Departments of Obstetrics and Gynecology, Mie University Graduate School of Medicine, Tsu, Mie, Japan.
Int J Gynecol Cancer. 2013 Jul;23(6):1111-7. doi: 10.1097/IGC.0b013e3182958f95.
Although CXC chemokine receptor type 4 (CXCR4) is known to be expressed in various solid tumors and plays an integral role in cancer invasion and metastasis, expression of CXCR4 in human vulvar cancer has not yet been investigated. We examined distribution and expression of this chemokine receptor in specimens of invasive and noninvasive human vulvar neoplasms to elucidate its clinical significance.
Study patients were 38 consecutive patients (31 with primary vulvar cancers and 7 with intraepithelial neoplasms) treated at one of our hospitals. Sections of all specimens were evaluated for CXCR4 expression by means of immunohistochemistry. Relations between CXCR4 expression and clinicopathologic features including prognosis were investigated.
None of the 7 vulvar intraepithelial lesions expressed CXCR4. Of the 31 invasive vulvar tumor samples examined, 19 (61%) stained positively for CXCR4; 15 (68%) of 22 squamous cell carcinomas and 2 (29%) of 7 Paget tumors were CXCR4 positive. The difference in expression between invasive cancers and intraepithelial neoplasms was significant (P = 0.003). FIGO (International Federation of Gynecology and Obstetrics) stage III-IV cancers, in comparison to FIGO stage I-II cancers, were more likely to be positive for CXCR4 (82% vs 50%, P = 0.08). In terms of disease-free survival, prognosis of cancers that expressed CXCR4 was poorer than that of CXCR4-negative cancers (P = 0.013), but in terms of disease-specific survival, prognosis did not differ significantly between CXCR4-positive and -negative cancers (P = 0.111).
More than half of invasive squamous cell vulvar cancers can be expected to express CXCR4, and CXCR4 expression correlates with poor disease prognosis.
已知 CXC 趋化因子受体 4（CXCR4）在各种实体瘤中表达，并在癌症侵袭和转移中发挥重要作用，但 CXCR4 在人外阴癌中的表达尚未得到研究。我们检查了浸润性和非浸润性人外阴肿瘤标本中这种趋化因子受体的分布和表达，以阐明其临床意义。
研究患者为在我院治疗的 38 例连续患者（31 例原发性外阴癌和 7 例上皮内瘤变）。通过免疫组织化学方法评估所有标本中 CXCR4 的表达。研究了 CXCR4 表达与包括预后在内的临床病理特征之间的关系。
7 例外阴上皮内病变中均无 CXCR4 表达。在检查的 31 例浸润性外阴肿瘤样本中，19 例（61%）CXCR4 染色阳性；22 例鳞状细胞癌中有 15 例（68%）和 7 例 Paget 瘤中有 2 例（29%）为 CXCR4 阳性。浸润性癌与上皮内肿瘤之间的表达差异有统计学意义（P = 0.003）。与 FIGO 分期 I-II 期癌症相比，FIGO 分期 III-IV 期癌症更可能为 CXCR4 阳性（82%比 50%，P = 0.08）。在无病生存率方面，表达 CXCR4 的癌症的预后比 CXCR4 阴性癌症差（P = 0.013），但在疾病特异性生存率方面，CXCR4 阳性和阴性癌症之间的预后无显著差异（P = 0.111）。
预计超过一半的浸润性鳞状细胞外阴癌可能表达 CXCR4，CXCR4 表达与不良疾病预后相关。
