Differential etiopathogenic features of vulvar squamous cell carcinomas in sub‐Saharan Africa and Europe. Issue 3 (31st October 2022)

• Record Type: Journal Article
• Authors: Rakislova, Natalia; Carreras‐Dieguez, Nuria; Manzotti, Carolina; Saúde, Ofelia; del Pino, Marta; Chulo, Laurina; Rangeiro, Ricardina; Lovane, Lucilia; Lorenzoni, Cesaltina; Fernandes, Fabiola; Rodrigo‐Calvo, Maria Teresa; Diaz‐Mercedes, Sherley; Ribera‐Cortada, Inmaculada; Sanfeliu, Esther; del Campo, Ricardo López; Marimon, Lorena; Alós, Silvia; Vega, Naiara; Pérez, Francisco M.; Trias, Isabel; Carrilho, Carla; Ordi, Jaume
• Is Part Of: International journal of cancer. Volume 152:Issue 3(2023)
• Page Start: 496
• Page End: 503
• Publication Date: 2022-10-31
• Subjects: HPV -- Mozambique -- p16 -- p53 -- Spain -- vulvar cancer; Cancer -- Periodicals; Cancer -- Prevention -- Periodicals; 616.994
• DOI: 10.1002/ijc.34314
• Languages: English
• ISSNs: 0020-7136

Abstract

Abstract: Two pathways have been described for vulvar squamous cell carcinomas (VSCC), one associated with human papillomavirus (HPV), and the other HPV‐independent. We compared the etiopathogenic features of a series of VSCC from Mozambique, a sub‐Saharan country with high prevalence of HPV and HIV, with those of Spain, a European country with low prevalence of HPV and HIV. All VSCC diagnosed at the two institutions from January 2018 to December 2020 were included (n = 35 and n = 41, respectively). HPV DNA detection and genotyping, and immunohistochemistry for p16 and p53 were performed. Tumors showing p16 positive staining and/or HPV DNA positivity were considered HPV‐associated. 34/35 tumors (97%) from Mozambique and 8/41 (19%) from Spain were HPV‐associated ( P < .001). Mean age of the patients from Mozambique and Spain was 45 ± 12 and 72 ± 14, respectively ( P < .001). No differences were found in terms of HPV genotypes or multiple HPV infection rates. 1/35 tumors (3%) from Mozambique and 29/41 (70%) from Spain showed abnormal p53 immunostaining ( P < .001). In contrast with the predominance of HPV‐independent VSCC affecting old women in Europe, most VSCC in sub‐Saharan Africa are HPV‐associated and arise in young women. This data may have important consequences for primary prevention of VSCC worldwide. Abstract : Vulvar squamous cell carcinoma (VSCC) can arise from HPV or non‐HPV causes, and that affects prognosis. Here, the authors compared VSCC samples from a population in Mozambique, where HPV prevalence is high, with those from Spain, where it is low. In Mozambique, 97% of VSCC were HPV‐associated, based on p16 staining and HPV DNA positivity, compared with only 19% of VSCC in Spain. Mean age of patients in Mozambique was 45, vs 72 in Spain. Vaccination programs, the authors suggest, could therefore help prevent the majority of VSCC in sub‐Saharan Africa.