Differentiated Vulvar Intraepithelial Neoplasia-like and Lichen Sclerosus-like Lesions in HPV-associated Squamous Cell Carcinomas of the Vulva

Most human papillomavirus (HPV)-associated vulvar squamous cell carcinomas (VSCCs) originate from high-grade squamous intraepithelial lesions, also named usual type vulvar intraepithelial neoplasia. However, growing evidence suggests that morphologic studies have limitations in predicting HPV status...

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Autores: Rakislova, Natalia, Alemany i Vilches, Laia, Clavero, Omar, Pino Saladrigues, Marta del, Saco, Adela, Quirós, Beatriz, Lloveras Rubio, Betlem, Alejo, Maria, Pawlita, Michael, Quint, Wim, Sanjosé Llongueras, Silvia de, Ordi i Majà, Jaume, VVAP Study Group
Tipo de recurso: artículo
Estado:Versión aceptada para publicación
Fecha de publicación:2018
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/122775
Acceso en línea:https://hdl.handle.net/2445/122775
Access Level:acceso abierto
Palabra clave:Papil·lomavirus
Càncer
Papillomaviruses
Cancer
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spelling Differentiated Vulvar Intraepithelial Neoplasia-like and Lichen Sclerosus-like Lesions in HPV-associated Squamous Cell Carcinomas of the VulvaRakislova, NataliaAlemany i Vilches, LaiaClavero, OmarPino Saladrigues, Marta delSaco, AdelaQuirós, BeatrizLloveras Rubio, BetlemAlejo, MariaPawlita, MichaelQuint, WimSanjosé Llongueras, Silvia deOrdi i Majà, JaumeVVAP Study GroupPapil·lomavirusCàncerPapillomavirusesCancerMost human papillomavirus (HPV)-associated vulvar squamous cell carcinomas (VSCCs) originate from high-grade squamous intraepithelial lesions, also named usual type vulvar intraepithelial neoplasia. However, growing evidence suggests that morphologic studies have limitations in predicting HPV status in vulvar lesions. We aimed to evaluate adjacent intraepithelial lesions in a series of DNA HPV-positive VSCCs, focusing on unusual histologic patterns mimicking differentiated vulvar intraepithelial neoplasia (dVIN) or lichen sclerosus (LS). We identified 326 DNA HPV-positive VSCC with at least 1 cm of skin adjacent to the invasive tumor and analyzed HPV typing, HPV E6*I mRNA, and p16 immunohistochemistry in all cases. A careful histologic evaluation was conducted. A conclusive association with HPV was based on a positive p16 or HPV E6*I mRNA result or both in addition to the HPV DNA, whereas cases negative for both markers were classified as nonconclusively associated with HPV. One hundred twenty-one tumors (37.1%) had normal adjacent skin, 191 (58.6%) had only high-grade squamous intraepithelial lesions, also named usual type vulvar intraepithelial neoplasia, and unusual intraepithelial lesions were identified in 14 (4.3%) tumors. Seven cases showed dVIN-like features, 5 showed adjacent LS-like lesion, and in 2 cases dVIN-like and LS-like lesions were identified simultaneously. Six of them were conclusively associated with HPV (3 dVIN-like, 2 LS-like, 1 with combined dVIN/LS-like features). All 6 tumors were associated with HPV16 and were positive for both p16 and HPV mRNA, and p16 was also positive in the dVIN-like and LS-like lesions. In summary, a small subset of VSCCs conclusively associated with HPV may arise on intraepithelial lesions, mimicking precursors of HPV-independent VSCC.Ovid2018201920182018info:eu-repo/semantics/articleinfo:eu-repo/semantics/acceptedVersion18 p.application/pdfhttps://hdl.handle.net/2445/122775Articles publicats en revistes (ISGlobal)reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésVersió postprint del document publicat a: http://dx.doi.org/10.1097/PAS.0000000000001047The American Journal of Surgical Pathology, 2018, vol 42, num. 6, p. 828-835http://dx.doi.org/10.1097/PAS.0000000000001047(c) Ovid, 2018info:eu-repo/semantics/openAccessoai:recercat.cat:2445/1227752026-05-29T05:05:01Z
dc.title.none.fl_str_mv Differentiated Vulvar Intraepithelial Neoplasia-like and Lichen Sclerosus-like Lesions in HPV-associated Squamous Cell Carcinomas of the Vulva
title Differentiated Vulvar Intraepithelial Neoplasia-like and Lichen Sclerosus-like Lesions in HPV-associated Squamous Cell Carcinomas of the Vulva
spellingShingle Differentiated Vulvar Intraepithelial Neoplasia-like and Lichen Sclerosus-like Lesions in HPV-associated Squamous Cell Carcinomas of the Vulva
Rakislova, Natalia
Papil·lomavirus
Càncer
Papillomaviruses
Cancer
title_short Differentiated Vulvar Intraepithelial Neoplasia-like and Lichen Sclerosus-like Lesions in HPV-associated Squamous Cell Carcinomas of the Vulva
title_full Differentiated Vulvar Intraepithelial Neoplasia-like and Lichen Sclerosus-like Lesions in HPV-associated Squamous Cell Carcinomas of the Vulva
title_fullStr Differentiated Vulvar Intraepithelial Neoplasia-like and Lichen Sclerosus-like Lesions in HPV-associated Squamous Cell Carcinomas of the Vulva
title_full_unstemmed Differentiated Vulvar Intraepithelial Neoplasia-like and Lichen Sclerosus-like Lesions in HPV-associated Squamous Cell Carcinomas of the Vulva
title_sort Differentiated Vulvar Intraepithelial Neoplasia-like and Lichen Sclerosus-like Lesions in HPV-associated Squamous Cell Carcinomas of the Vulva
dc.creator.none.fl_str_mv Rakislova, Natalia
Alemany i Vilches, Laia
Clavero, Omar
Pino Saladrigues, Marta del
Saco, Adela
Quirós, Beatriz
Lloveras Rubio, Betlem
Alejo, Maria
Pawlita, Michael
Quint, Wim
Sanjosé Llongueras, Silvia de
Ordi i Majà, Jaume
VVAP Study Group
author Rakislova, Natalia
author_facet Rakislova, Natalia
Alemany i Vilches, Laia
Clavero, Omar
Pino Saladrigues, Marta del
Saco, Adela
Quirós, Beatriz
Lloveras Rubio, Betlem
Alejo, Maria
Pawlita, Michael
Quint, Wim
Sanjosé Llongueras, Silvia de
Ordi i Majà, Jaume
VVAP Study Group
author_role author
author2 Alemany i Vilches, Laia
Clavero, Omar
Pino Saladrigues, Marta del
Saco, Adela
Quirós, Beatriz
Lloveras Rubio, Betlem
Alejo, Maria
Pawlita, Michael
Quint, Wim
Sanjosé Llongueras, Silvia de
Ordi i Majà, Jaume
VVAP Study Group
author2_role author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Papil·lomavirus
Càncer
Papillomaviruses
Cancer
topic Papil·lomavirus
Càncer
Papillomaviruses
Cancer
description Most human papillomavirus (HPV)-associated vulvar squamous cell carcinomas (VSCCs) originate from high-grade squamous intraepithelial lesions, also named usual type vulvar intraepithelial neoplasia. However, growing evidence suggests that morphologic studies have limitations in predicting HPV status in vulvar lesions. We aimed to evaluate adjacent intraepithelial lesions in a series of DNA HPV-positive VSCCs, focusing on unusual histologic patterns mimicking differentiated vulvar intraepithelial neoplasia (dVIN) or lichen sclerosus (LS). We identified 326 DNA HPV-positive VSCC with at least 1 cm of skin adjacent to the invasive tumor and analyzed HPV typing, HPV E6*I mRNA, and p16 immunohistochemistry in all cases. A careful histologic evaluation was conducted. A conclusive association with HPV was based on a positive p16 or HPV E6*I mRNA result or both in addition to the HPV DNA, whereas cases negative for both markers were classified as nonconclusively associated with HPV. One hundred twenty-one tumors (37.1%) had normal adjacent skin, 191 (58.6%) had only high-grade squamous intraepithelial lesions, also named usual type vulvar intraepithelial neoplasia, and unusual intraepithelial lesions were identified in 14 (4.3%) tumors. Seven cases showed dVIN-like features, 5 showed adjacent LS-like lesion, and in 2 cases dVIN-like and LS-like lesions were identified simultaneously. Six of them were conclusively associated with HPV (3 dVIN-like, 2 LS-like, 1 with combined dVIN/LS-like features). All 6 tumors were associated with HPV16 and were positive for both p16 and HPV mRNA, and p16 was also positive in the dVIN-like and LS-like lesions. In summary, a small subset of VSCCs conclusively associated with HPV may arise on intraepithelial lesions, mimicking precursors of HPV-independent VSCC.
publishDate 2018
dc.date.none.fl_str_mv 2018
2018
2018
2019
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/acceptedVersion
format article
status_str acceptedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/122775
url https://hdl.handle.net/2445/122775
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Versió postprint del document publicat a: http://dx.doi.org/10.1097/PAS.0000000000001047
The American Journal of Surgical Pathology, 2018, vol 42, num. 6, p. 828-835
http://dx.doi.org/10.1097/PAS.0000000000001047
dc.rights.none.fl_str_mv (c) Ovid, 2018
info:eu-repo/semantics/openAccess
rights_invalid_str_mv (c) Ovid, 2018
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 18 p.
application/pdf
dc.publisher.none.fl_str_mv Ovid
publisher.none.fl_str_mv Ovid
dc.source.none.fl_str_mv Articles publicats en revistes (ISGlobal)
reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,812429

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