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Sachan R, Shukla A, Maurya M, Patel M, Sankhwar P. ROC-analysis derived immunohistochemical P53 cut-off scores as an adjunct to routine histopathology for better diagnostic compartmentalisation of cervical lesions. Int J Appl Basic Med Res 2022; 12:177-184. [PMID: 36131854 PMCID: PMC9484512 DOI: 10.4103/ijabmr.ijabmr_416_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 03/29/2022] [Accepted: 06/01/2022] [Indexed: 12/24/2022] Open
Abstract
Objective The aim of this study was to evaluate the predictive value of Immunohistochemical p53 cut-off scores as an adjunct to routine histopathology for better diagnosis of cervical lesions. Materials and Methods Prospective study carried out for 1 year. After ethical approval and informed consent, a total of 100 cervical tissue samples were analyzed; chronic cervicitis (CC)-15, cervical intraepithelial neoplasia (CIN)-40, and squamous cell carcinoma cervix (SCC)-45 (FIGO 2018 clinical staging). After routine processing of tissue specimen, hematoxylin and eosin (HE) staining was done. Grading of cervical precancerous lesions (CIN) was done as per World Health Organisation criteria as CIN 1,2 or 3. Broder’s grading was assigned for every SCC sample. Results Mean p53 scores of CC, CIN, and SCC cases were 0.0, 1.70, and 4.38, respectively, CIN 1, 2, and 3 were 1.07, 1.63, and 2.22, respectively. SCC was differentiated from CIN3 with p53 ≥4.5 as predictor for SCC, sensitivity and specificity were 57.8% and 88.9%, respectively. Overall diagnostic accuracy of the proposed scoring system for differentiating CC, CIN, and SCC was 61%, while the accuracy of previous methods of interpreting p53 immunoreactivity as immunoscore >2 or arbitrary cut-off of >10% cells with nuclear positivity was only 48%. Conclusion ROC-derived immunoscore cut-offs can provide the much-needed objectivity and optimal decision thresholds to immunohistochemistry interpretation.
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Medeiros FS, Dos Santos Gomes FO, Paiva LA, da Silva NCH, da Silva MC, Rygaard MCV, Peixoto CA, Welkovic S, Menezes MLB, Cokan A, Diniz GTN, Donadi EA, Lucena-Silva N. Hierarchical evaluation of histology and p16-labeling can improve the risk assessment on cervical intraepithelial neoplasia progression. Exp Mol Pathol 2021; 124:104734. [PMID: 34914974 DOI: 10.1016/j.yexmp.2021.104734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 12/02/2021] [Accepted: 12/08/2021] [Indexed: 01/10/2023]
Abstract
OBJECTIVE High-grade cervical lesions (HSIL) are associated with the presence of high-risk HPV types, tissue expression of p16, and increased chance of malignant progression, requiring surgical intervention. To improve risk evaluation, we assessed the discriminatory power of the histological findings associated with p16 immunohistochemistry (IHC) staining to classify the low-grade cervical lesion (LSIL) and HSIL. METHODS We collected cervical biopsies from colposcopy-visible lesions and non-affected tissue (adjacent to the lesions) of 62 Brazilian women and labeled them with anti-p16 antibodies. In addition to the observational pattern and labeling to define the latent classes (affected vs. non-affected), a computational tool was used for semi-quantitative analysis of p16 expression. The intensity of staining of the nucleus or cytoplasm was captured using the Gimp 2.10 software. ROC curves were used to determine cutoff values for p16 expression in patients classified as LSIL and HSIL by latent class statistics for each labeling stratum. RESULTS p16 nuclear labeling showed the best sensitivity and specificity to discriminate LSIL with low p16 expression (62%) and HSIL with high p16 expression (37%). Many patients whose lesions had intermediate levels of p16 nuclear staining were subsequently stratified according to the expression of p16 in the cytoplasm, indicating that five of 21 LSIL were at risk of progression, and 13 of 41 HSIL at risk of regression. CONCLUSIONS We suggest a hierarchical analysis, with histology at the first level, followed by a labeling analysis in the nucleus and then in the cytoplasm to increase the accuracy of the HPV cervical lesion stratification.
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Affiliation(s)
- Fernanda Silva Medeiros
- Laboratory of Immunogenetics, Aggeu Magalhães Institute, Oswaldo Cruz Foundation, Recife, Brazil.
| | | | | | | | - Mauro César da Silva
- Laboratory of Immunogenetics, Aggeu Magalhães Institute, Oswaldo Cruz Foundation, Recife, Brazil
| | | | - Christina Alves Peixoto
- Laboratory of Ultrastructure, Aggeu Magalhães Institute, Oswaldo Cruz Foundation, Recife, Brazil.
| | - Stefan Welkovic
- Integrated Health Centre Amaury de Medeiros (CISAM), University of Pernambuco, Recife, Brazil
| | | | - Andrej Cokan
- Clinic for Gynecology and Perinatology, Department for Gynecologic and Breast Oncology, University Medical Centre Maribor, Slovenia.
| | - George Tadeu Nunes Diniz
- Laboratory Computational Methods, Aggeu Magalhães Institute, Oswaldo Cruz Foundation, Recife, Brazil.
| | - Eduardo Antônio Donadi
- Division of Clinical Immunology, Department of Medicine, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.
| | - Norma Lucena-Silva
- Laboratory of Immunogenetics, Aggeu Magalhães Institute, Oswaldo Cruz Foundation, Recife, Brazil.
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Nishio M, To Y, Maehama T, Aono Y, Otani J, Hikasa H, Kitagawa A, Mimori K, Sasaki T, Nishina H, Toyokuni S, Lydon JP, Nakao K, Wah Mak T, Kiyono T, Katabuchi H, Tashiro H, Suzuki A. Endogenous YAP1 activation drives immediate onset of cervical carcinoma in situ in mice. Cancer Sci 2020; 111:3576-3587. [PMID: 32716083 PMCID: PMC7541006 DOI: 10.1111/cas.14581] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 07/15/2020] [Accepted: 07/17/2020] [Indexed: 12/24/2022] Open
Abstract
Cervical cancer (CC) is usually initiated by infection with high‐risk types of human papillomavirus (HPV). The HPV E6 and E7 proteins target p53 and RB, respectively, but other cellular targets likely exist. We generated uterus‐specific MOB1A/B double KO (uMob1DKO) mice, which immediately developed cervical squamous cell carcinoma in situ. Mutant cervical epithelial cells showed YAP1‐dependent hyperproliferation, altered self‐renewal, impaired contact inhibition, and chromosomal instability. p53 activation was increased in uMob1DKO cells, and additional p53 loss in uMob1DKO mice accelerated tumor invasion. In human CC, strong YAP1 activation was observed from the precancerous stage. Human cells overexpressing HPV16 E6/E7 showed inactivation of not only p53 and RB but also PTPN14, boosting YAP1 activation. Estrogen, cigarette smoke condensate, and PI3K hyperactivation all increased YAP1 activity in human cervical epithelial cells, and PTPN14 depletion along with PI3K activation or estrogen treatment further enhanced YAP1. Thus, immediate CC onset may initiate when YAP1 activity exceeds an oncogenic threshold, making Hippo‐YAP1 signaling a major CC driver.
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Affiliation(s)
- Miki Nishio
- Division of Molecular and Cellular Biology, Kobe University Graduate School of Medicine, Kobe, Japan.,Division of Cancer Genetics, MIB, Kyushu University, Fukuoka, Japan
| | - Yoko To
- Division of Cancer Genetics, MIB, Kyushu University, Fukuoka, Japan.,Department of Obstetrics and Gynecology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Tomohiko Maehama
- Division of Molecular and Cellular Biology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yukari Aono
- Division of Molecular and Cellular Biology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Junji Otani
- Division of Molecular and Cellular Biology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hiroki Hikasa
- Department of Biochemistry, School of Medicine, University of Occupational and Environmental Health, Kita-kyushu, Japan
| | - Akihiro Kitagawa
- Department of Gastroenterological Surgery, Medical School and Graduate School of Frontier Biosciences, Osaka University, Suita, Japan
| | - Koshi Mimori
- Department of Surgery, Kyushu University Beppu Hospital, Beppu, Japan
| | - Takehiko Sasaki
- Department of Biochemical Pathophysiology, MRI, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hiroshi Nishina
- Department of Developmental and Regenerative Biology, MRI, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shinya Toyokuni
- Department of Pathology and Biological Responses, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - John P Lydon
- Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX, USA
| | - Kazuwa Nakao
- MIC, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tak Wah Mak
- The Princess Margaret Cancer Centre, UHN, Toronto, ON, Canada.,Department of Medical Biophysics, Toronto University, Toronto, ON, Canada
| | - Tohru Kiyono
- Division of Carcinogenesis and Cancer Prevention, National Cancer Center Research Institute, Tokyo, Japan
| | - Hidetaka Katabuchi
- Department of Obstetrics and Gynecology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Hironori Tashiro
- Department of Women's Health Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Akira Suzuki
- Division of Molecular and Cellular Biology, Kobe University Graduate School of Medicine, Kobe, Japan.,Division of Cancer Genetics, MIB, Kyushu University, Fukuoka, Japan
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