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.
Department of Obstetrics and Gynecology, Osaka University Faculty of Medicine, Suita, Japan.
Yutaka
Y
Ueda
Takayuki
T
Enomoto
Takashi
T
Miyatake
Kenneth R
KR
Shroyer
Tatsuo
T
Yoshizaki
Hiroyuki
H
Kanao
Yuko
Y
Ueno
Hongbo
H
Sun
Ryuichi
R
Nakashima
Kiyoshi
K
Yoshino
Toshihiro
T
Kimura
Tomoko
T
Haba
Kenichi
K
Wakasa
Yuji
Y
Murata
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*