[Molecular biological study on multifocal infection of HPV in uterine cervix, vagina and vulva].
Vaginal and vulvar scrapes from 30 patients which have HPV types 16 or 18 positive cervical neoplasia (13 of mild dysplasia, 5 of moderate dysplasia, 4 of severe dysplasia, 3 of carcinoma in situ, and 5 of invasive carcinoma) were examined by the polymerase chain reaction (PCR), to detect amplified E7 gene of HPV types 16 and 18 DNA sequences. In 24 vaginal and 15 vulvar scrapes, the same type of HPV as in cervical scrapes was detected. The frequencies of HPV DNA in vaginal and vulvar scrapes for histological diagnosis of cervical neoplasia were 84.6% (11/13) and 53.8% (7/13) in mild dysplasias, both were 100% (5/5) in moderate dysplasias, 75% (3/4) and 25% (1/4) in severe dysplasias, 66.7% (2/3) and 33.3% (1/3) in CISs, and 60% (3/5) and 20% (1/5) in invasive carcinomas, respectively. The results of vulvar scrapes showed that the frequency of HPV DNA in mild and moderate dysplasias was significantly higher than that in severe dysplasias, CISs and invasive carcinomas (p < 0.05). We suggest that, in addition to the investigation for the natural history of HPV infection, cell dynamics, local immunological status and any other factors in the HPV-infected lesion must be investigated to clarify the carcinogenesis of HPV in the uterine cervix. Furthermore, HPVs detected in the vagina and vulva were thought to have disappeared without reaching an integrated form during the follow-up of cervical neoplasia with HPV infection over a long period.