Maate Fred, Julius Peter, Siyumbwa Stepfanie, Pinder Leeya, Kaile Trevor, Mwanahamuntu Mulindi, Parham Groesbeck
Department of Pathology and Microbiology, Adult and Emergency Hospital, University Teaching Hospitals, Lusaka, Zambia.
Department of Pathology and Microbiology, School of Medicine, University of Zambia, Lusaka, Zambia.
Afr J Lab Med. 2022 May 12;11(1):1563. doi: 10.4102/ajlm.v11i1.1563. eCollection 2022.
Globally, women living with HIV have a higher risk of vulvar neoplasia than HIV-negative women. Vulvar neoplasia among women living with HIV has not previously been characterised in Zambia.
This study determined the clinical and pathologic features of vulvar neoplasia among women living with HIV at the University Teaching Hospital, Lusaka, Zambia.
We conducted a cross-sectional study of vulvar lesions among 53 women living with HIV who presented with vulvar lesions between July 2017 and February 2018. The study assessed clinical and histological characteristics and prevalence of high-risk human papillomavirus (HRHPV).
Twenty-one patients were diagnosed with vulvar squamous cell carcinoma (VSCC), 20 with usual vulvar intraepithelial neoplasm (uVIN), and the rest with either benign lesions or non-neoplastic lesions (NNL). Participants' mean age was 40 years. Patients with VSCC were significantly older than those with NNL (mean (s.d.): 43 (21) vs 33 (10), = 0.004). The prevalence of HRHPV was 88.9% in VSCC patients and 100.0% in high-grade squamous intraepithelial lesion patients. HPV16 was the most common (52.6%) genotype. The clinical features of neoplasia were similar to those of NNL.
VSCC was significantly more common among women aged ≥ 40 years. HRHPV in VSCC and high-grade squamous intraepithelial lesions was high. Women with vulvar lesions, especially those aged > 40 years, should be evaluated for vulvar cancer. Young girls should be vaccinated to prevent vulvar cancer.
在全球范围内，感染艾滋病毒的女性患外阴肿瘤的风险高于未感染艾滋病毒的女性。赞比亚此前尚未对感染艾滋病毒女性的外阴肿瘤进行过特征描述。
本研究确定了赞比亚卢萨卡大学教学医院感染艾滋病毒女性外阴肿瘤的临床和病理特征。
我们对2017年7月至2018年2月期间出现外阴病变的53名感染艾滋病毒女性的外阴病变进行了横断面研究。该研究评估了临床和组织学特征以及高危型人乳头瘤病毒（HRHPV）的患病率。
21名患者被诊断为外阴鳞状细胞癌（VSCC），20名被诊断为寻常型外阴上皮内瘤变（uVIN），其余患者为良性病变或非肿瘤性病变（NNL）。参与者的平均年龄为40岁。VSCC患者明显比NNL患者年龄大（平均（标准差）：43（21）岁对33（10）岁，P = 0.004）。VSCC患者中HRHPV的患病率为88.9%，高级别鳞状上皮内病变患者中为100.0%。HPV16是最常见的（52.6%）基因型。肿瘤的临床特征与NNL相似。
VSCC在年龄≥40岁的女性中明显更常见。VSCC和高级别鳞状上皮内病变中HRHPV的感染率很高。有外阴病变的女性，尤其是年龄>40岁的女性，应接受外阴癌评估。年轻女孩应接种疫苗以预防外阴癌。
