Barbara Gardella

The Role of β1 Integrin/CD29 as a Potential Prognostic Factor for the Risk of Progression to Cervical Carcinoma in HPV-Associated Lesions

Background and Objectives: Available evidence reports the overexpression of β1 integrin in dysplastic rather than normal cervical tissue. We aimed to evaluate the involvement of β1 (CD29) integrin in the progressive pathogenesis of cervical intraepithelial neoplasia (CIN). Materials and Methods: From January 2019 to December 2021, we prospectively enrolled women undergoing a colposcopy with a cervical biopsy for abnormal cervical cytology and/or undefined cytology with a positive HPV DNA test and women with relapsing cervical inflammatory disorders. Based on the histopathological results, women were divided into four groups: group A (CIN1), group B (CIN2), group C (CIN3), and group D (no CIN diagnosis) as a control group. Subsequently, cytofluorimetry and immunohistochemical analysis (based on the identified positive cell ratios as follows: ≤10%, negative; 10–25%, 1+ (weak); 25–50%, 2+ (medium); ≥50%, and 3+ (high)) for β1 integrin were carried out. Results: In total, 154 women were included. The average fluorescence intensity in the four groups was 2.35 ± 1.37, 2.73 ± 1.56, 3.09 ± 1.56, and 2.13 ± 1.25 UA from groups A to D, respectively; this figure was significantly different for CIN3 (group C) women relative to the other groups (p = 0.0132). Higher β1 integrin/CD29 concentrations in the CIN groups with HR-HPV 16 and 18 were also detected (p = 0.0292, 0.0367, and 0.0357 respectively for CIN3, CIN2, and CIN1). Immunohistochemistry analysis showed higher results for the CIN3 group compared to controls and all the other groups (p < 0.001). Conclusions: β1/CD29 integrin expression increased with CIN grade, and it was significantly higher in CIN3 lesions. This could be used as a promising screening tool to identify women prone to developing high-grade cervical lesions. However, additional evidence is needed to strengthen these findings.

Retrospective Study of the Risk of Progression to Squamous Cell Carcinoma of Vulvar Lichen Planus Forms Isolated or Associated With Other Dermatoses

ABSTRACT Aims The aim of the study was to examine the potential risk of vulvar lichen planus (LP), alone or associated with lichen sclerosus (LS) or lichen simplex chronicus (LSC), to evolve towards vulvar cancer (VSCC). Methods We retrospectively investigated the incidence of vulvar cancer in women diagnosed with LP, alone or associated with LS and LSC, between 2007 and 2022. Results We retrieved the data of 77 women with LP with a mean age of 63.5 ± 11.9 years old. Of these, 53 had LP, 19 had LP+LS, and 5 had LP+LSC. Ultrapotent topical corticosteroids were the first‐line treatment. The mean follow‐up time was 45 ± 30.14 months, during which four patients developed VSCC (5.19%). All four cases were found to be associated with the presence of multiple lichen, and the frequency of developing a neoplasm in the presence of LS or LSC superimposed on LP was found to be significant with Fisher's exact test ( p  = 0.0079). Conclusion Analyzing our data, we can point out a concrete possibility regarding the relationship between multiple lichen and VSCC compared to LP alone. However, the sample size is too small to allow definitive conclusions to be drawn, and multicenter studies would, therefore, be desirable in the future both to examine more thoroughly and in large numbers the relationship between LP, multiple lichen, and vulvar cancer and to find new treatment and follow‐up strategies for pathogenesis.