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In patients with high-grade squamous intraepithelial lesion (HSIL) of the vulva, the presence of multiple lesions, called multifocal HSIL, is common. The aim of this exploratory study was to investigate biomarker expression profiles in multifocal HSIL. In total, 27 lesions from 12 patients with high-risk human papillomavirus (HPV)-positive multifocal HSIL were tested for HPV genotype, expression of p16 and Ki-67, and DNA methylation of six genes. HPV16 was found most commonly in 21 (77.8%) HSILs. In two (16.4%) patients, HPV genotype differed between the lesions. All lesions demonstrated diffuse p16 staining, of which three (11.1%) were combined with patchy staining. One patient (8.3%) demonstrated markedly different DNA methylation levels between lesions. Generally, heterogeneity in methylation profiles was observed between different patients, even when other biomarkers showed similar expression. In conclusion, this study is the first to demonstrate heterogeneity of individual lesions in patients with multifocal HSIL. The studied biomarkers have the potential to refine prognostic and predictive diagnostics. Future prospective, longitudinal studies are needed to further explore the potential of a biomarker profile for management of patients with multifocal HSIL.
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http://dx.doi.org/10.3390/cancers13225646 | DOI Listing |
Front Oncol
August 2025
Department of Pathology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China.
Background: Cervical high-grade squamous intraepithelial lesion (HSIL), a precancerous condition, can progress to cervical squamous cell carcinoma (CSCC), the most prevalent histological subtype of cervical cancer. Although CSCC most commonly metastasizes via lymphatic or hematogenous routes, contiguous superficial spread to the endometrium, fallopian tubes, and ovaries is rare.
Case Presentation: A 61-year-old postmenopausal woman was referred to our hospital for further evaluation after a positive HPV-16 test and normal ThinPrep Cytologic Test (TCT) results during a routine health examination at an external institution two weeks earlier.
Lab Invest
August 2025
Department of Gynaecology, Jena University Hospital, 07747 Jena, Germany.
HPV-DNA integration into the host genome is a frequent event in cervical carcinogenesis and may drive clonal expansion of the affected cells. Based on viral cellular junction (vcj) sequences, highly specific vcj-PCRs can be designed to detect viral integrants in DNA from cervical cell scrapes or tissue samples. In a recent study, such patient specific vcj-PCR assays were employed for the detection of recurrent high-grade squamous intraepithelial lesions (HSIL) during post-operative surveillance.
View Article and Find Full Text PDFJ Turk Ger Gynecol Assoc
September 2025
Department of Gynecology-Obstetrics and Pediatrics, Faculdade de Medicina da Universidade Do Porto, Porto, Portugal.
Vulvar intraepithelial neoplasia (VIN) represents a heterogeneous group of premalignant lesions arising through distinct human papillomavirus (HPV)-associated and HPV-independent pathways. Despite well-characterized differences in etiology, prognosis, and progression risk, current management remains largely uniform and predominantly surgical. This one-size-fits-all approach neglects opportunities for individualized care and exposes patients, particularly younger women and those with multifocal disease, to potentially avoidable psychosexual morbidity.
View Article and Find Full Text PDFJ Low Genit Tract Dis
June 2025
Departments of Obstetrics and Gynecology and Pharmacology and Physiology, University of Rochester Medical Center, Rochester, NY.
Objectives: This study aimed to evaluate the efficacy of treatments for usual-type vulvar intraepithelial neoplasia (uVIN).
Materials And Methods: This review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, searching PubMed, Embase, Scopus, Web of Science, the Cochrane Central Register of Controlled Trials, PsycINFO, and Clinical Trial Databases in July 2024. Clinical trials comparing treatments for uVIN to a placebo or other treatments were included.
Int J Gynaecol Obstet
August 2025
Université de Montréal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada.
Objectives: To compare topical imiquimod with CO laser therapy for the treatment of a first episode of vulvar high-grade squamous intraepithelial lesions (vHSIL), to identify serious adverse effects of both treatment modalities, and to examine risk factors for treatment failure.
Methods: This retrospective chart-based cohort study included 47 patients initially treated with topical imiquimod or CO laser therapy between 2017 and 2021. The primary outcome was treatment failure, defined as the need for repeat treatment.