Immunohistochemical markers for epithelial-mesenchymal transition (EMT) – correlation to molecular subtype in vulvar cancer

Background: Epithelial-mesenchymal transition (EMT) is associated with increased metastatic spread. Data on vulvar carcinoma are limited. Some of the most validated markers to identify cells undergoing EMT are vimentin, e-cadherin and cyclin D1.

Methods: Thirty-two squamous cell carcinoma of the vulva were evaluated for immunohistochemical expression of EMT-markers (vimentin, cyclin D1, e-cadherin) using immunoreactive score (IRS). Overall staining scores were compared to the molecular subtypes of vulval carcinoma, defining p16+ve/p53wt and p16-ve/p53mut VCX.

Results: Staining for vimentin and cyclin D1 was seen within tumor cells at the front of invasion in 100% and 84.4% of the tumors, respectively. The majority of cases (68.7%) showed negative or reduced staining for e-cadherin. p16-ve/p53mut represented higher expression of the EMT markers vimentin (4.5 versus 0; p=0.03) and cyclin D1 (7 versus 5; p=0.87) without differences in e-cadherin (6 versus 3; p=1.0) when compared to p16+ve/p53wt VCX.

Conclusion: The present study indicates an EMT-phenotype in p16-ve/p53mut VCX which may represent one driver for the prognostic poor outcome in that molecular type of VCX.

Publication History

Article published online:
11 June 2025