228 Detection and Genotyping of High-Risk Human Papillomavirus in Vulvar Inverted Follicular Keratoses-like Lesions
Bibliographic record
Abstract
The nature of inverted follicular keratoses (IFKs) is disputed, with some suggesting that they represent a variant of verruca or seborrheic keratosis. While both verruca and genital seborrheic keratoses have been associated with human papillomavirus (HPV), no HPV association has been reported in extragenital IFKs. Furthermore, vulvar IFKs have not been separately examined for HPV. We aimed to detect and compare the type-distribution of high-risk HPVs (hrHPVs) in vulvar and extragenital IFKs using a PCR-based detection method. Vulvar and extragenital IFKs from 2014 to 2016 from patients without prior history of HPV-associated lesions were identified and reviewed. Cases with greater than 90% lesional tissue were selected for DNA extraction and assessed for adequate DNA yield. Each case was assayed using the GeneNav HPV One kit (GenomeMe, Richmond, BC, Canada) for HPV16 and HPV18 with nonspecific detection of other hrHPVs. Cases demonstrating other hrHPV types were genotyped using the GeneNav HPV genotyping kit. Immunohistochemical staining for p16 and Ki67 was also performed. Twenty-six cases including four vulvar IFKs (4/26, 15.4%) meeting study criteria were identified. There were no appreciable morphologic differences between the vulvar and extragenital lesions. All four vulvar IFK cases (4/4, 100%) were positive for HPV16. Two of these were concurrently positive for HPV18 (2/4, 50%). Other hrHPV subtypes were not detected. HPV was not detected in any of the 22 extragenital IFKs. Immunohistochemical staining for p16 in all of the hrHPV-positive cases revealed strong diffuse staining with a high Ki-67 proliferation index. In contrast, the HPV-negative extragenital cases showed only patchy p16 and low K-67 expression. Although morphologically similar to extragenital non-HPV related lesions, vulvar IFKs appear to harbor hrHPVs, including HPV16, and should be considered as a previously unreported morphologic variant of high-grade vulvar intraepithelial lesion.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".