Multiple Intraepithelial Neoplasias of the Lower Female Genital Tract

Frega, A; Sesti, Francesco; Sopracordevole, Francesco; Biamonti, Alberto; Votano, Sergio; Catalano, Angelica; Milazzo, G.; Gentile, Marco; Ricciardi, Enzo; French, Deborah; Mangino, Massimo

doi:10.1097/lgt.0b013e31829706bc

Cited by 4 publications

(7 citation statements)

References 27 publications

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“…In addition, in high-grade lesions subgroup, more than half (53.3%) of the patients were HPV16 infection. Consistent with the second pathogenesis theory and previous study [ 5 ], in this study, multiple HPV infections were an independent risk factor for multicentric lesions. However, multiple HPV infections did not significantly increase the risk of high-grade lesion beyond that for the highest-risk type found [ 24 ].…”

Section: Discussionsupporting

confidence: 92%

“…The average age of patients with multicentric lesions has not been consistent in previous studies, ranged from 36.3 to 43 years [ 3 – 5 , 13 ]. In this study, the median age of patients with multicentric lesions was higher than that reported in the previous literatures.…”

Section: Discussionmentioning

confidence: 75%

“…The images of VAIN under colposcopy were mainly micropapillary hyperplasia, acetic acid white epithelium, punctate blood vessels and Lugol’s iodine non-coloring [ 11 ]. Frega et al [ 5 ] compared patients with multicentric lesions detected synchronously with those detected sequentially, and found a significant correlation between immunosuppression and synchronously detected multicentric lesions. Hammer A et al [ 22 ] provided molecular evidence of HPV latency in humans.…”

Section: Discussionmentioning

confidence: 99%

“…Multicentric lesions can occur sequentially but be detected at the same clinical visit [ 4 ]. Multicentric lesions were significantly more likely to be detected synchronously than sequentially [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…At present, there are few articles which describing the characteristics and significance of multicentric intraepithelial lesions. and the sample sizes of the previous studies have been small [ 3 – 5 ]. Moreover, HPV testing is useful for the detection of multicentric lesions, however, available data about the HPV genotypes prevalence in multicentric lesions are limited.…”

Section: Introductionmentioning

confidence: 99%

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Human papillomavirus genotypes and the risk factors associated with multicentric intraepithelial lesions of the lower genital tract: a retrospective study

et al. 2021

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Background Multicentric intraepithelial lesions of the lower genital tract (multicentric lesions) were defined as intraepithelial lesions of two or three sites within cervix, vagina, and vulva occurring synchronously or sequentially. The characteristics of multicentric lesions has been poorly understood. This study aimed to evaluate the risk factors for multicentric lesions, including specific HPV genotypes. Methods A retrospective case-control study was performed involving patients histologically diagnosed with multicentric lesions between January 2018 and October 2019. Controls were patients histologically diagnosed with single cervical intraepithelial neoplasia (CIN) and admitted during the same period. Univariable and multivariable analyses were used to assess the risk factors for multicentric lesions. Results Of 307 patients with multicentric lesions, the median age was 50 years (interquartile range: 43–55.5), and they were older than patients with single CIN (median age: 43 years, interquartile range: 36–50). In the multicentric lesion group, the proportions of cytologic abnormalities, HPV positivity, and multiple HPV infections were 68.9, 97.0, and 36.5%, respectively. In the multivariable analysis, menopause, a history of malignant tumors beyond the lower genital tract and multiple HPV infections were associated with the incidence of multicentric lesions (Odd ratio (OR) = 3.14, 95% confidence interval (CI) 2.24–4.41; OR = 9.58, 95% CI 1.02–89.84; OR = 1.47, 95% CI 1.03–2.10). The common HPV genotypes were HPV16, HPV53, HPV58, HPV52, HPV51, HPV56 and HPV18 in patients with multicentric lesions. The proportion of HPV16 infection was higher in high-grade lesions group than that in low-grade lesions group (OR = 2.54, 95% CI 1.34–4.83). The OR for multicentric lesions, adjusted for menopause, smoking, gravidity, parity, a history of malignant tumor beyond the lower genital tract and multiple HPV infection, was 1.97 (95% CI 1.04–3.75) in patients with HPV51 infection. Conclusions Multicentric lesions were associated with menopause, a history of malignant tumors and multiple HPV infections. HPV16 was the most common genotype, especially in high grade multicentric lesions and HPV51 infection was found to be a risk factor for detecting multicentric lesions.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Human papillomavirus genotypes and the risk factors associated with multicentric intraepithelial lesions of the lower genital tract: a retrospective study

et al. 2021

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Vaginale intraepitheliale Neoplasie (VaIN)

Ackermann

Dannecker

Horn

et al. 2018

Tumorerkrankungen Der Vulva Und Vagina

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Preferential Tissue Sites of Different Cancer-risk Groups of Human Papillomaviruses

Okodo,

Okayama,

Sasagawa

et al. 2023

Preprint

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The oncogenic potential of human papillomavirus (HPV) may be used to determine the tissue tropism of each HPV type. Cervical cancer develops in the squamo-columar junction of the cervices, and most such lesions are induced by high-risk (HR) HPV types. This suggests that HR types preferentially infect the cervix, whereas the preferential infection site for low-risk (LR) types is not well defined. Determination of HPV tropism when using cytology samples can be uncertain since it is difficult to avoid contamination of cell samples between the cervix and the vagina. Herein, cell samples were carefully collected by independently scraping the cervix and vagina, after which the HPV types were determined. HPV tissue tropism was determined by considering what HPV types were positive at only one of the sites (the cervix or the vagina) as the viruses that preferentially infected that site. This method revealed that all LR types were only identified in vaginal samples, whereas 87% of HR types were identified in cervical sites. Thus, LR types may preferentially infect the vagina, whereas HR types infect the cervix. These findings suggest that preferential tissue tropism of certain HPV types is a probable factor for malignant progression.

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Multiple Intraepithelial Neoplasias of the Lower Female Genital Tract

Abstract: Our results support the hypothesis that a positive HPV-mRNA test could be a marker of persistent infection and a risk factor for the onset of metachronous lesions.

Cited by 4 publications

References 27 publications

Human papillomavirus genotypes and the risk factors associated with multicentric intraepithelial lesions of the lower genital tract: a retrospective study

Human papillomavirus genotypes and the risk factors associated with multicentric intraepithelial lesions of the lower genital tract: a retrospective study

Vaginale intraepitheliale Neoplasie (VaIN)

Preferential Tissue Sites of Different Cancer-risk Groups of Human Papillomaviruses

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