June 29, 2022

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HPV infection not Only causes cervical cancer Also related to this cancer

HPV infection not Only causes cervical cancer Also related to this cancer



 

HPV infection not Only causes cervical cancer Also related to this cancer.  Vulvar itching may be cancer, and it is also related to HPV infection.

 

Speaking of HPV virus, a disease naturally emerges in everyone’s mind: cervical cancer. In addition, it can also cause another female cancer-squamous intraepithelial lesions of the vulva, that is, vulvar cancer ! HPV infection is a high-risk factor for vulvar cancer.

 

The most common vulvar cancer is squamous intraepithelial lesions of the vulva. It refers to the clinical and pathological changes related to HP V infection that occur in the skin and mucous membrane of the female external genitalia and are confined to the squamous epithelium.

 

It is seen in women around 45 years of age, and has been increasing among young women in recent years.

 

According to the 2014 World Health Organization “Female Genital Tumor Classification”, vulvar squamous intraepithelial lesions are divided into: vulvar low-grade squamous intraepithelial lesion (VLSIL), vulvar high-grade squamous intraepithelial lesion (VHISL) and differentiated vulvar epithelium Internal neoplasia. Which VLSIL and VHISL were associated with HPV infection .

 

HPV infection not Only causes cervical cancer Also related to this cancer. 

 

VLSIL:

formerly known as VINI, mild dysplasia, flat condyloma, atypical knockout cells, etc. It is related to both low-risk and high-risk HPV infections . It is more common in young women.

More than 30% of cases are combined with other parts of the lower genital tract Intraepithelial lesions (the most common part of the cervix). The lesions often regress on their own, and the risk of developing into invasive cancer is extremely low.

 

VHISL:

formerly known as VINII, VINIII, carcinoma in situ, Bowen’s disease, Bowen-like dysplasia, etc., which mostly occur in premenopausal women, most of which are caused by HPV16 infection.

If the advanced invasive cancer is not treated The stakes are high. The recurrence rate after complete local resection is 15%; if the resection margin is involved, the recurrence rate is as high as 50%.

 

Differentiated vulvar intraepithelial neoplasia:

formerly known as differentiated VIN, single vulvar cancer. This type has nothing to do with HPV infection and may be caused by P53 mutation.

It occurs mostly in elderly women, often accompanied by lichen sclerosus, lichen planus, and sometimes keratinizing squamous cell carcinoma.

 

 


How to judge whether it is vulvar cancer?What are the symptoms?

 

The symptoms of vulvar cancer are non-specific, and most of them are vulvar itching, skin breakage and ulcers, and some patients are asymptomatic. Lesions can occur in any part of the vulva.

The most common vulvar lesions are papules, spots, plaques or papillary warts. The number is single or multiple, the color is gray, pink, and a few are melanin deposits slightly higher than the skin. In severe cases, it can cover the entire vulva diffusely.

 

The diagnosis of vulvar cancer requires pathological examination. For suspicious lesions, spot biopsy can be performed under colposcopy, and HPV testing can assist in the diagnosis.

 

 


How to treat vulvar cancer after diagnosis?

 

The principle of treatment is: eliminate the focus, relieve symptoms, and block the occurrence of invasive cancer.

 

VLSIL:

If there are no obvious symptoms, treatment can be temporarily discontinued , but regular follow-ups are required. For symptomatic patients, topical medication, such as imiquimod ointment, can also be used to treat young patients with extensive lesions. | VHSIL: Because of the higher risk of developing malignant tumors, treatment and standardized management are recommended.

Drug therapy, physical therapy, surgical resection and combination therapy can be selected according to the patient’s disease severity, scope, size, location, age, patient’s wishes and follow-up conditions.

 

1) Expected observation:

It is limited to young women with good compliance and asymptomatics, and patients undergoing temporary immunosuppressive therapy during pregnancy or planning a recent pregnancy should be closely observed, and the expectation time should not exceed 1 year.

2) Drug treatment:

Those who exclude malignant lesions and have long-term follow-up conditions can be treated with drugs, such as imiquimod, cidofovir, 5-fluorouracil ointment, etc., but full biopsy evaluation should be performed before drug treatment to exclude invasive cancer. Otherwise, there is a risk of missed diagnosis of early invasive cancer.

3) Physiotherapy:

such as laser, photodynamic therapy, etc., but it also emphasizes that multiple biopsies should be used to exclude invasive cancer before treatment, and physical therapy is contraindicated for patients with highly suspected invasive cancer.

4) Surgical treatment:

It is an important method of VHSIL treatment. Localized vulvar resection can be used for localized lesions with a margin of at least 0.5 cm beyond the lesion. For larger fusion or more extensive or multifocal lesions, consider vulvar skin resection. Only vulvectomy can be done for older people, wide range of lesions, and high suspicion of malignancy.

 

Differentiated vulvar intraepithelial neoplasia:

The lesion develops rapidly, so it is necessary to completely remove the lesion. All types of vulvar squamous intraepithelial lesions have recurred to varying degrees after treatment. The high-risk factors for recurrence are high-grade lesions, positive resection margins, and high-risk HPV persistent infections. Therefore, regular follow-up after surgery is very important.

 

 


How to prevent the occurrence of vulvar cancer in life?

 

There are more than 160 types of HPV virus, of which more than 40 are related to reproductive tract infections. HPV infection is not only the culprit of cervical cancer, it can also cause vulvar cancer, vaginal cancer, genital warts and so on. Therefore, how to prevent and avoid HPV infection is the basis for preventing the occurrence of various diseases. Daily can start from the following points:

1. Keep the vulva clean: Use warm water to clean the vulva daily to reduce the chance of local infection.

2. Safe sex: maintaining a stable partnership and using condoms can reduce the HPV infection rate.

3. Start sex at the right age to avoid early marriage and childbirth: the first sex is younger than 16 years old, early childbirth, and multiple births will increase the incidence of cervical cancer.

4. Prevention of reproductive tract infections and sexually transmitted diseases: Reproductive tract infections and sexually transmitted diseases can cause damage to the mucous membrane of the reproductive tract and increase the chance of HPV infection.

5. Quit smoking: Smoking affects the body’s immune function and can increase the chance of HPV infection.

6. Vaccination of HPV vaccine: HPV vaccine is the most reliable way to prevent HPV infection.

7. Regular cervical cancer screening: early detection, early treatment and early recovery.

 

 

HPV infection not Only causes cervical cancer Also related to this cancer

(source:internet, reference only)


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