Vulvar intraepithelial neoplasia (VIN) is a premalignant pathology which leads to vulvar carcinoma, the fourth most common gynaecological cancer. Although invasive vulvar cancer rate has remained the same in the last two decades, VIN incidence has doubled. To date, no screening programme exists for early diagnosis of vulvar HSIL, the diagnosis being based on clinical findings and confirmed by biopsy. The aim of this study was to demonstrate if HPV is the carcinogenetic factor incriminated in vulvar cancer.
During 2011-2016, in the Obstetrics & Gynaecology Clinical Hospital "Panait Sirbu" Bucharest, 20 VIN patients were diagnosed. There were also 12 vulvar cancer which after the confirmation of squamous carcinoma diagnosis, received standard surgical treatment. 9 patients were HPV-PCR tested from biopsy tissue. Surgical treatment was rendered in oncology hospitals with good functional results and no local relapses. HPV infection was present in all 9 biopsy tests, high risk strains 16,18,31,35 and 51 being most commonly found. 6 patients also had positive cervical HPV testing.
Although VIN is not very frequent, because of the appearance on exophytic and endophytic lesions and even vulvar distrophy, the carcinogenetic factor – HPV, should be systematically tested. Early surgical treatment of confirmed vulvar cancer has the best prognostic.