所有外阴癌中大约 25%-43% 与人乳头瘤病毒 (HPV) 有关。在许多国家，外阴癌的发病率正在上升，这可能是由于 HPV 暴露量增加所致。然而，探索外阴癌 HPV 患病率和基因型分布随时间变化的研究很少。我们的目的是在未经选择的全国范围挪威女性样本中评估外阴鳞状细胞癌中 HPV 患病率和基因型分布的时间趋势。此外，我们探索了与 HPV 状态相关的临床和组织病理学方面，并调查了 HPV 状态是否与生存相关。从挪威癌症登记处提取了 1970-1975 年和 2000-2005 年的所有外阴鳞状细胞癌病例，并提取了相应的组织块。检索到。经过详细的组织学检查后，使用实时 TaqMan PCR 进行 HPV 检测。使用Kaplan-Meier 方法计算总生存率。采用多变量 Cox 回归分析来估计根据诊断年龄、分期和诊断时期调整的风险比。对 352 例外阴鳞状细胞癌病例进行组织学检查。我们获得了 282 例病例的有效 HPV 分析结果，总体而言，29.8% (95% CI 24.5%-35.5%) 的病例为高危 HPV (hrHPV) 阳性。比较这两个时期，我们发现hrHPV阳性肿瘤的比例从1970-1975年的23%（95% CI 16.0%-31.4%）显着增加到2000年的35.3%（95% CI 27.8%-43.3%） -2005年（P = 0.025）。主要基因型为 HPV 16 (73%)、HPV 33 (21%) 和 HPV 18 (6%)，两个时期的分布相似。在最近的队列中，检测到了几种其他基因型：HPV 6、11、39、45、52、58 和 66 的比例较小，范围为 1.8% 至 3.6%。在单变量分析中，与 HPV 阴性肿瘤患者相比，HPV 阳性肿瘤患者的总生存期有所改善（风险比 [HR] 0.65，95% CI 0.48-0.86）。挪威外阴鳞状细胞癌中 HPV 的患病率是2000-2005 年明显高于 1970-1975 年。这两个时期的三种主要基因型是 HPV 16、33 和 18。然而，在过去几十年中出现了其他几种 HPV 基因型。 HPV 阳性与更好的总体生存率相关。© 2023 作者。斯堪的纳维亚妇产科学报，约翰·威利 (John Wiley) 出版

Approximately 25%-43% of all vulvar carcinomas are associated with human papillomavirus (HPV). In many countries, vulvar carcinoma incidence rates are increasing, possibly due to greater HPV exposure. However, studies exploring changes in HPV prevalence and genotype distribution in vulvar carcinoma over time are scarce. Our aim was to evaluate time trends in HPV prevalence and genotype distribution in vulvar squamous cell carcinoma in an unselected, nationwide sample of Norwegian women. Further, we explored clinical and histopathological aspects in relation to HPV status and investigated whether HPV status was associated with survival.All vulvar squamous cell carcinoma cases from 1970-1975 and 2000-2005 were extracted from the Cancer Registry of Norway and corresponding tissue blocks were retrieved. After detailed histology review, HPV testing was conducted using real-time TaqMan PCR. Overall survival rates were calculated using the Kaplan-Meier method. Multivariable Cox regression analysis was performed to estimate hazard ratios adjusted for age at diagnosis, stage and diagnostic period.Histological review was performed on 352 vulvar squamous cell carcinoma cases. We were able to obtain valid HPV analysis results for 282 cases, Overall, 29.8% (95% CI 24.5%-35.5%) of cases were high-risk HPV (hrHPV)-positive. When comparing the two periods, we found that the percentage of hrHPV-positive tumors increased significantly from 23% (95% CI 16.0%-31.4%) in 1970-1975 to 35.3% (95% CI 27.8%-43.3%) in 2000-2005 (P = 0.025). The predominant genotypes were HPV 16 (73%), HPV 33 (21%), and HPV 18 (6%), with similar distributions in both periods. In the more recent cohort, several additional genotypes were detected: HPV 6, 11, 39, 45, 52, 58 and 66 were found in smaller percentages, ranging from 1.8% to 3.6%. In univariate analysis, patients with HPV-positive tumors showed improved overall survival compared with patients with HPV-negative tumors (hazard ratio [HR] 0.65, 95% CI 0.48-0.86).The prevalence of HPV in vulvar squamous cell carcinomas in Norway was significantly higher in 2000-2005 than in 1970-1975. The three predominant genotypes were HPV 16, 33 and 18 in both time periods. However, several other HPV genotypes have emerged over the last decades. HPV-positivity was associated with better overall survival.© 2023 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG).