文章：

外阴上皮内瘤变中CK17与SOX2的表达研究：基于150例外阴病变组织的综合分析

Expression of CK17 and SOX2 in Vulvar Intraepithelial Neoplasia: A Comprehensive Analysis of 150 Vulvar Lesions

原文发布日期：26 November 2024

DOI: 10.3390/cancers16233966

类型: Article

开放获取: 是

英文摘要：

Background: Recently, the immunohistochemical markers cytokeratin 17 (CK17) and SRY-box2 (SOX2) have been evaluated as adjuncts for the diagnosis of high-grade vulvar intraepithelial neoplasia (VIN). In the present study, the aim was to assess CK17 and SOX2 expression in VIN by studying 150 vulvar lesions, originally reported as high-grade VIN and to assess the diagnostic accuracy. Methods: All slides (H&E, p16INK4a, p53, Ki-67, CK17, and SOX2 stains) were independently assessed by six pathologists and the final diagnosis was reached in consensus meetings, as follows: 46 human papillomavirus (HPV)-independent VIN (including 30 p53 mutant and 16 p53 wild-type lesions), 58 high-grade squamous intraepithelial lesions (HSILs), 4 low-grade SILs (LSILs), 37 non-dysplastic lesions, and 5 lesions where the histology was inconclusive. Results: CK17 positivity was observed in 100% p53 wild-type HPV-independent VIN, compared to 73% p53 mutant HPV-independent VIN, 14% HSILs, 0% LSILs, and 24% non-dysplastic lesions. SOX2 positivity was observed in 13% p53 wild-type HPV-independent VIN, 43% p53 mutant HPV-independent VIN, 2% HSILs, 0% LSILs, and 3% non-dysplastic lesions. The highest diagnostic accuracy (89%) for HPV-independent VIN was obtained when combining p53 and CK17 immunohistochemistry. The addition of SOX2 did not further increase diagnostic accuracy. Conclusion: To conclude, aside from p53, both CK17 and SOX2 can be of value for reaching an accurate diagnosis of HPV-independent VIN.

摘要翻译： 

背景：近期，细胞角蛋白17（CK17）和SRY盒转录因子2（SOX2）作为辅助诊断高级别外阴上皮内瘤变（VIN）的免疫组化标志物受到关注。本研究旨在通过分析150例最初诊断为高级别VIN的外阴病变标本，评估CK17与SOX2在VIN中的表达情况及其诊断效能。方法：由六名病理医师独立审阅所有切片（包括H&E、p16INK4a、p53、Ki-67、CK17及SOX2染色），经共识会议达成最终诊断：46例人乳头瘤病毒（HPV）非依赖性VIN（含30例p53突变型与16例p53野生型病变）、58例高级别鳞状上皮内病变（HSIL）、4例低级别鳞状上皮内病变（LSIL）、37例非异型增生性病变及5例组织学无法明确诊断的病变。结果：CK17阳性率在p53野生型HPV非依赖性VIN中达100%，而在p53突变型HPV非依赖性VIN中为73%，HSIL中为14%，LSIL中为0%，非异型增生性病变中为24%。SOX2阳性率在p53野生型HPV非依赖性VIN中为13%，p53突变型HPV非依赖性VIN中为43%，HSIL中为2%，LSIL中为0%，非异型增生性病变中为3%。联合p53与CK17免疫组化检测对HPV非依赖性VIN的诊断准确率最高（达89%），加入SOX2检测未能进一步提升诊断准确率。结论：除p53外，CK17与SOX2对HPV非依赖性VIN的精准诊断均具有重要价值。

原文链接：

Expression of CK17 and SOX2 in Vulvar Intraepithelial Neoplasia: A Comprehensive Analysis of 150 Vulvar Lesions