A microRNA signature to predict risk progression of vulvar lichen sclerosus to squamous cell carcinoma

DearEditor, Biomarkers useful for the identification of patients at risk of developing vulvar squamous cell carcinoma (VSCC) on a vulvar lichen sclerosus (VLS) background could lead to relevant prognostic advantages. To date, the development of such biomarkers is an unmet medical need. Among potential biomarker molecules, microRNAs (miRNAs) have been gaining attention. Involvement of miRNAs in vulvar carcinogenesis has been addressed with some evidence.1–6 We aimed to investigate whether miRNA expression could be useful to predict the progression from VLS to VSCC. This study, which was approved by the University-Hospital of Ferrara institutional review board (identification code 452/2021/Oss/AOUFe), included two different groups of formalin-fixed paraffin-embedded (FFPE) histologically proven VLS specimens: (i) 10 VLS samples that did not evolve towards carcinoma from patients with a mean clinical follow-up of 6 years, defined as VLS free from cancer (VLSfc); (ii) 13 samples including either VLS in which an invasive VSCC was histologically diagnosed in a subsequent biopsy, obtained after the first histological diagnosis of lichen sclerosus (n = 2, LIC19 and LIC20), or 11 VLS samples in which an invasive VSCC was diagnosed in the same surgical specimen. Both these sample types were defined as VLS cancer-associated (VLSca).