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Prevalence of human papillomavirus types in invasive vulvar cancers and vulvar intraepithelial neoplasia 3 in the United States before vaccine introduction
Journal article   Open access   Peer reviewed

Prevalence of human papillomavirus types in invasive vulvar cancers and vulvar intraepithelial neoplasia 3 in the United States before vaccine introduction

Julia W Gargano, Edward J Wilkinson, Elizabeth R Unger, Martin Steinau, Meg Watson, Youjie Huang, Glenn Copeland, Wendy Cozen, Marc T Goodman, Claudia Hopenhayn, …
Journal of lower genital tract disease, Vol.16(4), pp.471-479
10/2012
DOI: 10.1097/LGT.0b013e3182472947
PMCID: PMC5553114
PMID: 22652576
url
https://www.ncbi.nlm.nih.gov/pmc/articles/5553114View
Open Access

Abstract

The study aimed to determine the baseline prevalence of human papillomavirus (HPV) types in invasive vulvar cancer (IVC) and vulvar intraepithelial neoplasia 3 (VIN 3) cases using data from 7 US cancer registries. Registries identified eligible cases diagnosed in 1994 to 2005 and requested pathology laboratories to prepare 1 representative block for HPV testing on those selected. Hematoxylin-eosin-stained sections preceding and following those used for extraction were reviewed to confirm representation. Human papillomavirus was detected using L1 consensus polymerase chain reaction (PCR) with PGMY9/11 primers and type-specific hybridization, with retesting of samples with negative and inadequate results with SPF10 primers. For IVC, the confirmatory hematoxylin-eosin slides were re-evaluated to determine histological type. Descriptive analyses were performed to examine distributions of HPV by histology and other factors. Human papillomavirus was detected in 121/176 (68.8%) cases of IVC and 66/68 (97.1%) cases of VIN 3 (p < .0001). Patients with IVC and VIN 3 differed by median age (70 vs 55 y, p = .003). Human papillomavirus 16 was present in 48.6% of IVC cases and 80.9% of VIN 3 cases; other high-risk HPV was present in 19.2% of IVC cases and 13.2% of VIN 3 cases. Prevalence of HPV differed by squamous cell carcinoma histological subtype (p < .0001) as follows: keratinizing, 49.1% (n = 55); nonkeratinizing, 85.7% (n = 14), basaloid, 92.3% (n = 14), warty 78.2% (n = 55), and mixed warty/basaloid, 100% (n = 7). Nearly all cases of VIN 3 and two thirds of IVC cases were positive for high-risk HPV. Prevalence of HPV ranged from 49.1% to 100% across squamous cell carcinoma histological subtypes. Given the high prevalence of HPV in IVC and VIN 3 cases, prophylactic vaccines have the potential to decrease the incidence of vulvar neoplasia.
 Microscopy Polymerase Chain Reaction United States - epidemiology Papillomavirus Infections - complications Prevalence Humans Middle Aged Vulvar Neoplasms - virology Genotype Papillomaviridae - isolation & purification Papillomaviridae - genetics Carcinoma in Situ - virology Viral Structural Proteins - genetics Papillomaviridae - classification Histocytochemistry Aged, 80 and over Adult Female Papillomavirus Infections - virology Aged DNA, Viral - genetics

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