are presented. In situ hybridization (ISH) was used to characterize the subtypes of HPV. One patient with erythematous systemic lupus developed in situ carcinoma after 5 years. The other two cases also developed aggressive multicentric, invasive squamous cell carcinoma after 10 years of diagnosis of condyloma. In all cases HPV cytological abnormalities were seen throughout the pathological examination. HPV 16 and 18 were present in cells of invasive squamous cell carcinoma in cases 2 and 3. HPV 6 and 11 were detected only in the condyloma area in case 2. HPV 30 was seen only in the condyloma area in case 3. This report emphasizes the need for biopsies of all unusually persistent or treatment-resistant condylomas, particularly in young and/or immunosuppressed patients.
我们报告了3例33岁以下患者发生的与尖锐湿 疣相关的侵袭性外阴癌。同时还讨论了人乳头瘤病毒（HPV）在外阴癌发生中的作用。本文介绍了3例经活检和/或外阴切除证实的与侵袭性外阴鳞状细胞癌相关的尖锐湿 疣患者，其中原位癌1例，浸润癌2例。采用原位杂交（ISH）对HPV亚型进行鉴定。1例红斑性系统性狼疮患者在5年后发生原位癌。另外2例在尖锐湿 疣诊断10年后也发生了侵袭性多中心鳞状细胞癌。在所有病例的病理检查中均可见HPV细胞学异常。病例2和病例3的浸润性鳞状细胞癌细胞中存在HPV 16和18。病例2仅在尖锐湿 疣区域检测到HPV 6和11。病例3仅在尖锐湿 疣区域发现HPV 30。本报告强调，对于所有异常持续或治疗抵抗的尖锐湿 疣，尤其是年轻和/或免疫抑制患者，均需进行活检。
