Using Southern Blot hybridization 18 invasive malignant tumours of the vulva and 2 intraepithelial vulvar neoplasias were tested for the prevalence of HPV-DNA. In 6 of 11 primary squamous carcinomas, including one carcinoma of the Bartholinic gland, HPV 16 could be identified. Contrarily, in all seven recurrent vulvar tumours examined, including 5 squamous carcinomas, 1 fibrosarcoma and 1 zylindroma, no HPV-DNA was found. No correlation existed between HPV status of the tumours and grade of differentiation or keratinization, or the tumour-stage and lymph-node status. In one tumour-invaded lymph-node HPV 16 was detected as in the corresponding primary tumour. 12 samples from tumour free abdominal skin considered as corresponding normal tissue specimens were negative for HPV-DNA. A correlation between clinical course of the disease and HPV status of the primary tumours was not observed.
Monoclonal antibodies to the extracellular domain of the EGF-receptor were used for immunohistochemical staining. Nine of 10 squamous cell carcinomas of the cervix, vagina, and vulva showed strong staining for EGF-receptors. Of 12 endometrial carcinomas and 19 ovarian tumors approximately 50% revealed moderate staining. Cells with immunohistochemically identifiable EGF-receptors and those without coexist in EGF-receptor positive tumors. The percentage of positive cells in endometrial carcinomas was higher than in ovarian carcinomas, 80% and 25%, respectively. There was good correlation between the immunohistochemical detection of EGF-receptors and the amount of EGF-receptors quantitated by biochemical methods, although immunohistochemistry appeared to be somewhat less sensitive (especially in breast carcinomas).
The TA-4 antigen obtained from squamous cell carcinoma of the uterine cervix has a subunit, the SCC antigen, which can be measured in serum with a polyclonal antibody in a radioimmunoassay. SCC values less than or equal to 1.5 ng/ml were found in 96% of 48 clinically healthy women. This concentration was then set as the cut off value. Of the 122 patients with untreated squamous cell carcinoma of the cervix, 76% had SCC concentrations above 1.5 ng/ml. The CEA was raised in 50% of the cases. In stages III and IV, 89% of the SCC values was raised and 65% of the CEA. Among the 50 patients with recurrent or progressive cervical carcinoma elevated levels of SCC were found in 78% and raised CEA concentrations in 52%. Only in 25% of the cases were both tumour markers raised at the same time. Complete remission was clinically established in 48 patients with cervical carcinoma who had had increased SCC values prior to therapy. The SCC values were in the normal range in 71% of the patients, the CEA values were normal in 81%. The increase in SCC concentration often preceded the tumour recurrence by months. Up to 70% of the patients with vaginal or vulvar carcinoma had elevated SCC levels. SCC proved to be a valuable tumour marker for the follow up of cervical, vaginal, and vulvar cancer.
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