Scurry J., Hung J., Flowers L., Kneafsay P., Gazdar A.
Pathology, Mercy Hospital for Women, Melbourne, Victoria, Australia; British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Hamon Center for Therapeutic Oncology Research, Dallas, Texas, USA; Department of Laboratory Medicine, University of Calgary and Calgary Laboratory Services, Calgary, Alberta, Canada.
Int J Gynecol Cancer. 1999 May;9(3):187-193. doi: 10.1046/j.1525-1438.1999.99015.x.
To better characterize the two clinicopathologic types of squamous cell carcinoma, human papillomavirus (HPV) positive and negative, and their adjacent skin changes, we performed cytomorphometric analysis on 12 HPV-positive squamous cell carcinomas and adjacent vulvar intraepithelial neoplasia and 22 HPV-negative squamous cell carcinomas and adjacent squamous cell hyperplasia and lichen sclerosis. Our results were that 83% (10 of 12) HPV-positive carcinomas and 78% (7 of 9) adjacent vulvar intraepithelial neoplasia were aneuploid, compared with 59% (13 of 22) HPV-negative carcinomas, 6% (1 of 16) squamous cell hyperplasias and 0% (0 of 20) lichen scleroses. Seventy-five percent (9 of 12) HPV carcinomas and 78% (7 of 9) vulvar intraepithelial neoplasias showed two aneuploid peaks, but no HPV-negative carcinoma or non-neoplastic epithelial lesion showed multiple aneuploid peaks. Fifty percent of squamous cell hyperplasias (8 of 16) and lichen scleroses (10 of 20) adjacent to HPV-negative carcinomas were hypodiploid. The mean DNA indices were: 1.70 for the dominant tumor cell population of HPV-positive carcinoma, 1.64 for the dominant population of vulvar intraepithelial intraepithelial neoplasia, 1.41 for HPV-negative carcinoma, 0.85 for squamous cell hyperplasia and 0.83 for lichen sclerosis. In conclusion, the higher rate of aneuploidy, higher mean DNA index, and presence of multiploid peaks in HPV-positive carcinomas and adjacent vulvar intraepithelial neoplasias compared with the lower rate of aneuploidy, lower mean DNA index, absence of multiploid peaks of HPV-negative carcinomas and tendency to hypodiploidy in squamous cell hyperplasia and lichen sclerosis support the hypothesis that there are two clinicopathologic types of vulvar carcinoma, with different pathogenetic mechanisms. The similarities in ploidy findings between vulvar HPV-positive carcinomas and vulvar intraepithelial neoplasia and those previously published for cervical carcinoma and cervical intraepithelial neoplasia support the view that these two cancers are analogous and have similar pathogenetic mechanisms. The frequent finding of hypodiploidy in squamous cell hyperplasia and lichen sclerosis next to HPV-negative carcinomas requires further investigation of the molecular pathogenesis of this cancer type.
为了更好地描述人乳头瘤病毒（HPV）阳性和阴性的两种鳞状细胞癌临床病理类型及其相邻皮肤变化，我们对12例HPV阳性鳞状细胞癌及其相邻的外阴上皮内瘤变、22例HPV阴性鳞状细胞癌及其相邻的鳞状细胞增生和扁平苔藓进行了细胞形态计量分析。我们的结果显示，83%（12例中的10例）的HPV阳性癌和78%（9例中的7例）相邻的外阴上皮内瘤变为非整倍体，相比之下，HPV阴性癌为59%（22例中的13例），鳞状细胞增生为6%（16例中的1例），扁平苔藓为0%（20例中的0例）。75%（12例中的9例）的HPV癌和78%（9例中的7例）的外阴上皮内瘤变显示出两个非整倍体峰，但没有HPV阴性癌或非肿瘤性上皮病变显示出多个非整倍体峰。与HPV阴性癌相邻的鳞状细胞增生（16例中的8例）和扁平苔藓（20例中的10例）中有50%为亚二倍体。平均DNA指数分别为：HPV阳性癌的主要肿瘤细胞群体为1.70，外阴上皮内瘤变的主要群体为1.64，HPV阴性癌为1.41，鳞状细胞增生为0.85，扁平苔藓为0.83。总之，与HPV阴性癌的非整倍体率较低、平均DNA指数较低、无多倍体峰以及鳞状细胞增生和扁平苔藓中亚二倍体倾向相比，HPV阳性癌和相邻外阴上皮内瘤变的非整倍体率较高、平均DNA指数较高以及存在多倍体峰支持了外阴癌存在两种临床病理类型且发病机制不同的假说。外阴HPV阳性癌与外阴上皮内瘤变之间的倍体结果与先前发表的宫颈癌和宫颈上皮内瘤变的结果相似，支持了这两种癌症相似且发病机制相同的观点。在HPV阴性癌旁的鳞状细胞增生和扁平苔藓中频繁发现亚二倍体，这需要对这种癌症类型的分子发病机制进行进一步研究。
