Intraepithelial neoplasia and early stage vulvar cancer. Epidemiological, clinical and virological observations.
OBJECTIVE
Evaluation of vulvar intraepithelial neoplasia (VIN) and early vulvar cancer risk factor occurrence, frequency, localization and development.


METHODS
A clinical study carried out on 293 women aged 23-76 years with VIN and vulvar cancer stage I and in a control group of 115 cytologically and colposcopically negative women.


METHODS
Clinical, colposcopic and morphological evaluation of the localization of VIN and vulvar carcinoma stage I concomitant with intraepithelial neoplasia in other parts of the lower genital tract. Anamnestic inquiry regarding risk factors. In situ hybridisation technique for HPV detection. Thomson's method for blood serum vitamin A level assessment.


CONCLUSIONS
An increased frequency of VIN and Ca stage I, especially in young women, has been observed in the past 15 years. In a group of young women under 45 years of age, those lesions were multifocal in 43 cases (63.2%), and unifocal in 25 patients (36.8%). In women over 45 years of age, multifocal lesions occurred in 35 (31.8%), and unifocal in 75 patients (68.2%). HPV infections concomitant with VIN and vulvar cancer stage I occurred in 61.5% of young women and in 17.5% of older females. VIN and stage I vulvar carcinoma coexisted with cervical intraepithelial neoplasia and cervical and/or vaginal cancer in 14 women (7.9%). The risk factor for VIN and early vulvar carcinoma occurrence in young women was different than in older patients. Long-term follow-up of VIN 1 and VIN 2 showed that in over 1/3 of cases the lesions were persistent or recurred after a transient remission. Progression depended not only on dysplasia stage, but also on histological pattern.
Basta
A
A
Department of Gynaecology and Oncology, Collegium Medicum, Jagiellonian University, Kraków, Poland.
Adamek
K
K
Pityński
K
K
D000328:Adult; D000367:Age Factors; D000368:Aged; D002278:Carcinoma in Situ / Q000150:complications* / Q000453:epidemiology / Q000821:virology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D017403:In Situ Hybridization; D008875:Middle Aged; D009367:Neoplasm Staging; D027383:Papillomaviridae / Q000235:genetics / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000150:complications* / Q000453:epidemiology; D012307:Risk Factors; D014412:Tumor Virus Infections / Q000150:complications* / Q000453:epidemiology; D014846:Vulvar Neoplasms / Q000150:complications* / Q000453:epidemiology / Q000821:virology