Clinical and Histopathological Characteristics of Vulvar Cancer Patients Whose Histology Blocks Stain Positive and Those That Stain Negative for P16ink4a at the Kenyatta National Hospital: a 5-year Retrospective Study

Abstract

Introduction: Vulva cancer, though routinely rare, is increasingly being seen in younger patients. It has been strongly associated with Human Papilloma Virus (HPV) infection. However, the epidemiological studies describing the association are conflicting thus the pathogenic mechanism of how HPV contributes to vulva cancer remains controversial. There is a paucity of data on vulvar cancer in our local setting hence this study is aimed at adding our knowledge on this gynecological malignancy and also forming a basis for further research. Study objective: To evaluate the clinical and histopathological characteristics of vulva cancer patients whose histology blocks stain positive and those that stain negative for P16INK4a at the Kenyatta National Hospital over a 5-year period 2018-2022. Study site: Kenyatta National Hospital Records Department & the University of Nairobi Pathology Department. Study population: Women with histologically confirmed VSCC. Methodology: Through a descriptive cross-sectional study design and consecutive sampling approach, records of 55 women who presented with Vulvar Squamous Cell Carcinoma (VSCC) were retrieved from hospital records, their clinicopathological characteristics captured and laboratory samples retrieved and assessed for histological subtype of the tumor as well as the presence of P16INK4a protein as a marker of HPV infection. Data analysis was performed with SPSS 26. Proportions were used to describe the categorical distribution of various patient characteristics. The connection between the presence or absence of P16INK4a and patient clinical and histo- pathological features was evaluated using the Chi-square test of independence. Multivariate analysis was conducted using logistic regression. Odds ratios and 95% confidence intervals were used to express the results of the regression model. P values less than 0.005 were regarded as statistically significant. The acquired findings were displayed as frequency tables and graphs that show the relative frequencies and group percentages.