U. Hording et al., VULVAR INTRAEPITHELIAL NEOPLASIA-III - A VIRAL DISEASE OF UNDETERMINED PROGRESSIVE POTENTIAL, Gynecologic oncology, 56(2), 1995, pp. 276-279
Seventy-three patients with vulvar intraepithelial neoplasia (VIN) gra
de III were followed for a median of 5 years after primary treatment.
Thirty women also had a diagnosis of cervical neoplasia. During the fo
llow-up 26 patients (36%) had one or more vulvar recurrences. Recurren
ces were seen significantly more often in the patients who also had ce
rvical neoplasia, indicating a common etiology. Microinvasive carcinom
a developed in 12 patients, 3 of whom later developed frankly invasive
vulvar cancer. The original, paraffin-embedded vulvar specimens were
examined by the polymerase chain reaction for human papillomavirus DNA
of the types HPV 6, 11, 16, 18, and 33. HPV types 16 and 33 were foun
d in 90% of the VIN lesions. It is concluded that VIN In: is an HPV-re
lated disease in all or almost all cases, and that a generalized genit
al HPV infection may be a factor in the development of multicentric ge
nital neoplasia. No association was observed between the specific HPV
type and the risk of recurrent vulvar disease, cervical neoplasia, or
malignant progression. (C) Academic Press, Inc.