SOX-2 Expression in Cervical Squamous Intraepithelial Neoplasia and Invasive Squamous Cell Carcinoma: An Immunohistochemical Study
DOI:
https://doi.org/10.51168/mfy24h33Cuvinte cheie:
Cervical intraepithelial neoplasia, histoscore, immunohistochemistry, SOX-2, squamous cell carcinomaRezumat
Background: SOX-2 is a transcription factor that plays a key role in stem cell maintenance and pluripotency and has emerged as a potential marker of cancer stem cell activity in cervical carcinogenesis. However, its expression across the entire spectrum of cervical squamous intraepithelial lesions (SIL) and invasive squamous cell carcinoma (SCC) has not been fully characterised. This study evaluated the immunohistochemical (IHC) expression of SOX-2 in low-grade SIL (LSIL), high-grade SIL (HSIL), and invasive SCC of the uterine cervix and examined its association with histopathological grade and patient age.
Methodology: This hospital-based cross-sectional observational study was carried out in the Department of Pathology in collaboration with the Department of Obstetrics and Gynaecology, B.R.D. Medical College, Gorakhpur, over a one year period (2024–2025). A total of 150 histopathologically confirmed formalin-fixed paraffin-embedded cervical biopsy specimens underwent IHC staining using a monoclonal anti-SOX2 antibody (clone SOX2/1791). Nuclear immunoreactivity was evaluated using a semi-quantitative histoscore (H-score), with scores ranging from 5 to 12 considered positive. Statistical analysis was performed using SPSS version 25.0. Categorical variables were analysed using the Chi-square test or Fisher's exact test, as appropriate, and a p-value < 0.05 was considered statistically significant.
Results: SOX-2 positivity was observed in 115 of 150 cases (76.6%), increasing progressively from LSIL (16.7%) to HSIL (69.6%) and SCC (81.0%) (χ² = 26.91, p < 0.001). A significant association was also observed with advancing age (χ² = 27.28, p = 0.000017). No significant association was found between SOX-2 expression and tumour grade (p = 0.44) or histological subtype (p = 0.66) within SCC.
Conclusions: SOX-2 expression rises progressively with increasing severity of cervical squamous lesions, supporting its role as a biomarker of cervical carcinogenesis and a potential adjunct IHC marker for risk stratification of premalignant and malignant cervical lesions.
Referințe
1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2021;71:209-49. https://doi.org/10.3322/caac.21660
2. Ramamoorthy T, Kulothungan V, Sathishkumar K, Tomy N, Mohan R, Balan S, et al. Burden of cervical cancer in India: Estimates of years of life lost, years lived with disability and disability adjusted life years at national and subnational levels. Reprod Health 2024;21:111. https://doi.org/10.1186/s12978-024-01837-7
3. Longworth MS, Laimins LA. Pathogenesis of human papillomaviruses in differentiating epithelia. Microbiol Mol Biol Rev 2004;68:362-72. https://doi.org/10.1128/MMBR.68.2.362-372.2004
4. Moshi JM, Ummelen M, Broers JLV, Theys J, van Engeland M, Speel EJM, et al. SOX2 expression in the pathogenesis of premalignant lesions of the uterine cervix: Its histo-topographical distribution distinguishes between low- and high-grade CIN. Histochem Cell Biol 2022;158:545-59. https://doi.org/10.1007/s00418-022-02145-6
5. Hou T, Zhang W, Tong C, Zhang Y, Wang J, Chen X, et al. Putative stem cell markers in cervical squamous cell carcinoma are correlated with poor clinical outcome. BMC Cancer 2015;15:785. https://doi.org/10.1186/s12885-015-1826-4
6. Shen L, Huang X, Xie X, Su J, Yuan J, Chen X. High expression of SOX2 and OCT4 indicates radiation resistance and an independent negative prognosis in cervical squamous cell carcinoma. J Histochem Cytochem 2014;62:499-509. https://doi.org/10.1369/0022155414532654
7. Dayalan S, Raghavan V. Comparative evaluation of SOX2 and p16 expression in intraepithelial neoplasia and invasive cancer of cervix. J Clin Diagn Res 2021;15:EC01-5. https://doi.org/10.7860/JCDR/2021/50358.15426
8. Mondal AN, Mohapatra K, Choudhury S. Immunohistochemical expression of p16 and SOX2 in preneoplastic and neoplastic lesions of cervix. Int J Life Sci Pharma Res 2025;15:1-8. https://doi.org/10.25258/ijddt.16.5s.36
9. Ji J, Zheng PS. Expression of Sox2 in human cervical carcinogenesis. Hum Pathol 2010;41:1438-47. https://doi.org/10.1016/j.humpath.2009.11.021
10. Yang Z, Pan X, Gao A, Zhu W. Expression of Sox2 in cervical squamous cell carcinoma. J Clin Pathol 2014;67:726-9.
11. Yang Z, Pan X, Gao A, Zhu W. SOX2 expression in cervical squamous cell carcinoma and its clinical significance. Asian Pac J Cancer Prev 2015;16:7725-33.
12. Stewart C, Crook ML. SOX2 expression in cervical intraepithelial neoplasia grade 3 (CIN3) and superficially invasive (Stage IA1) squamous carcinoma of the cervix. Int J Gynecol Pathol 2016;35:1-7. https://doi.org/10.1097/PGP.0000000000000273
13. Romagosa C, Simonetti S, López-Vicente L, Mazo A, Lleonart ME, Castellvi J, et al. p16INK4a overexpression in cancer: A tumour suppressor gene associated with senescence and high-grade tumours. Oncogene 2011;30:2087-97. https://doi.org/10.1038/onc.2010.614
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Copyright (c) 2020 Dr. Priyamvada Maurya, Shaila Mitra, Sonal R. Goel, Ankita Kumari, Rajesh Kumar Rai
TAceastă lucrare este licențiată în temeiul Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
