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Comprehensive Analysis of 130 Multicentric Intraepithelial Female Lower Genital Tract Lesions by HPV Typing and p16 Expression Profile
- Source :
- Journal of Lower Genital Tract Disease. 11:300
- Publication Year :
- 2007
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2007.
-
Abstract
- HPV associated cervical transformation is characterized by well-defined steps, including persistent HPV infection and deregulated oncogene expression. Recent studies have suggested that a number of lower genital tract lesions are clonally related to cervical lesions. In the current study, HPV infections and oncogene expression were assessed in a large series of patients with multicentric lower genital tract disease to analyze the transformation steps in extracervical disease.One hundred and thirty biopsies of 52 women treated for multicentric synchronous or metachronous lower genital tract intraepithelial neoplasias were collected. Up to seven multicentric specimens taken from one patient were studied with a maximum follow up of 20 years. HPV typing and p16(ink4a) immunostaining was performed.HPV DNA was present in 121 of 130 specimens (93%). HPV16 was frequently found in VIN, VaIN and AIN (73, 60 and 77%, respectively), whereas only 37% of CIN were HPV16 positive. Infections with identical HPV types in multicentric lesions were diagnosed in 46% of the HPV positive patients. p16INK4a expression was negative in the nine HPV negative lesions whereas about 90% of the high grade lesions showed diffuse p16 staining.Our findings indicate that multicentric lower genital tract disease evolves through different pathways. Some cases were related to a high susceptibility towards HPV infections, while others exhibited features of clonal propagation of transformed cervical cell clones. The clinical management of the latter group is particularly challenging, because malignant cell clones can persist over a long time course.
- Subjects :
- Adult
Gene Expression Regulation, Viral
Cancer Research
Pathology
medicine.medical_specialty
Vaginal Neoplasms
Tumor suppressor gene
Genital Neoplasms, Female
HPV typing
Uterine Cervical Neoplasms
Disease
Biology
Polymerase Chain Reaction
Lesion
Biomarkers, Tumor
Humans
Medicine
Typing
Lower genital tract
Papillomaviridae
DNA Primers
Colposcopy
Human papillomavirus 16
Vulvar Neoplasms
Oncogene
medicine.diagnostic_test
business.industry
Genes, p16
Papillomavirus Infections
HPV infection
Obstetrics and Gynecology
General Medicine
Middle Aged
Anus Neoplasms
Uterine Cervical Dysplasia
medicine.disease
Gene Expression Regulation, Neoplastic
Oncology
DNA, Viral
Immunology
Genital neoplasm
Female
medicine.symptom
business
Precancerous Conditions
Subjects
Details
- ISSN :
- 10892591
- Volume :
- 11
- Database :
- OpenAIRE
- Journal :
- Journal of Lower Genital Tract Disease
- Accession number :
- edsair.doi.dedup.....67b083bd3bda1055eb08760d51f9ba41