Analysis of clonality and HPV infection in benign, hyperplastic, premalignant, and malignant lesions of the vulvar mucosa

Am J Clin Pathol. 2004 Aug;122(2):266-74. doi: 10.1309/65MK-PQT3-E2BD-M67E.

Abstract

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.

Publication types

  • Comparative Study

MeSH terms

  • Carcinoma in Situ / genetics
  • Carcinoma in Situ / pathology
  • Carcinoma in Situ / virology
  • Carcinoma, Basal Cell / genetics
  • Carcinoma, Basal Cell / pathology
  • Carcinoma, Basal Cell / virology
  • Carcinoma, Squamous Cell / genetics
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / virology
  • Clone Cells*
  • Dosage Compensation, Genetic
  • Female
  • Humans
  • Hyperplasia / genetics
  • Hyperplasia / pathology
  • Hyperplasia / virology
  • Lichen Sclerosus et Atrophicus / genetics
  • Lichen Sclerosus et Atrophicus / pathology
  • Lichen Sclerosus et Atrophicus / virology
  • Melanoma / genetics
  • Melanoma / pathology
  • Melanoma / virology
  • Microdissection
  • Paget Disease, Extramammary / genetics
  • Paget Disease, Extramammary / pathology
  • Paget Disease, Extramammary / virology
  • Papillomaviridae / isolation & purification
  • Papillomavirus Infections / pathology*
  • Polymorphism, Restriction Fragment Length
  • Precancerous Conditions / genetics
  • Precancerous Conditions / pathology
  • Precancerous Conditions / virology
  • Reverse Transcriptase Polymerase Chain Reaction
  • Vulvar Diseases / genetics
  • Vulvar Diseases / pathology*
  • Vulvar Diseases / virology*