Ngamkham Jarunya, Boonmark Krittika, Phansri Thainsang
Department of Research and Technology Assessment, National Cancer Institute, Bangkok, Thailand E-mail :
Asian Pac J Cancer Prev. 2016;17(3):1129-34. doi: 10.7314/apjcp.2016.17.3.1129.
Vulva and Vaginal cancers are rare among all gynecological cancers worldwide, including Thailand, and typically affect women in later life. Persistent high risk human papillomavirus (HR-HPV) infection is one of several important causes of cancer development. In this study, we focused on HPV investigation and specific type distribution from Thai women with abnormality lesions and cancers of the vulva and Vaginal. A total of ninety paraffin-embedded samples of vulva and Vaginal abnormalities and cancer cells with histologically confirmed were collected from Thai women, who were diagnosed in 2003-2012 at the National Cancer Institute, Thailand. HPV DNA was detected and genotyped using polymerase chain reaction and enzyme immunoassay with GP5+/ bio 6+ consensus specific primers and digoxigenin-labeled specific oligoprobes, respectively. The human β-globin gene was used as an internal control. Overall results represented that HPV frequency was 16/34 (47.1%) and 8/20 (40.0%) samples of vulva with cancer and abnormal cytology lesions, respectively, while, 3/5 (60%) and 16/33 (51.61%) samples of Vaginal cancer and abnormal cytology lesions, respectively, were HPV DNA positive. Single HPV type and multiple HPV type infection could be observed in both type of cancers and abnormal lesion samples in the different histological categorizes. HPV16 was the most frequent type in all cancers and abnormal cytology lesions, whereas HPV 18 was less frequent and could be detected as co-infection with other high risk HPV types. In addition, low risk types such as HPV 6, 11 and 70 could be detected in Vulva cancer and abnormal cytology lesion samples, whereas, all Vaginal cancer samples exhibited only high risk HPV types; HPV 16 and 31. In conclusion, from our results in this study we suggest that women with persistent high risk HPV type infection are at risk of developing vulva and Vaginal cancers and HPV 16 was observed at the highest frequent both of these, similar to the cervical cancer cases. Although the number of samples in this study was limited and might not represent the overall incidence and prevalence in Thai women, but the baseline data are of interest and suggest further study for primary cancer screening and/or developing the efficiency of prophylactic HPV vaccines in Thailand.
在包括泰国在内的全球所有妇科癌症中，外阴癌和阴道癌都较为罕见，且通常影响老年女性。持续性高危型人乳头瘤病毒（HR-HPV）感染是癌症发生的几个重要原因之一。在本研究中，我们重点关注了泰国患有外阴和阴道异常病变及癌症的女性的HPV检测及具体类型分布情况。从2003年至2012年在泰国国家癌症研究所确诊的泰国女性中，总共收集了90份经组织学确认的外阴和阴道异常及癌细胞石蜡包埋样本。分别使用聚合酶链反应和酶免疫测定法，采用GP5+/bio 6+共识特异性引物和地高辛标记的特异性寡核苷酸探针检测HPV DNA并进行基因分型。人β-珠蛋白基因用作内部对照。总体结果显示，外阴癌样本和细胞学异常病变样本中HPV阳性率分别为16/34（47.1%）和8/20（40.0%），而阴道癌样本和细胞学异常病变样本中HPV DNA阳性率分别为3/5（60%）和16/33（51.61%）。在不同组织学分类的癌症和异常病变样本中，均可观察到单一HPV类型感染和多种HPV类型感染。HPV16是所有癌症和细胞学异常病变中最常见的类型，而HPV 18较不常见，且可检测到与其他高危HPV类型共同感染。此外，在外阴癌和细胞学异常病变样本中可检测到低危型HPV，如HPV 6、11和70，而所有阴道癌样本仅表现为高危HPV类型；HPV 16和31。总之，根据我们在本研究中的结果，我们认为持续性高危型HPV感染的女性有患外阴癌和阴道癌的风险，并且在这两种癌症中HPV 16的检出频率均最高，这与宫颈癌病例情况相似。尽管本研究中的样本数量有限，可能无法代表泰国女性的总体发病率和患病率，但这些基线数据很有意义，提示有必要进一步开展研究，以进行原发性癌症筛查和/或提高泰国预防性HPV疫苗的有效性。
