The prognostic value of blood and lymph vessel parameters in lichen sclerosus for vulvar squamous cell carcinoma development: an immunohistochemical and electron microscopy study

• Published in: American journal of obstetrics and gynecology 2010-08, Vol.203 (2), p.167.e1-167.e8
• Main Authors: van der Avoort, Irene A.M., MD, MSc, van der Laak, Jeroen A.W.M., PhD, Otte-Höller, Irene, MSc, van de Nieuwenhof, Hedwig P., MD, MSc, Massuger, Leon F.A.G., MD, PhD, de Hullu, Joanne A., MD, PhD, van Kempen, Léon C.L.T., PhD
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Biopsy, Needle; Blood Vessels - pathology; Carcinoma, Squamous Cell - pathology; Cell Transformation, Neoplastic - pathology; Dermatology; Female; Female genital diseases; Gynecology. Andrology. Obstetrics; Humans; Immunohistochemistry; lichen sclerosus; Lymphatic Vessels - pathology; malignant potential; Medical sciences; Microscopy, Electron; microvessel density; Obstetrics and Gynecology; Paraffin Embedding; pericytes; Precancerous Conditions - pathology; Probability; Prognosis; Psoriasis. Parapsoriasis. Lichen; Statistics, Nonparametric; Tumors; Vulva - pathology; Vulva - ultrastructure; vulvar cancer; Vulvar Lichen Sclerosus - pathology; Vulvar Neoplasms - pathology
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2010.02.002

Objective The objective of the study was to quantify vessel type and density in lichen sclerosus (LS) to find a marker for its malignant potential. Study Design Quantitative analysis was performed on paraffin-embedded tissue samples of 28 patients with LS (7 adjacent to vulvar squamous cell carcinoma, 21 solitary) and immunohistochemical staining for CD34 (vascular and lymphangiogenic lymph endothelial cells), D2-40 (lymphatic-specific marker), and α-SMA (pericyte marker). Electron microscopy was performed on fresh tissue. Results No significant differences in vessel density or other vessel parameters could be demonstrated between the 2 groups. In hyalinized lesions, vessel diameter, and α-SMA positivity was reduced compared with nonhyalinized lesions. Electron microscopy revealed detachment of pericytes from vascular endothelial cells and increased thickening of basement membrane, whereas endothelial cell function did not appear strongly impaired. Conclusion Malignant potential of LS cannot be predicted by vessel characteristics. Hyalinization in LS is associated with pericyte detachment from the basal lamina of vascular endothelial cells.