Vulvar squamous cell carcinoma arising on human papillomavirus-independent precursors mimicking high-grade squamous intra-epithelial lesion: a distinct and highly recurrent subtype of vulvar cancer.

Autor: Carreras-Dieguez N; Clinical Institute of Gynecology, Obstetrics, and Neonatology, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain., Saco A; Department of Pathology, Hospital Clínic of Barcelona, University of Barcelona, Barcelona, Spain., Del Pino M; Clinical Institute of Gynecology, Obstetrics, and Neonatology, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain., Pumarola C; Clinical Institute of Gynecology, Obstetrics, and Neonatology, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain., Del Campo RL; Department of Pathology, Hospital Clínic of Barcelona, University of Barcelona, Barcelona, Spain., Manzotti C; Department of Pathology, Hospital Clínic of Barcelona, University of Barcelona, Barcelona, Spain.; Barcelona Institute for Global Health (ISGlobal), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain., Garcia A; Department of Pathology, Hospital Clínic of Barcelona, University of Barcelona, Barcelona, Spain., Marimon L; Department of Pathology, Hospital Clínic of Barcelona, University of Barcelona, Barcelona, Spain.; Barcelona Institute for Global Health (ISGlobal), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain., Diaz-Mercedes S; Department of Pathology, Hospital Clínic of Barcelona, University of Barcelona, Barcelona, Spain.; Barcelona Institute for Global Health (ISGlobal), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain., Fuste P; Clinical Institute of Gynecology, Obstetrics, and Neonatology, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain., Rodrigo-Calvo MT; Department of Pathology, Hospital Clínic of Barcelona, University of Barcelona, Barcelona, Spain., Vega N; Department of Pathology, Hospital Clínic of Barcelona, University of Barcelona, Barcelona, Spain., Torné A; Clinical Institute of Gynecology, Obstetrics, and Neonatology, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain.; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain., Rakislova N; Department of Pathology, Hospital Clínic of Barcelona, University of Barcelona, Barcelona, Spain.; Barcelona Institute for Global Health (ISGlobal), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.
Jazyk: angličtina
Zdroj: Histopathology [Histopathology] 2023 Apr; Vol. 82 (5), pp. 731-744. Date of Electronic Publication: 2023 Jan 15.
DOI: 10.1111/his.14860
Abstrakt: Aims: Each category of vulvar squamous cell carcinoma (VSCC), human papillomavirus (HPV)-associated and HPV-independent, arises on a specific intra-epithelial precursor: high-grade squamous intra-epithelial lesions (HSIL) and differentiated vulvar intra-epithelial neoplasia (dVIN), respectively. However, a subset of HPV-independent VSCC arises on an intra-epithelial precursor closely mimicking HSIL. We aimed to explore the clinicopathological features of the HPV-independent tumours with HSIL-like lesions and compare them with HPV-independent VSCC with dVIN and HPV-associated tumours with HSIL.
Methods and Results: We retrospectively identified 105 cases of surgically treated VSCC with adjacent intra-epithelial precursors. The cases were classified into three groups based on the HPV status and the adjacent precursor identified: (i) HPV-associated VSCC with HSIL (n = 26), (ii) HPV-independent VSCC with dVIN lesions (n = 54) and (iii) HPV-independent VSCC with HSIL-like lesions (n = 25). We analysed the histological and clinical features including the recurrence-free survival and disease-specific survival in the three groups. Patients with HPV-independent VSCC with HSIL-like lesions and with dVIN were older than patients with HPV-associated VSCC (76 and 77 versus 66 years, respectively, P < 0.001). HPV-independent VSCC with HSIL-like lesions recurred more frequently [hazard ratio (HR) = 3.87; P < 0.001] than HPV-independent VSCC with dVIN (HR = 2.27; P = 0.1) and HPV-associated VSCC (HR = 1). In the multivariate analysis, HPV-independent VSCC with HSIL-like lesions remained significant for recurrence. No differences in disease-specific survival were observed between the three groups.
Conclusions: Even though VSCC with HSIL-like lesions are not associated with higher mortality, they are more likely to recur and might benefit from more intensive treatment strategies and closer surveillance after treatment.
(© 2023 The Authors. Histopathology published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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