Squamous cell carcinoma of the vulva. Expression of tumor proteases cathepsin-D and pro-cathepsin-L

OBJECTIVE: To analyze the expression of cathepsin (cath)-D and pro-cath-L in squamous cell carcinoma of the vulva and to determine whether those proteases have prognostic significance. STUDY DESIGN: Seventy-eight carcinomas were evaluated for tumor type, grade, inflammation and vascular space involvement. Formalin-fixed, paraffin-embedded tissue was stained for cath-D and pro-cath-L. Distribution, intensity and number of stained cells were examined and analyzed by the chi 2 test and receiver operator characteristic curves. RESULTS: Cath-D and pro-cath-L staining showed different distribution patterns. Cath-D expression at the tumor border was associated with development of recurrence (P = .018). Lymph node involvement was dependent on the staining patterns of cath-D and pro-cath-L. The number of pro-cath-L-positive cells correlated with the development of recurrence (P < .01). CONCLUSION: Protease expression of cath-D and pro-cath-L is localized in different tumor areas. The different staining patterns are associated with lymph node involvement and development of recurrence. The number of pro-cath-L-positive cells may be useful for predicting tumor recurrence.