Analysis of clonality and HPV infection in benign, hyperplastic, premalignant, and malignant lesions of the vulvar mucosa.
To elucidate the pathogenesis of vulvar carcinomas, we studied clonality and human papillomavirus (HPV) infection in vulvar epithelial diseases. Monoclonal composition was demonstrated in all 9 invasive tumors (squamous cell carcinoma [SCC], 6; basal cell carcinoma, 1; malignant melanoma, 2), 15 of 20 cases of vulvar intraepithelial neoplasia (VIN), 7 of 9 cases of Paget disease, 2 of 6 cases of lichen sclerosus (LS), and 2 of 3 cases of squamous cell hyperplasia (SCH); high-risk type HPV was revealed in 5 of 6 SCCs and 17 of 20 VINs. These observations might imply that a subset of cases of LS and SCH result from a neoplastic proliferation, similar to VINs but not related to infection with high-risk type HPV. In 1 case of SCC with concurrent VIN 3 in an adjacent lesion, both lesions showed the same pattern of X chromosome inactivation and the presence of HPV-16 in episomal and integrated forms, suggesting that monoclonal expansion triggered by high-risk type HPV integration is an early event for carcinogenesis of HPV-associated SCC.
Ueda
Yutaka
Y
Department of Obstetrics and Gynecology, Osaka University Faculty of Medicine, Suita, Japan.
Enomoto
Takayuki
T
Miyatake
Takashi
T
Shroyer
Kenneth R
KR
Yoshizaki
Tatsuo
T
Kanao
Hiroyuki
H
Ueno
Yuko
Y
Sun
Hongbo
H
Nakashima
Ryuichi
R
Yoshino
Kiyoshi
K
Kimura
Toshihiro
T
Haba
Tomoko
T
Wakasa
Kenichi
K
Murata
Yuji
Y
D002278:Carcinoma in Situ / Q000235:genetics / Q000473:pathology / Q000821:virology; D002280:Basal Cell Carcinoma / Q000235:genetics / Q000473:pathology / Q000821:virology; D002294:Carcinoma, Squamous Cell / Q000235:genetics / Q000473:pathology / Q000821:virology; D002999:Clone Cells; D004303:Dosage Compensation, Genetic; D005260:Female; D006801:Humans; D006965:Hyperplasia / Q000235:genetics / Q000473:pathology / Q000821:virology; D018459:Lichen Sclerosus et Atrophicus / Q000235:genetics / Q000473:pathology / Q000821:virology; D008545:Melanoma / Q000235:genetics / Q000473:pathology / Q000821:virology; D042282:Microdissection; D010145:Paget Disease, Extramammary / Q000235:genetics / Q000473:pathology / Q000821:virology; D027383:Papillomaviridae / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000473:pathology*; D012150:Polymorphism, Restriction Fragment Length; D011230:Precancerous Conditions / Q000235:genetics / Q000473:pathology / Q000821:virology; D020133:Reverse Transcriptase Polymerase Chain Reaction; D014845:Vulvar Diseases / Q000235:genetics / Q000473:pathology* / Q000821:virology*