S-Phase fraction, p53, and HER-2/neu status as predictors of nodal metastasis in early vulvar cancer.
OBJECTIVE
Our aim was to determine the value of the S-phase fraction, p53, and HER-2/neu status as predictors of inguinal nodal metastasis in early vulvar cancer.


METHODS
The charts of 100 consecutive patients with invasive squamous cell cancer of the vulva were reviewed and a cohort of patients with clinical stage I or II disease treated primarily with radical surgery and inguinal node dissection was identified. Within this cohort, all node-positive patients were matched with node-negative controls by depth of invasion. Tumor from the 13 node-positive patients and 26 controls was then analyzed by flow cytometry and immunohistochemistry.


RESULTS
The median value of the S-phase fraction was higher in tumor from patients with inguinal nodal metastasis (median, 18.2; 25th-75th percentile: 13.9-28.3) than in node-negative patients (median, 8.9; 25th-75th percentile: 5.4-15.6) (P = 0.01). The presence of the HER-2/neu immunopositivity was also found to be associated with nodal metastasis (OR 4.05, 95% CI 1.0-16.6), but we found no evidence that DNA index or the presence of p53 immunopositivity was associated with nodal metastasis.


CONCLUSIONS
Early vulvar cancer patients with inguinal node metastasis have a significantly higher S-phase fraction and are more likely to have HER-2/neu immunopositivity when compared to those without nodal metastasis.
Gordinier
M E
ME
Women & Infants Hospital/Brown University, Providence, Rhode Island 02905, USA.
Steinhoff
M M
MM
Hogan
J W
JW
Peipert
J F
JF
Gajewski
W H
WH
Falkenberry
S S
SS
Granai
C O
CO
D002294:Carcinoma, Squamous Cell / Q000737:chemistry / Q000473:pathology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008207:Lymphatic Metastasis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000032:analysis*; D016196:S Phase; D016159:Tumor Suppressor Protein p53 / Q000032:analysis*; D014846:Vulvar Neoplasms / Q000737:chemistry / Q000473:pathology*
D018719:Erb-b2 Receptor Tyrosine Kinases; D016159:Tumor Suppressor Protein p53