title: S-Phase fraction, p53, and HER-2/neu status as predictors of nodal metastasis in early vulvar cancer.
abstract: 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.
authors.affiliation: Women & Infants Hospital/Brown University, Providence, Rhode Island 02905, USA.
authors.forename: M E
authors.initials: ME
authors.lastname: Gordinier
authors.forename: M M
authors.initials: MM
authors.lastname: Steinhoff
authors.forename: J W
authors.initials: JW
authors.lastname: Hogan
authors.forename: J F
authors.initials: JF
authors.lastname: Peipert
authors.forename: W H
authors.initials: WH
authors.lastname: Gajewski
authors.forename: S S
authors.initials: SS
authors.lastname: Falkenberry
authors.forename: C O
authors.initials: CO
authors.lastname: Granai
mesh_terms: 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*
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases; D016159:Tumor Suppressor Protein p53