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Large contribution of human papillomavirus in vaginal neoplastic lesions: A worldwide study in 597 samples

2014; Elsevier BV; Volume: 50; Issue: 16 Linguagem: Inglês

10.1016/j.ejca.2014.07.018

1879-0852

Laia Alemany, Maëlle Saunier, Leopoldo Tinoco, Beatriz Quirós, Isabel Alvarado‐Cabrero, María Alejo, Elmar A. Joura, Paula Maldonado, Jo Ellen Klaustermeier, Jorge Salmerón, C. Bergeron, Karl Ulrich Petry, Núria Guimerà, Omar Clavero, Raúl Murillo, Christine Clavel, Vincent Wain, D.T. Geraets, Robert Jach, Paul Cross, Carla Carrilho, Claudio Molina, H. R. Shin, Václav Mandys, Andrzej Nowakowski, August Vidal, Luis Estuardo Lombardi, Henry C Kitchener, Adela Sica, Claudia Magaña-León, Michael Pawlita, Wim Quint, Ignacio G. Bravo, Núbia Muñóz, Silvia de Sanjosé, F. Xavier Bosch,

Colorectal and Anal Carcinomas

Abstract Aim This work describes the human papillomavirus (HPV) prevalence and the HPV type distribution in a large series of vaginal intraepithelial neoplasia (VAIN) grades 2/3 and vaginal cancer worldwide. Methods We analysed 189 VAIN 2/3 and 408 invasive vaginal cancer cases collected from 31 countries from 1986 to 2011. After histopathological evaluation of sectioned formalin-fixed paraffin-embedded samples, HPV DNA detection and typing was performed using the SPF-10/DNA enzyme immunoassay (DEIA)/LiPA 25 system (version 1). A subset of 146 vaginal cancers was tested for p16 INK4a expression, a cellular surrogate marker for HPV transformation. Prevalence ratios were estimated using multivariate Poisson regression with robust variance. Results HPV DNA was detected in 74% (95% confidence interval (CI): 70–78%) of invasive cancers and in 96% (95% CI: 92–98%) of VAIN 2/3. Among cancers, the highest detection rates were observed in warty-basaloid subtype of squamous cell carcinomas, and in younger ages. Concerning the type-specific distribution, HPV16 was the most frequently type detected in both precancerous and cancerous lesions (59%). p16 INK4a overexpression was found in 87% of HPV DNA positive vaginal cancer cases. Conclusions HPV was identified in a large proportion of invasive vaginal cancers and in almost all VAIN 2/3. HPV16 was the most common type detected. A large impact in the reduction of the burden of vaginal neoplastic lesions is expected among vaccinated cohorts.