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Assessment of Promising Protein Markers for Vulva Cancer
  1. Guus Fons, MD*,
  2. Matthé P. M. Burger, MD, PhD*,
  3. Fiebo J. W. Ten Kate, MD, PhD and
  4. Jacobus Van Der Velden, MD, PhD*
  1. *Department of Gynaecological Oncology and
  2. Department of Pathology, Academic Medical Centre, Amsterdam, the Netherlands.
  1. Address correspondence and reprint requests to Guus Fons, Department of Obstetrics and Gynaecology, Academic Medical Centre, Meibergdreef 9, 1100DD Amsterdam, the Netherlands. E-mail: g.fons{at}


Objectives: To validate the results of a previous study with the tissue microarray technology showing that cyclooxygenase 2 (COX-2) overexpression and absent caspase 3 expression are associated with poor disease-specific survival in univariate analysis.

Methods: The study group comprised 80 consecutive patients with vulva cancer treated in the period from 1999 to 2003 in a university hospital. A tissue microarray with 3 tumor tissue cores per patient was constructed and stained with antibodies against COX-2, caspase 3, epidermal growth factor receptor, p16INK4, cyclin D1, and Ki-67. The impact of the expression of these protein markers and selected clinicopathologic variables on disease-specific as well as disease-free survival was measured. Cox proportional hazard model was used for both univariate and multivariate analyses.

Results: In multivariate analysis, lymph node metastases and strong COX-2 expression were related to disease-free (hazard ratio [HR], 8.33, 95% confidence interval [CI], 2.97-23.36; P < 0.001; and HR, 6.42; 95% CI, 2.33-17.72; P < 0.001) and disease-specific survival (HR, 6.04; 95% CI, 2.12-17.19; P = 0.001; and HR, 5.11; 95% CI, 1.82-14.36; P = 0.002). In the present series, no association was found between caspase 3 expression and survival.

Conclusion: The prognostic significance of COX-2 overexpression was confirmed. In contrast, in the present series, no relation was found between caspase 3 expression and survival.

  • tissue microarray
  • vulva cancer
  • cyclooxygenase 2

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