title: Intraepithelial neoplasia and early stage vulvar cancer. Epidemiological, clinical and virological observations.
abstract: 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.
authors.affiliation: Department of Gynaecology and Oncology, Collegium Medicum, Jagiellonian University, Kraków, Poland.
authors.forename: A
authors.initials: A
authors.lastname: Basta
authors.forename: K
authors.initials: K
authors.lastname: Adamek
authors.forename: K
authors.initials: K
authors.lastname: Pityński
mesh_terms: 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