Cell cycle proteins as molecular markers of malignant change in vulvar lichen sclerosus

Abstract

Lichen sclerosus (LS) has a known association with the development of squamous cell carcinoma of the vulva. The purpose of this study was to investigate molecular markers, which could indicate premalignant changes. Multiple sequential vulvar biopsies were taken over a period of 11 years from a patient with longstanding LS. Immunohistochemical staining was used to demonstrate a range of molecular markers. Increased expression of p53 and Ki67 was found in areas of squamous hyperplasia (SH) and differentiated vulvar intraepithelial neoplasia (dVIN) which correlated with the subsequent development of invasive squamous cell carcinoma (SCC). Molecular changes have been found to accompany histologic changes in the progression of vulvar LS to malignancy. Such markers may prove a useful addition in the clinical management of these conditions.

Claudin and p53 expression in vulvar lichen sclerosus and squamous-cell carcinoma

“…Increased expression of the p53 protein occurs in vulvar SCC, as well as in benign diseases, such as LS 19 27. It is still unclear whether increased p53 expression is due to tumorigenesis or to cellular repair mechanisms against stress 27 50 51.…”

“…It is still unclear whether increased p53 expression is due to tumorigenesis or to cellular repair mechanisms against stress 27 50 51. The follow-up study to determine the percentage of vulvar LS patients who develop SCC suggested that there is a relationship between LS and tumorigenesis 19 27…”

“…Somatic mutations and/or disruption of the p53 pathway are described in almost all malignant tumours 24–26. In contrast, upregulation of p53 expression is found in benign diseases, such as LS, likely as a mechanism to prevent tumorigenesis 19 27…”

Efficacy of Photodynamic Therapy in Vulvar Lichen Sclerosus Treatment Based on Immunohistochemical Analysis of CD34, CD44, Myelin Basic Protein, and Ki67 Antibodies

“…There are research studies on molecular markers, which could indicate premalignant changes. 22,23 Markers such as cell cycle proteins have previously been described to control cellular proliferation and apoptosis and may prove to be a useful addition to the clinical management of this condition. Ki67 was the cell proliferation marker investigated in our study.…”

A rare primary immunodeficiency

“…Though vulval carcinoma has been reported in adults with AD-HIES, there have been no such reports in children 10–12. Since our case already has a premalignant condition of the vulva at such a young age, a close follow-up is required for detecting malignant transformation of this lesion 13…”