| BackgroundVulvar intraepithelial neoplasia(VIN)is the precancerous lesions of vulvar cancer which has been verified by many studies of the world. Vulvar squamous-cells carcinoma is the most common cancer of vulva.In recent years,the incidence of VIN and vulvar cancer is higher,and the patients are younger than before.The main treatment of vulva cancer is still radical operation at present,and it brings so many serious complications and makes the quality of life of the patients lower.For reducing the complications,now we are trying to decrease the area of the surgery,so we can reduce the pain of the patients at maximum and improve the quality of their lives. It is very important for the clinical theatment that we can find and diagnose early vulvar cancer.Therefore finding an biomarker to detect and diagnose the early vulvar cancer is the urgent thing for all the doctors.Tumor-testis antigen is high specificity, which merely expresses in the tissue of normal testis and expresses in many different tumour tissue,so it may be concerned with the development and immunogenicity of tumor. Sperm associated antigen 9(SPAG9)is the newest founded member of the tumor-testis antigen family,it specially expresses in the mormal tissue of testisconvolutedtubule,and is not exists in other normal tissue.Many studies demonstrate that SPAG9 exists in tissue of various tumores,and has obvious humoral immunity reaction.ObjectiveTo investigate the expression of sperm associated antigen-9(SPAG9) in the tissue of vulvar intraepithelial neoplasia and vulvar squamous cell carcinoma and its potential clinical effect.MethodsThe tissue obtained from 16 patients with VIN and 41 patients with vulvar squamous cell carcinoma who took surgery in department of obstetric and gynecologic of provincial Hospital Affiliated to Shangdong University from January 2000 to October 2010.Immunohistochemistry staining were used to detect the expression of SPAG9 on the protein level,the control group include 10 normal tissue of vulva.The results were analyzed by the immunohistochemistry H-score.Results 1.SPAG9 is expressed in the cytoplasm of the atypical hyperplasia squamous epithelium cells and the tumour cells of the Vulvar squamous cells carcinoma.The rate of expressions of SPAG9 in the tissue of lesions of vulva is 100%,but in the normal tissue is 0.2. The expression of SPAG9 in VIN and vulvar squamous cell carcinomaThe H-score of the tissue of vulvar squamous cell carcinoma patients (41) are significantly higher than that of VIN(16) (P<0.05).3. The expression of SPAG9 in vulvar squamous cell carcinoma of different stagesAccording to the FIGO 2000 clinical stage,we compared the expression of SPAG9 in vulvar squamous cell carcinoma of different stages.The H-score of the tissue of stageⅡ-Ⅲ(25) of vulvar squamous cell carcinoma are higher than that of stageⅠ(16),but the difference is not significant (P>0.05).4. The expression of SPAG9 in vulvar squamous cell carcinoma of different gradesAccording to the levels of differentiation of the tumour cells,we compared the expression of SPAG9 in vulvar squamous cell carcinoma of different grades.The H-score of the tissue of G2-3(22) of vulvar squamous cell carcinoma are significantly higher than that of Gl(19) (P<0.05).5. The expression of SPAG9 in vulvar squamous cell carcinoma with or without lymph node metastasisAccording to the condition of lymph node metastasis which were verified by the pathology,we compared the expression of SPAG9 in vulvar squamous cell carcinoma with or without lymph node metastasis. The H-score of the tissue with lymph node metastasis of vulvar squamous cell carcinoma(12) are significantly higher than that of without lymph node metastasis (29) (P<0.05).ConclusionsThe status of the expression of SPAG9 in the tissue of VIN and vulvar squamous cell carcinoma suggests it maybe have an important effect on the genesis and progression of vulvar squamous carcinoma. SPAG9 has the possibility to become the biological marker for the early discovery,early diagnosis and prognosis estimation of vulvar squamous cell carcinoma. |
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