Similarly, two other studies found an increase in nuclear survivin immuno-expression from normal epithelium and lichen sclerosus to high grade classic vulvar intraepithelial neoplasia, differentiated vulvar intraepithelial neoplasia and invasive keratinizing squamous cell carcinoma (p = 0.0001), suggesting its diagnostic and prognostic potential in VSCC (30, 97). This evidence concerns the gene BIRC5 and squamous cell carcinoma.