Abstract：
Differentiated vulvar intraepithelial neoplasia (dVIN) is the precursor of human papillomavirus (HPV)-independent vulvar squamous cell carcinoma (VSCC). Given the rare incidence of dVIN, limited information on the exact cancer risk is available. We systematically reviewed the primary and recurrent VSCC risk in patients with dVIN, as well as the time to cancer development. A systematic search was performed up to July 2021 according to the PRISMA guidelines. Five reviewers independently screened articles on title, abstract and full text, followed by critical appraisal of selected articles using the Quality in Prognostic Studies (QUIPS) tool. Of the 455 screened articles, 7 were included for analysis. The absolute risk for primary VSCC in dVIN varied between 33 and 86%, with a median time to progression to VSCC of 9-23 months. The risk of developing recurrent VSCC in dVIN associated VSCC was 32-94%, with a median time to recurrence of 13-32 months. In conclusion, patients with dVIN have a high risk of developing primary and recurrent VSCC with a short time to cancer progression. Increased awareness, timely recognition, aggressive treatment and close follow-up of HPV-independent vulvar conditions including dVIN is therefore strongly recommended.
摘要：
分化型外阴上皮内瘤变（dVIN）是人乳头瘤病毒（HPV）非依赖性外阴鳞状细胞癌（VSCC）的前体。鉴于dVIN的罕见发生率，关于确切癌症风险的信息有限。我们系统地回顾了dVIN患者的原发性和复发性VSCC风险，以及癌症发展的时间。根据PRISMA指南，系统搜索已进行到2021年7月。五名审稿人独立筛选标题文章，摘要和全文，然后使用预后研究质量（QUIPS）工具对选定的文章进行批判性评估。在455篇筛选的文章中，包括7个用于分析。dVIN中原发性VSCC的绝对风险在33%至86%之间变化，进展到VSCC的中位时间为9-23个月。dVIN相关VSCC发生VSCC复发的风险为32-94%，中位复发时间为13-32个月。总之,dVIN患者发生原发性和复发性VSCC的风险很高,且癌症进展时间短.提高认识,及时识别,因此,强烈建议对包括dVIN在内的HPV非依赖性外阴疾病进行积极治疗和密切随访.
