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

van de Nieuwenhof, H. P., de Hullu, J. A., Kaanders, J. H. A. M., Bulten, J., Massuger, L. F. A. G. & van Kempen, L. C. L. T., Dec-2010, In : Virchows Archiv : an International Journal of Pathology. 457, 6, p. 693-703 11 p.

Research output: Contribution to journalArticleAcademicpeer-review

  • 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

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.

Original languageEnglish
Pages (from-to)693-703
Number of pages11
JournalVirchows Archiv : an International Journal of Pathology
Issue number6
Publication statusPublished - Dec-2010


  • Adult, Aged, Aged, 80 and over, Antigens, Neoplasm/metabolism, Biomarkers, Tumor/metabolism, Carbonic Anhydrase IX, Carbonic Anhydrases/metabolism, Carcinoma, Squamous Cell/diagnosis, 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

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