Hemoglobin level predicts outcome for vulvar cancer patients independent of GLUT-1 and CA-IX expression in tumor tissue.

Abstract

Intratumoral hypoxia has been associated with poor prognosis in several solid tumors. The aim of this study was to determine whether the hypoxia-associated markers glucose transporter (GLUT)-1 and carbonic anhydrase (CA)-IX expression and preoperative hemoglobin (Hb) levels correlate with presence of inguinofemoral or distant metastases, and disease-free survival (DSS) in vulvar squamous cell carcinoma (SCC) patients. Vulvar SCC (n=103) were reviewed for histopathological characteristics by an expert gynecopathologist and stained for GLUT-1 and CA-IX. Clinical data and preoperative Hb levels were obtained from medical records. No significant correlations were observed between GLUT-1 or CA-IX expression patterns and preoperative Hb levels, presence of inguinofemoral or distant metastases and DSS. However, anemic patients (Hb<11.2 g/dL) had significantly more inguinofemoral metastases and lower Hb level was an independent prognostic factor for a worse DSS (p<0.001). The number of comorbidic conditions was inversely correlated with preoperative Hb level. Preoperative Hb levels are associated with poor DSS for vulvar SCC patients, whereas tumor hypoxia reflected by GLUT-1 and CA-IX expression does not have a predictive value. Because preoperative Hb levels inversely correlated with the number of comorbidic conditions and not with GLUT-1 or CA-IX expression, it is most likely that preoperative Hb levels represent overall physical condition.

• Authors: Hedwig P van de Nieuwenhof, Joanne A de Hullu, Johannes H A M Kaanders, Johan Bulten, Leon F A G Massuger, Léon C L T van Kempen
• Journal: Virchows Archiv : an international journal of pathology (Virchows Arch) Vol. 457 Issue 6 Pg. 693-703 (Dec 2010) ISSN: 1432-2307 [Electronic] Germany
• PMID: 20890613 (Publication Type: Journal Article)

Chemical References

• Antigens, Neoplasm
• Biomarkers, Tumor
• Glucose Transporter Type 1
• Hemoglobins
• CA9 protein, human
• Carbonic Anhydrase IX
• Carbonic Anhydrases

Topics

• Adult
• Aged
• Aged, 80 and over
• Antigens, Neoplasm (metabolism)
• Biomarkers, Tumor (metabolism)
• Carbonic Anhydrase IX
• Carbonic Anhydrases (metabolism)
• Carcinoma, Squamous Cell (diagnosis, metabolism, pathology)
• Female
• Gene Expression Regulation, Neoplastic
• Glucose Transporter Type 1 (metabolism)
• Hemoglobins (metabolism)
• Humans
• Middle Aged
• Neoplasm Staging
• Predictive Value of Tests
• Prognosis
• Retrospective Studies
• Vulvar Neoplasms (diagnosis, metabolism, pathology)