KERATIN PATTERN OF NORMAL VULVA, VULVAL INTRAEPITHELIAL NEOPLASIA ANDVULVAL CARCINOMA

The presence of specific keratins can be of diagnostic value for study ing normal and neoplastic epithelium of the vulva. The aim of the pres ent study was to investigate normal, preneoplastic and neoplastic epit helium of the vulva. Keratins 5, 6 and 18, identified by a polyspecifi c anti-human CK antibody (clone LP 34, DAKO),and the keratin subtypes 7,10,14,18,19 and 20 of normal dysplastic and malignant vulval epithel ium (paraffin-embedded sections) were detected by immunohistochemical APAAP staining. Keratins 5,6 and 18(clone IP 34) and keratin subtype 1 0 are expressed in the upper third of the normal vulval epithelium. In mild and moderate intraepithelial neoplasia only a few cells express these keratins. In patients with severe intraepithelial neoplasia (VIN III) the expression of-these keratins seems to be associated with rec urrence of the disease. In biopsy specimens of patients without recurr ence we find positive results for keratins 5,6 and 18 (clone LP 34) an d keratin 10. If patients have a recurrence of the disease, expression of these keratins is only diffuse or is absent. The expression of the se keratin subtypes in vulval carcinoma is mostly seen in differentiat ed cells. There was no association between recurrence and keratin patt ern. We have not found any other expression of the tested keratin subt ypes in VIN and in vulval carcinoma.