EVALUATION OF PROTEIN MARKERS OF MALIGNANT POTENTIAL IN VULVAR LICHEN SCLEROSUS
DOI:
https://doi.org/10.11603/mcch.2410-681X.2022.i2.13212Keywords:
vulvar lichen sclerosus, squamous cell carcinoma of the vulva, vulvar intraepithelial neoplasia, protein markers, immunohistochemical studies, p53, p16, Ki-67Abstract
Introduction. Vulvar lichen sclerosus is a chronic T-cell inflammatory skin disease with a spectrum of clinical and pathological manifestations of unknown etiology and pathogenesis. The exact causes and pathogenesis of sclerosing lichen of the vulva are not fully known, but autoimmune, genetic, hormonal and infectious factors, as well as pathologies of the nervous system, play a role in the occurrence of this disease.
The aim of the study – immunohistochemical evaluation and study of molecular biomarkers p53, p16, Ki-67, which may indicate precancerous changes of the vulva.
Research Methods. The study involved 34 women aged 61 to 74 years, whose average age at the time of diagnosis of vulvar lichen sclerosus, vulvar intraepithelial neoplasia and leukoplakia of the vulva was (67.2±3.7) years according to the clinical databases of the National Cancer Institute and the Medical Center "Verum", with typical clinical signs of damage to the vulva. All patients underwent a biopsy of the vulva to establish the correct diagnosis, clarify the diagnosis of vulvar lichen sclerosus, and in case of diagnostic uncertainty and suspicion of neoplasia.
Results and Discussion. Biopsies performed in all patients showed a number of histological signs. In some patients (79.4 %), classic signs of vulvar lichen sclerosus were observed, sometimes with areas of ulcers that could be caused by scratches. Others (11.8 %) were diagnosed with mild and moderate dysplasia and vulvar lichen sclerosus. Squamous cell carcinoma was also diagnosed (8.8%). Immunohistochemical studies were performed in all patients based on the analysis of immunostaining of molecular markers p53, Ki-67 and p16, which are contained in the nucleus, they are well studied in high-grade squamous intraepithelial lesions and differentiated vulvar intraepithelial neoplasia.
Conclusions. Biomarkers p53, p16 and Ki-67 showed promise in retrospective tissue studies. Immunohistochemical studies not only confirmed the histological findings, but also helped determine the degree of dysplasia in the diagnosis of vulvar lichen sclerosus.
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