ORIGINAL ARTICLES

Expression of EphA2 and EphrinA-1 in vulvar carcinomas and its relation to prognosis

R Holm¹, S Knopp¹, Z Suo¹, C Tropè^1,2 and J M Nesland¹

¹ Department of Pathology, Rikshospitalet-Radiumhospitalet Medical Center, Oslo, Norway
² Department of Gynecologic Oncology, Rikshospitalet-Radiumhospitalet Medical Center, Oslo, Norway

Correspondence to:
Dr Ruth Holm, Department of Pathology, Rikshospitalet-Radiumhospitalet Medical Center, Montebello, 0310 Oslo, Norway; ruth.holm{at}radiumhospitalet.no

Aims: To examine the expression of EphA2 and EphrinA-1 in vulvar squamous cell carcinomas and investigate their prognostic relevance.

Methods: Tumours from 224 patients with vulvar squamous cell carcinomas were investigated for expression of EphA2 and EphrinA-1 using single and double immunostaining methods.

Results: High expression (strong/moderate staining intensity) of EphA2 and EphrinA-1 was observed in 114 (51%) and 126 (56%) vulvar carcinomas, respectively. In the three cases tested using the double immunostaining method, colocalisation of EphA2 and EphrinA-1 proteins was identified in the same neoplastic cells. High EphA2 expression was significantly correlated to high expression of EphrinA-1 (p<0.01) and cyclin A (p<0.01), large tumour size (p = 0.03), deep invasion (p<0.01) and higher FIGO stage (p = 0.05). A correlation between high EphrinA-1 expression and high levels of cyclin A (p<0.01) and p21 (p<0.01), deep invasion (p<0.01) and higher FIGO stage (p = 0.01) was also seen. In univariate analysis, high expression of EphrinA-1 was associated with poor survival (p = 0.03). However, in the multivariate analysis neither EphrinA-1 nor EphA2 were significantly correlated to survival.

Conclusions: EphA2 and EphrinA-1 were overexpressed in 51% and 56% of the vulvar squamous cell carcinomas, respectively, and high levels of EphA2 and EphrinA-1 proteins were associated with deep tumour invasion and high FIGO stage. However, EphA2 and EphrinA-1 were not independently associated with clinical outcome in vulvar carcinomas.

Keywords: immunohistochemistry; vulvar cancer; EphA2; EphrinA-1

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• Holm, R, Knopp, S, Kumar, R, Lee, J, Nesland, J M, Trope, C, Callen, D F (2008). Expression of ZNF652, a novel zinc finger protein, in vulvar carcinomas and its relation to prognosis. J. Clin. Pathol. 61: 59-63 [Abstract] [Full Text]