Hørding U, Daugaard S, Iversen A K, Knudsen J, Bock J E, Norrild B
Department of Obstetrics and Gynecology Y, University Hospital, Copenhagen, Denmark.
Gynecol Oncol. 1991 Jul;42(1):22-6. doi: 10.1016/0090-8258(91)90224-s.
Vulvar intraepithelial neoplasia (VIN) is becoming more widespread and the patients are becoming still younger. Although progression to invasive vulvar carcinoma is uncommon, local recurrences are frequent and about one-quarter of the patients have multicentric genital disease. The aim of the present study was to search for a possible significant association of human papillomavirus (HPV) infection with vulvar carcinoma, recurrences, and multicentric disease. We used the polymerase chain reaction to examine vulvar and cervical biopsies from 43 patients with vulvar neoplasia for HPV type 16, which is the subtype most often detected in genital malignant or premalignant lesions. HPV 16 DNA sequences were found in 14 of 24 (58%) vulvar squamous carcinomas and in 15 of 19 (79%) VIN lesions. Nine patients (21%) had associated cervical neoplasia and six of these harbored HPV 16 in both lesions. Patients with recurrent intraepithelial neoplasia had a significantly higher incidence of HPV 16-positive lesions. No association was found with regard to the occurrence of multicentric disease or risk of malignant progression.
外阴上皮内瘤变（VIN）正变得越来越普遍，且患者愈发年轻化。尽管进展为浸润性外阴癌并不常见，但局部复发频繁，约四分之一的患者患有多中心性生殖器疾病。本研究的目的是探寻人乳头瘤病毒（HPV）感染与外阴癌、复发及多中心性疾病之间可能存在的显著关联。我们采用聚合酶链反应检测了43例外阴肿瘤患者的外阴和宫颈活检组织，以检测16型HPV，该亚型是在生殖器恶性或癌前病变中最常检测到的类型。在24例外阴鳞状细胞癌中的14例（58%）以及19例VIN病变中的15例（79%）发现了16型HPV DNA序列。9例患者（21%）伴有宫颈肿瘤，其中6例在两个病变部位均携带16型HPV。上皮内瘤变复发的患者中，16型HPV阳性病变的发生率显著更高。未发现与多中心性疾病的发生或恶性进展风险有关联。
