[Clinicopathological features of human papilloma virus associated squamous cell carcinomas of the vulva].

OBJECTIVE

To investigate the relationship between human papilloma virus (HPV) status and clinicopathological features of vulva carcinoma and its clinical significance.

METHODS

Histological sections of 37 cases of vulval carcinoma were subclassified. Standard PCR (HPV types 6/11, 16, 18) were applied to formalin fixed, paraffin wax sections.

RESULTS

There were 24 cases of keratinizing squamous cell carcinoma (KSC), 7 cases of basaloid carcinoma (BC) and 6 cases of warty carcinoma (WC). HPVs, Mainly HPV 16, were detected in 10 of the 37 cases, and all of them were women with BC and WC types. Although BC and WC constituted 35% of the total number of cases, the HPV detective rate was significantly higher than that of KSC (83.3% vs 0.0%), and the tumors were frequently accompanied by valvar intra-epithelial neoplasm (VIN). Clinically, women with BC and WC were younger than women with KSC (mean age at diagnosis for WC, BC and KSC were 36.7, 58.9, 63.3 years respectively). Besides, the incidence of lymph node metastasis in BC and WC were lower than that in KSC (7.6% vs 25.0%). BC and WC were more likely to have another invasive or noninvasive squamous neoplasm of the cervix and vagina (3/13 vs 0/24), and recurrence rate was higher (12.5% vs 7.7%). However, their survival rates following surgical treatment of recurrences were also higher. Squamous cell carcinoma of the vulva are etiologically diverse tumors which have different clinical and pathological profiles.

CONCLUSION

It is suggested that an etiological classification of squamous carcinoma of the vulva may at least be grouped at present into a small but substantial proportion (BC and WC) related to HPV and the majority portion (KSC) of unknown etiology.