Objective: To investigate the relationship between clinicopathological features and human papillomavirus types in female lower genital tract carcinoma.
Methods: Clinicopathological features of 100 cases of female lower genital tract carcinoma (63 cervical carcinoma and 37 vulvar carcinoma) were studied retrospectively. Standard PCR (HPV type 6/11, 16, 18) was applied to formalin fixed, paraffin embedded sections.
Results: There were 54 cases of cervical carcinoma and 33 cases of vulvar carcinoma in the 87 cases of target DNA qualified samples. The HPV detection rate in cervical carcinoma was 83.3%. HPV16 (55.6%) and HPV 18(24.4%) were the predominant types. In vulvar carcinoma, HPVs, mainly HPV 16(70%, 7/10), were detected in basaloid (83.3%, 5/6) and warty carcinoma (83.3%, 5/6), but none in conventional type of keratinized squamous cell carcinoma (0.0%, 0/21). Three of the 6 women with basaloid carcinoma were associated with cervical squamous neoplasia, and the same HPV type was found in both lesions in 2 of the 3 patients with two primary tumors. Four patients with basaloid carcinoma recurred after simple vulvectomy or local excision, but no lymph node metastasis occurred and all were still alive at last follow-up, with a median follow-up of 6.3 years. In contrast, the majority of the women with keratinized squamous cell carcinoma were over 65 years of age, with histologic extensive keratinization and poorer prognosis.
Conclusions: A high detection rate of HPV 16 and 18 was found in cervical carcinoma. However, the sensitivity of HPV in vulvar carcinoma seems to be more related to histologic type.