Expression of Molecular Markers and Risk Categorization in Pre-neoplastic and Non-neoplastic Cervical Lesions

Abstract

Worldwide, cervical cancer is the fourth most common cancer in women [1]. It is preceded by many stages of pre-neoplastic lesions classified as Atypical squamous cells of undetermined significance (ASC-US) / Atypical squamous cells cannot exclude HSIL (ASC-H), Low-grade squamous intraepithelial lesion (LSIL), and High-grade squamous intraepithelial lesion (HSIL) (Bethesda, 2001). However, a large proportion of cases of epithelial malignancy arise from apparently normal cell and also from the LSIL where as many HSILs remain static for many years [2]. In this study, many important markers and epidemiological parameters Pap smears were examined to look for high risk cases of cervical non-malignant lesions. Methods: A total of 60 cases and controls were selected by colposcopic examination and smears were collected. Slides were used for immunohistochemical staining for four markers: p53, Ki-67, PCNA and CEA and PAP stain. All experimentally generated data were analyzed by Epi Info (TM) 3.5.3. Results: Expression of PCNA, p53, Ki-67 and CEA were significantly associated with both in Epithelial Cell Abnormalities (ECA) and Negative for Intraepithelial Lesion or Malignancy (NILM). Among HSIL, LSIL and ASCUS, HSIL was more common in Muslim women in comparison to Hindus. Whereas inflammatory lesions like RCC and RCCI were more common in Hindu population. Muslim women have a more normal Cytopathology smear than Hindus. Conclusions: Both the NILM and ECA cases carry risk for cancer conversion. Women with High grade Squamous Intraepithelial lesion or HSIL with PCNA, p53, Ki-67 and CEA strong positivity may have a higher risk of developing cervical cancer.