A review of molecular pathological markers in vulvar carcinoma: lack of application in clinical practice

• Published in: Journal of clinical pathology Vol. 62; no. 3; pp. 212 - 218
• Main Authors: Knopp, S, Tropè, C, Nesland, J M, Holm, R
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and Association of Clinical Pathologists 01.03.2009; BMJ Publishing Group; BMJ Publishing Group LTD
• Subjects: Angiogenesis Inducing Agents - analysis; Biological and medical sciences; Biomarkers, Tumor - analysis; Cancer therapies; Carcinoma, Squamous Cell - diagnosis; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - virology; Cell Cycle; Cervical cancer; Epidermal growth factor; Female; Genital cancers; Human papillomavirus; Humans; Hyaluronan Receptors - analysis; Investigative techniques, diagnostic techniques (general aspects); Medical prognosis; Medical sciences; Metastasis; Multivariate analysis; Papillomaviridae - isolation & purification; Papillomavirus Infections - complications; Papillomavirus Infections - pathology; Pathogenesis; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Patients; Prognosis; Receptor, Epidermal Growth Factor - analysis; Rodents; Tumors; Vascular endothelial growth factor; Vulvar Neoplasms - diagnosis; Vulvar Neoplasms - pathology; Vulvar Neoplasms - virology; Anatomic pathology; Genetic marker; Professional practice; Biological marker; Review; Vulva carcinoma; Molecular marker; Bibliographic review
• ISSN: 0021-9746; 1472-4146
• DOI: 10.1136/jcp.2008.057240

Vulvar carcinoma is a rare female genital neoplasia. Radical surgery, which has been the standard treatment approach, is often accompanied by considerable morbidity. To reduce the incidence of complications there has been a movement toward individualised therapy and less radical surgery. Associated with this, new tumour markers that could serve as prognostic indicators would be of considerable value to guide treatment decision. In this review, a brief update of molecular pathological markers of vulvar carcinomas is provided, and their impact as prognostic markers is addressed. p16, p21, p14, p27, cyclin A, cyclin D1, p53, vascular endothelial growth factor (VEGF), transforming growth factor α, HER-2 and epidermal growth factor receptor (EGFR) have been found to be important in the pathogenesis and/or progression of vulvar carcinomas. Furthermore, human papillomavirus, p16, p21, p14, p53, VEGF, CD44v3, CD44v6, CD44v4, CD44v9, CD44v10, HER-2, EGFR, matrix metalloproteinase-12, caspase 3, Bcl-2 and nm23-H1 have been correlated to clinical outcome of patients with vulvar carcinomas. However, due to the relative small number of studies reported for each molecular pathological marker, and the relative small number of vulvar carcinomas included and the lack of multivariate analysis in the majority of these studies, no conclusion regarding the prognostic value of these markers can be drawn. Therefore, the investigated markers have not yet earned a place in standard clinical diagnostics or treatment, and further studies are needed to clarify the clinical value of these markers.