Journal
EUROPEAN JOURNAL OF CANCER
Volume 50, Issue 16, Pages 2846-2854Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.ejca.2014.07.018
Keywords
Vaginal cancer; Vaginal intraepithelial neoplasia; Human papillomavirus; Vaccine
Categories
Funding
- Instituto de Salud Carlos III [RCESP C03/09, RTICESP C03/10, RTIC RD06/0020/0095, RD12/0036/0056, CIBERESP]
- Agencia de Gestio d'Ajuts Universitaris i de Recerca (Catalan Government) from the Stichting Pathologie Ontwikkeling en Onderzoek (SPOO) foundation (The Netherlands) [AGAUR 2005SGR 00695, 2009SGR126]
- Lilly Foundation (Premio de Investigacion Biomedica Preclinica)
- Sanofi Pasteur MSD & Merck Co, Inc.
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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. (c) 2014 Elsevier Ltd. All rights reserved.
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