Abstract
BackgroundThe aim of this study was to determine how Stathmin-1 and Heat Shock Protein 27 (HSP27) can be used as adjunctive biomarkers to differentiate high-grade dysplasia from benign/reactive lesions in cervical tissues. In addition, we aimed to see if any of these markers can differentiate endometrial from endocervical adenocarcinomas.MethodsFifty cases including benign cervical tissue, low-grade squamous intraepithelial lesion (LSIL), high-grade squamous intraepithelial lesion (HSIL), adenocarcinoma in situ of the endocervix, invasive endocervical adenocarcinoma, and endometrial adenocarcinoma were selected. Stathmin-1 and HSP27 immunohistochemistry (IHC) were performed for each case and the results were compared to the previously available p16 IHC stains.Resultsp16 stained positively in 100% of HSIL, endocervical adenocarcinoma in situ, and invasive endocervical cases. Stathmin-1 stained positively in 43% of HSIL and 90% of endocervical adenocarcinoma in situ and all invasive endocervical cases. Stathmin-1 and p16 were negative in all benign cervical samples. Stathmin-1, HSP27, and p16 stained 100% of LSIL cases. HSP27 stained indiscriminately, including 100% of benign cervical tissue. 87% of the endometrial adenocarcinomas stained positively for p16, Stathmin-1, and HSP27.Conclusionp16 remains superior to both Stathmin-1 and HSP27 in differentiating dysplasia from benign, reactive changes of the cervix.
Highlights
The aim of this study was to determine how Stathmin-1 and Heat Shock Protein 27 (HSP27) can be used as adjunctive biomarkers to differentiate high-grade dysplasia from benign/reactive lesions in cervical tissues
We investigated Stathmin-1and HSP27in comparison to p16 expression in benign cervix, low-grade squamous intraepithelial lesion (LSIL), High-grade squamous intraepithelial lesion (HSIL), adenocarcinoma in situ (AIS), usual type invasive adenocarcinoma of the cervix, and endometrial endometrioid adenocarcinoma
In most of the cases the diagnosis of such lesions is feasible by morphology alone, there are situations where biomarkers are needed for distinction between benign and dysplastic entities. p16 IHC has been the most reliable surrogate marker in high-grade dysplasia and is broadly used along with Ki67 to differentiate benign mucosa and LSIL from HSIL; it can stain some benign or non-human papillomavirus (HPV) related neoplasia
Summary
The aim of this study was to determine how Stathmin-1 and Heat Shock Protein 27 (HSP27) can be used as adjunctive biomarkers to differentiate high-grade dysplasia from benign/reactive lesions in cervical tissues. The most important ancillary studies when assessing for cervical dysplasia are p16 and Ki67 immunohistochemistry (IHC) stains, as well as in situ hybridization for human papillomavirus (HPV) RNA [2,3,4]. Prior studies have proposed Stathmin and Heat Shock Protein 27 (HSP27) as adjunct biomarkers which can help differentiate high-grade dysplasia from low-grade dysplasia and benign/reactive cervical tissue [1, 11,12,13]. High-grade squamous intraepithelial lesion (HSIL), Liou et al Diagnostic Pathology (2021) 16:85 low-grade squamous intraepithelial lesion (LSIL), endocervical adenocarcinoma in situ (AIS) and usual type invasive endocervical adenocarcinoma are human papillomavirus (HPV)-driven lesions; HPV RNA in-situ hybridization is an important ancillary test to support these diagnoses [22]
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