Rueda-Leverone N G, Di Paola G R, Meiss R P, Vighi S G, Llamosas F
Gynecol Oncol. 1987 Mar;26(3):331-9. doi: 10.1016/0090-8258(87)90025-4.
Thirty cases of vulvar intraepithelial neoplasia (VIN) were analyzed in order to determine the frequency of association with human papillomavirus (HPV) infection, and the relationship between this association and patient's age, extent of vulvar lesions, and coexistence with cervicovaginal neoplasia. The presence of condyloma or moderate to marked koilocytosis, now considered as morphological evidence of HPV infection, was observed in 66.6% of our cases. A search for HPV antigens, using the peroxidase-antiperoxidase (PAP) method, was performed in 13 selected cases, and positive staining was detected in 3 of them. The presence of HPV infection correlates with a mean age of 48.8 years, 50% of multicentricity of VIN and coexistence with cervical neoplasia in 30% of the cases, as opposed to a mean age of 55.5 years, 10% of multicentricity of VIN and absence of cervical neoplasia in patients without HPV infection. The demonstration of multiple foci of early stromal invasion in a 43-year-old woman, with multicentric VIN lesions associated with HPV infection, indicates that, even in the presence of such clinicopathological features, the risk of developing stromal invasion should be considered. Considerations are made in relation with the presence of HPV antigen in morphological normal epithelium adjacent to the lesion. Therapeutic implications were also investigated.
分析了30例外阴上皮内瘤变（VIN）病例，以确定与人乳头瘤病毒（HPV）感染相关的频率，以及这种关联与患者年龄、外阴病变范围和宫颈阴道肿瘤并存之间的关系。在我们66.6%的病例中观察到有尖锐湿疣或中度至重度挖空细胞，目前将其视为HPV感染的形态学证据。对13例选定病例采用过氧化物酶-抗过氧化物酶（PAP）法检测HPV抗原，其中3例检测到阳性染色。HPV感染的存在与平均年龄48.8岁、VIN多中心性占50%以及30%的病例中与宫颈肿瘤并存相关，而未感染HPV的患者平均年龄为55.5岁、VIN多中心性占10%且无宫颈肿瘤。一名43岁女性出现多个早期间质浸润灶，伴有与HPV感染相关的多中心VIN病变，这表明即使存在此类临床病理特征，也应考虑发生间质浸润的风险。对病变相邻形态学正常上皮中HPV抗原的存在情况进行了考量。还研究了其治疗意义。
