title: Downregulated CD44 and hyaluronan expression in vulvar intraepithelial neoplasia and squamous cell carcinomas.
abstract: OBJECTIVE
  To investigate the expression of CD44 and hyaluronan in vulvar squamous cell carcinomas, vulvar intraepithelial neoplasia (VIN) and lichen sclerosus (LS) cases.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Kuopio University Hospital in Finland.
  
  
  METHODS
  A total of 18 vulvar squamous cell carcinomas, 22 VIN and 14 LS cases were studied by immunohistochemistry and histochemistry. Co-localization of these markers was also studied by dual fluorescence staining.
  
  
  METHODS
  Expression and cellular localization of CD44 and hyaluronan. RESULTS. In the normal squamous cell epithelium and in most LS samples, CD44 and hyaluronan were expressed homogeneously along plasma membranes with extensive co-localization. In carcinomas and VIN, both CD44 and hyaluronan were mostly irregular and without co-localization. In most VIN samples, CD44 was membranous, while hyaluronan was intracellular in 45% of the cases. CD44 showed both plasma membrane and intracellular localization in 39% of the carcinomas and in 94% of the cases hyaluronan was located only intracellularly. In LS, stromal hyaluronan staining was stronger than in carcinomas (p = 0.01). CD44 and hyaluronan staining was not associated with the grade of VIN, while there was good differentiation in carcinomas associated with preserved membranous CD44 (p = 0.012). Hyaluronan was not associated with the grade or stage of cancer.
  
  
  CONCLUSIONS
  Differences in hyaluronan and CD44 expression in VIN and squamous cell carcinomas compared to normal epithelium suggest that they have a role in vulvar malignancy.
authors.affiliation: Department of Pathology, Kuopio University Hospital, Kuopio, Finland.
authors.forename: Kirsi
authors.initials: K
authors.lastname: Hämäläinen
authors.forename: Veli-Matti
authors.initials: VM
authors.lastname: Kosma
authors.forename: Marja-Liisa
authors.initials: ML
authors.lastname: Eloranta
authors.forename: Raija
authors.initials: R
authors.lastname: Tammi
authors.forename: Markku
authors.initials: M
authors.lastname: Tammi
authors.forename: Marjo
authors.initials: M
authors.lastname: Leppänen
authors.forename: Merja
authors.initials: M
authors.lastname: Leppänen
authors.forename: Seppo
authors.initials: S
authors.lastname: Heinonen
authors.forename: Maarit
authors.initials: M
authors.lastname: Anttila
mesh_terms: D000328:Adult; D000368:Aged; D002278:Carcinoma in Situ / Q000378:metabolism* / Q000473:pathology; D002294:Carcinoma, Squamous Cell / Q000378:metabolism* / Q000473:pathology; D002462:Cell Membrane / Q000473:pathology; D015536:Down-Regulation / Q000502:physiology; D005260:Female; D006801:Humans; D018960:Hyaluronan Receptors / Q000378:metabolism*; D006820:Hyaluronic Acid / Q000378:metabolism*; D018459:Lichen Sclerosus et Atrophicus / Q000378:metabolism; D008875:Middle Aged; D012189:Retrospective Studies; D014846:Vulvar Neoplasms / Q000378:metabolism* / Q000473:pathology
chemical_list: D018960:Hyaluronan Receptors; D006820:Hyaluronic Acid