Epithelial–mesenchymal transition (EMT) in vulvar cancer with and without inguinal lymph node involvement

Abstract

Purpose Epithelial-mesenchymal transition (EMT) is associated with increased metastatic spread and poor prognosis. Data on vulvar carcinoma are limited. Methods Thirty-two cases of squamous cell carcinoma of the vulva (16 with and 16 without inguinal lymph node metastases) and their lymph node deposits were evaluated for immunohistochemical expression of EMT markers (vimentin, cyclin D1, e-cadherin), p16, p53 and Ki-67. Results of EMT-immunostainings were compared to lymph node involvement and expression of p53 and p16. The micro-anatomical staining pattern for EMT markers comparing the tumor center with the front of invasion was analysed in each tumor. Results There was no difference in the expression of EMT markers between node negative and node positive tumors. Staining for vimentin and cyclin D1 was seen within tumor cells at the front of invasion in 100 and 84.4% of the tumors, respectively. The majority of cases (68.7%) showed negative or reduced staining for e-cadherin in this micro-anatomical localization. Tumor cells within the lymph node metastases showed positive staining for e-cadherin in 75% and for cyclin D1 in 49% of the cells but were negative for vimentin in 13 out of 16 cases (81.3%). Tumors with aberrant p53 staining represented a non-significant higher vimentin but significantly higher cyclin D1 expression at the front of invasion than those with p53 wild-type pattern. Conclusion The present study shows no differences in the expression of EMT markers between node positive and node negative vulvar cancers. The evaluation of immunostaining within the micro-anatomical context indicates that an EMT-phenotype is restricted to the tumor cells at the front of invasion. Paired analyses of vulvar carcinomas and their lymph node deposits suggest mesenchymal-epithelial transition (MET) in the metastatic deposits. Immunohistochemical staining results may suggest that EMT is more prevalent in vulvar cancer with aberrant p53 staining.

A retrospective comparative cohort study of ultra-pulse CO2 lattice laser and glucocorticoids in the treatment of vulvar epithelial nonneoplastic lesions

“…The findings revealed a remarkable improvement in the itching of the vulva and pain during intercourse without adverse effects ( 8 , 9 ). This may be related to the thermal response of the laser inducing tissue edema and the release of HSP70 and transforming growth factor beta (TGF) ( 10 ), which in turn improves skin circulation and nutrition in the localized nonneoplastic lesions of the vulvar epithelium and repairs damaged tissue from local scratching ( 1 ). In our study, the efficacy of CO 2 lattice laser and glucocorticoids was more than 50% at 1, 3, and 6 months of treatment.…”

“…Non-neoplastic lesions of vulvar epithelium are a cluster of long-term disorders with degenerative and pigmented alterations of the female vulvar skin and mucous membranes ( 1 ). The pathological alterations often observed in non-neoplastic lesions of the vulvar epithelium lichen simplex chronicus (LSC) and lichen sclerosus.…”

“…In recent years, Li et al have found that CO 2 lattice laser can remarkably improve regional cutaneous microcirculation due to the micropore thermal effect ( 1 , 2 ). Moreover, a few cases of nonneoplastic lesions of the vulvar epithelium treated with the CO 2 lattice laser have been reported.…”

CYP27B1 Enzyme in Psoriasis: A Preliminary Study of Immunohistochemical Observations

“…A scoring system was devised after checking the literature [23][24][25][26], integrating multiple markers while accommodating their unique characteristics within the scoring criteria. Ki67 staining involved estimating the percentage of positively stained nuclei among epithelial cells across high-powered fields.…”