title: Prognostic significance of cell cycle- and invasion-related molecular markers and genomic instability in primary carcinoma of the vagina.
abstract: OBJECTIVE
  This study aimed to analyze the prognostic value of DNA content and biological markers for cell cycle regulation and invasion in primary carcinoma of the vagina (PCV).
  
  
  METHODS
  Seventy-two consecutive patients with PCV, categorized as short-term (≤ 2 years) and long-term (≥ 8 years) survivors, were evaluated for DNA content by image cytometry, and for expression of p53, p21, cyclin A, Ki67, E-cadherin, and laminin-5γ2 chain by immunohistochemistry. The relationship between these biological markers and histopathological and clinical parameters was assessed.
  
  
  RESULTS
  All PCV showed aneuploid DNA content. Most of the PCV patients showed no overexpression of p53 and high expression of p21, cyclin A, and Ki67. Loss or underexpression of E-cadherin was found in 94% (68/72) of PCV patients, and all patients showed immunopositivity for the laminin-5γ2 chain. Tumors with a vaginal longitudinal location in the lower third or in the entire vagina more often had overexpression of p53, high expression of Ki67 (P = 0.044), and underexpression of E-cadherin (P = 0.038), than tumors confined only to the upper third. Overexpression of p53 was significantly associated with short-term survival in the univariate analysis, but not in the multivariate analysis adjusted for age at diagnosis and tumor size.
  
  
  CONCLUSIONS
  The expression level of some markers was related to tumor location, which might be indicative of different genesis. Overexpression of p53 was associated with short-term survival, but the only independent predictors of survival were age at diagnosis and tumor size.
authors.affiliation: Department of Gynecological Oncology, Radiumhemmet, Karolinska University Hospital, Stockholm, Sweden. kristina.hellman@ki.se
authors.forename: Kristina
authors.initials: K
authors.lastname: Hellman
authors.forename: Hemming
authors.initials: H
authors.lastname: Johansson
authors.forename: Sonia
authors.initials: S
authors.lastname: Andersson
authors.forename: Folke
authors.initials: F
authors.lastname: Pettersson
authors.forename: Gert
authors.initials: G
authors.lastname: Auer
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis* / Q000235:genetics / Q000378:metabolism; D002277:Carcinoma / Q000175:diagnosis* / Q000235:genetics / Q000378:metabolism / Q000473:pathology; D015815:Cell Adhesion Molecules / Q000032:analysis* / Q000378:metabolism; D018797:Cell Cycle Proteins / Q000032:analysis* / Q000378:metabolism; D005260:Female; D042822:Genomic Instability / Q000235:genetics / Q000502:physiology; D006801:Humans; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011379:Prognosis; D017741:Survivors / Q000706:statistics & numerical data; D014625:Vaginal Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000378:metabolism / Q000473:pathology
chemical_list: D014408:Biomarkers, Tumor; D015815:Cell Adhesion Molecules; D018797:Cell Cycle Proteins