Lymphoid elements and apoptosis-related proteins (Fas, Fas ligand, p53 andbcl-2) in lichen sclerosus and carcinoma of the vulva

We studied some of the morphological and immunohistochemical parameters of lichen sclerosus (LS) and carcinomas of the vulva in order to verify some c haracteristics in LS related to neoplasm transformation. Parameters such as proliferating index, rate of proliferation of lymphoid elements into a tum or and types of such elements were studied. In parallel, the number of cell s positive to apoptosis-related proteins such as Fas, Fas ligand, p53 and b cl-2 were evaluated. Biopsy material from patients with different vulvar di sorders - 22 samples with LS and 23 samples with vulvar squamous cell carci noma (VSCC)- was studied by the methods of morphometry and immunohistochemi stry. In LS, the number of T cells is a few times higher than those of B ce lls. Among the T cells, the number of killers is significantly higher than the number of helpers. Carcinomas, especially those with lymphoid depletion , are characterized by a further significant increase in some parameters su ch as the rate of lymphoid proliferation and the number of T helpers and ki llers. The progression in to tumorigenesis was accompanied with a significa nt increase in the number of Fas(+) and FasL(+) lymphocytes. In tumor epith elial cells the proliferative index increased in carcinomas with lymphoid d epletion. The number of p53(+) epithelial cells increased whereas the numbe r of bcl-2(+) cells showed a distinct tendency to decrease with progression in to tumorigenesis. Development of a tumor is manifested in deep changes in relationships between different lymphoid components. Only two lymphoid m arkers are significantly different in VSCC compared to LS: the number of T killers and macrophages. The other parameters studied (rate of proliferativ e activity, the total number of T cells and T helpers, B cells, IL-2-connec tive cells) already showed high expression in LS as the first signs of tran sformation of this inflammation into neoplasia.