VULVAR INTRAEPITHELIAL NEOPLASIA-III - A VIRAL DISEASE OF UNDETERMINED PROGRESSIVE POTENTIAL

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.