RESUMEN
Cryostat sections of 20 clinical condylomata of the vulva induced by human papillomavirus and 5 normal control biopsies were examined using immunohistochemistry. The results indicated that in vulvar papillomavirus infection the intraepithelial Langerhans' cells showed abnormal morphology and a significantly lower density than controls. CD1a positive Langerhans' cells were also observed in dermis of condylomata, suggesting an abnormal epithelial traffic of dendritic cells. T lymphocytes with a mean CD4/CD8 ratio of 0.25 and a mean density of 267 +/- 59 cells/mm2 of epithelial section were the main cellular infiltrate in vulvar papillomavirus infection. Most of the T cells were HLA-DR negative. Those condylomata with moderate to severe mononuclear infiltrate showed leucocyte function antigen 1 positive T cells forming small clusters in the lower epithelial half around the ICAM-1 positive keratinocytes. Vulvar warts also showed epithelial areas with overlapped ICAM-1 and HLA-DR expression. Scattered T gamma-delta and B lymphocytes, macrophages and NK cells were observed among the cells of the dermal infiltrate of vulvar condylomata.
Asunto(s)
Moléculas de Adhesión Celular/biosíntesis , Condiloma Acuminado/metabolismo , Antígenos HLA-DR/biosíntesis , Papillomaviridae , Infecciones por Papillomavirus/metabolismo , Enfermedades de la Vulva/metabolismo , Adulto , Antígenos CD/biosíntesis , Relación CD4-CD8 , Condiloma Acuminado/inmunología , Condiloma Acuminado/patología , Condiloma Acuminado/virología , Epitelio/inmunología , Epitelio/metabolismo , Epitelio/patología , Femenino , Expresión Génica , Humanos , Inmunohistoquímica , Molécula 1 de Adhesión Intercelular , Células Asesinas Naturales/metabolismo , Células Asesinas Naturales/patología , Células de Langerhans/metabolismo , Células de Langerhans/patología , Antígeno-1 Asociado a Función de Linfocito/metabolismo , Macrófagos/metabolismo , Macrófagos/patología , Persona de Mediana Edad , Infecciones por Papillomavirus/inmunología , Infecciones por Papillomavirus/patología , Infecciones por Papillomavirus/virología , Subgrupos de Linfocitos T/metabolismo , Subgrupos de Linfocitos T/patología , Enfermedades de la Vulva/inmunología , Enfermedades de la Vulva/patología , Enfermedades de la Vulva/virologíaRESUMEN
The clinical staging of malignant disease is necessary before initiating nonsurgical therapy. Unfortunately, such staging does not help answer critical questions about the course and natural history of the cancerous process. Answers to these questions are crucial to the planning of future therapeutic programs. A postoperative staging system, amenable to computer analysis, that can be retrospectively applied to a large series of invasive squamous cell carcinomas of the vulva is presented. A review of the experience of a large oncologic service at the University of Buenos Aires, which used this new classification system, shows the system's applicability. Such a system could, in time, provide answers to many questions concerning invasive squamous cell carcinoma of the vulva.