two distinct pathways to development of squamous cell carcinoma of the vulva两个截然不同的发展路径的鳞状细胞癌的阴户.pdf

Hindawi Publishing Corporation Journal of Skin Cancer Volume 2011, Article ID 951250, 7 pages doi:10.1155/2011/951250 Review Article Two Distinct Pathways to Development of Squamous Cell Carcinoma of the Vulva Yutaka Ueda, Takayuki Enomoto, Toshihiro Kimura, Kiyoshi Yoshino, Masami Fujita, and Tadashi Kimura Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan Correspondence should be addressed to Takayuki Enomoto, enomoto@gyne.med.osaka-u.ac.jp Received 22 July 2010; Accepted 15 September 2010 Academic Editor: Giuseppe Argenziano Copyright © 2011 Yutaka Ueda et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Squamous cell carcinoma (SCC) accounts for approximately 95% of the malignant tumors of the vaginal vulva and is mostly found in elderly women. The future numbers of patients with vulvar SCC is expected to rise, mainly because of the proportional increase in the average age of the general population. Two different pathways for vulvar SCC have been put forth. The first pathway is triggered by infection with a high-risk-type Human Papillomavirus (HPV). Integration of the HPV DNA into the host genome leads to the development of a typical vulvar intraepithelial neoplasia (VIN), accompanied with overexpression of p14ARF and p16INK4A . This lesion subsequently forms a warty- or basaloid-type SCC. The HPV vaccine is a promising new tool for prevention of this HPV related SCC of the vulva. The second pathway is HPV-independent. Keratinizing SCC develops within a background of lichen sclerosus (LS) throu