Abstract
The purpose of the study was to determine pathomorphological and pathohistological characteristics of primary vulvar carcinoma. Materials, methods, and study design: A retro- and prospective comprehensive morphological study of 117 patients was conducted at Bondar Regional Cancer Research Center (Donetsk) over the period from 2002 to 2019. Out of 117 we identified 44 patients with primary vulvar cancer without previous inflammatory diseases (cancer de novo). The materials were fixed in formalin and examined using standard methods of histological staining and morphometry. Statistical analysis methods were used to process the data. Results and Discussion: The differentiated VIN type occurred in 61.2% of cases, the undifferentiated type – in 37.8%. VIN1 was characterized by basal cell hyperplasia, VIN2 – by abnormal vertical anisomorphy, VIN3 – by significant abnormal cell stratification and differentiation. Cell proliferative activity increased with VIN severity, with the highest mitotic index and nuclear-cytoplasmic ratio in VIN3. In VIN1, a positive reaction to nuclear proliferation antigen was observed in the lower third of the epithelial layer. In VIN2 and VIN3, the positive reaction covered most of the epithelium. Well-differentiated SCC (G1) was characterized by polymorphic cell complexes with a small number of pathological mitoses and apoptosis. Moderately differentiated SCC (G2) had a pronounced inflammatory reaction and necrosis, with disruption of the basement membrane. Poorly differentiated SCC (G3) demonstrated loss of vertical anisomorphy, high mitotic index and presence of tumor emboli in vessels. Conclusions: The study showed significant differences in the morphological and morphometric characteristics of different types of VIN and invasive vulvar carcinoma. The results will help to improve the diagnosis and treatment of primary vulvar cancer, especially in understanding its pathogenesis and prognostic factors.
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