Plantier Françoise
Cabinet de dermatopathologie Mathurin-Moreau, hôpital Cochin Paris, Paris 19(e), Paris, France.
Ann Pathol. 2022 Jan;42(1):58-67. doi: 10.1016/j.annpat.2021.02.014. Epub 2021 Mar 18.
Vulvar squamous cell carcinoma arises from precursor lesions: vulvar intraepithelial neoplasias (VIN). Most of them are caused by the human papillomavirus (HPV), and the precursor lesion for this group is VIN usual type/high grade squamous intraepithelial lesion (uVIN/HSIL) of variable clinical presentation and having a light invasive potential. Some VIN are HPV-independent and arise in older women against the background of chronic dermatoses, mostly lichen sclerosus. Their histological diagnosis is more subtle. They have a higher invasive potential. A third precursor, leading to well-differentiated, or even verrucous, carcinomas, is still ill-defined to this day. We detail these lesions' clinics, histology, and biomarkers (immunohistochemical and molecular).
外阴上皮内瘤变(VIN)。其中大多数由人乳头瘤病毒(HPV)引起,该组的前驱病变是临床表现各异且具有轻度侵袭潜能的寻常型VIN/高级别鳞状上皮内病变(uVIN/HSIL)。一些VIN与HPV无关,发生于老年女性慢性皮肤病(主要是硬化性苔藓)的背景下。它们的组织学诊断更为细微。它们具有更高的侵袭潜能。导致高分化甚至疣状癌的第三种前驱病变至今仍定义不清。我们详细阐述了这些病变的临床、组织学及生物标志物(免疫组化和分子方面)情况。