Objective： To evaluate the rate and types of human papillomavirus infection in vulvar intraepithelial neoplasia. Methods： We detected and identified HPV in 40 VIN cases with 67 lesions using PCR based reverse line b...Objective： To evaluate the rate and types of human papillomavirus infection in vulvar intraepithelial neoplasia. Methods： We detected and identified HPV in 40 VIN cases with 67 lesions using PCR based reverse line blot hybridization and DNA sequencing. Among the 40 patients, 13 were diagnosed as VIN Ⅲ, 11 as VIN Ⅱ, and 16 as VIN Ⅰ. 31 patients had multifocal disease. First a fragment of 150 bp was amplified from the L1 region of HPV with GPS/GP6 primers. If the result was negative, a short fragment of 65 bp was amplified also from the LI region with SPFI/SPF2 primers. Results： Using general primer GPS/GP6, the positive rate was 52.2% （35167）. Using a short PCR fragment （SPF PCR）, the positive rate of the rest 32 lesions was 81.2% （26132）. The total positive rate was 91.0% （61/67）. 90% of the HPV types found in VIN were high risk types. All 35 GP PCR products were analyzed by sequencing. The gene types of 31 mono-infection lesions were in accordance with the reverse line blot results, while sequence results of the 4 multi-infection samples could not be analyzed. The SPF PCR products were also sequenced, 24 of the 26 SPF PCR products could be analyzed and 2 samples failed. 80.6% （25/31） cases with multifocal VIN displayed the identical type of HPV, suggesting monoclonality in different lesions from the same patient. Conclusion： The high risk type of HPV is associated with vulvar intraepithelial neoplasia and may be necessary for development of HPV-associated invasive vulvar carcinoma.展开更多
Vulvar intraepithelial neoplasia （VIN） is a relatively uncommon disease that includes all of the precancerous lesions of vulvar malignancies with an incidence of approximately 2.5 per 100 000 women.In 2004,the Inter...Vulvar intraepithelial neoplasia （VIN） is a relatively uncommon disease that includes all of the precancerous lesions of vulvar malignancies with an incidence of approximately 2.5 per 100 000 women.In 2004,the International Society for the Study of Vulvovaginal Diseases （ISSVD） abolished the old VIN grading system and introduced a two-tier classification for squamous VIN：the usual type and the differentiated type;the term VIN applied only to histologically ＆quot;high-grade＆quot; squamous lesions （old terms VIN 2 and VIN 3）.1 The two types of VIN differ in etiology,morphology,biology,clinical features and malignant potential.The usual type VIN （uVIN）,which is associated with HPV infection,is the most comrnon subtype,accounting for more than 80% of all VIN cases.Currently,the old 3-grade system of the VIN terminology is still used in most of the hospitals in China.In this presentation,we categorized the patients with the ISSVD 2004 classification standard and attempted to describe the clinical features and the outcome of surgical treatment of uVIN using the retrospective data from three academic hospitals in China.展开更多
文摘Objective： To evaluate the rate and types of human papillomavirus infection in vulvar intraepithelial neoplasia. Methods： We detected and identified HPV in 40 VIN cases with 67 lesions using PCR based reverse line blot hybridization and DNA sequencing. Among the 40 patients, 13 were diagnosed as VIN Ⅲ, 11 as VIN Ⅱ, and 16 as VIN Ⅰ. 31 patients had multifocal disease. First a fragment of 150 bp was amplified from the L1 region of HPV with GPS/GP6 primers. If the result was negative, a short fragment of 65 bp was amplified also from the LI region with SPFI/SPF2 primers. Results： Using general primer GPS/GP6, the positive rate was 52.2% （35167）. Using a short PCR fragment （SPF PCR）, the positive rate of the rest 32 lesions was 81.2% （26132）. The total positive rate was 91.0% （61/67）. 90% of the HPV types found in VIN were high risk types. All 35 GP PCR products were analyzed by sequencing. The gene types of 31 mono-infection lesions were in accordance with the reverse line blot results, while sequence results of the 4 multi-infection samples could not be analyzed. The SPF PCR products were also sequenced, 24 of the 26 SPF PCR products could be analyzed and 2 samples failed. 80.6% （25/31） cases with multifocal VIN displayed the identical type of HPV, suggesting monoclonality in different lesions from the same patient. Conclusion： The high risk type of HPV is associated with vulvar intraepithelial neoplasia and may be necessary for development of HPV-associated invasive vulvar carcinoma.
文摘Vulvar intraepithelial neoplasia （VIN） is a relatively uncommon disease that includes all of the precancerous lesions of vulvar malignancies with an incidence of approximately 2.5 per 100 000 women.In 2004,the International Society for the Study of Vulvovaginal Diseases （ISSVD） abolished the old VIN grading system and introduced a two-tier classification for squamous VIN：the usual type and the differentiated type;the term VIN applied only to histologically ＆quot;high-grade＆quot; squamous lesions （old terms VIN 2 and VIN 3）.1 The two types of VIN differ in etiology,morphology,biology,clinical features and malignant potential.The usual type VIN （uVIN）,which is associated with HPV infection,is the most comrnon subtype,accounting for more than 80% of all VIN cases.Currently,the old 3-grade system of the VIN terminology is still used in most of the hospitals in China.In this presentation,we categorized the patients with the ISSVD 2004 classification standard and attempted to describe the clinical features and the outcome of surgical treatment of uVIN using the retrospective data from three academic hospitals in China.
