细胞角蛋白17和SOX2在外阴上皮内瘤变中的表达：150例外阴病变的综合分析
Expression of CK17 and SOX2 in Vulvar Intraepithelial Neoplasia: A Comprehensive Analysis of 150 Vulvar Lesions.
作者信息
Thuijs Nikki B, Voss Féline O, Ewing-Graham Patricia C, Dasgupta Shatavisha, Berkhof Johannes, Bulten Johan, van de Vijver Koen, Bleeker Maaike C G
机构信息
Department of Pathology, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
Cancer Center Amsterdam, Imaging and Biomarkers, 1081 HV Amsterdam, The Netherlands.
出版信息
Cancers (Basel). 2024 Nov 26;16(23):3966. doi: 10.3390/cancers16233966.
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, p16, 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.
背景
最近，免疫组化标志物细胞角蛋白17（CK17）和SRY盒2（SOX2）已被评估为高级别外阴上皮内瘤变（VIN）诊断的辅助手段。在本研究中，目的是通过研究150例最初报告为高级别VIN的外阴病变来评估CK17和SOX2在VIN中的表达，并评估诊断准确性。
方法
所有切片（苏木精-伊红染色、p16、p53、Ki-67、CK17和SOX2染色）由六位病理学家独立评估，并在共识会议上达成最终诊断，如下：46例人乳头瘤病毒（HPV）非依赖性VIN（包括30例p53突变型和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SIL（LSIL）、37例非发育异常病变以及5例组织学结果不确定的病变。
结果
在p53野生型HPV非依赖性VIN中观察到CK17阳性率为100%，相比之下，p53突变型HPV非依赖性VIN为73%，HSIL为14%，LSIL为0%，非发育异常病变为24%。在p53野生型HPV非依赖性VIN中观察到SOX2阳性率为13%，p53突变型HPV非依赖性VIN为43%，HSIL为2%，LSIL为0%，非发育异常病变为3%。联合p53和CK17免疫组化时，HPV非依赖性VIN的诊断准确性最高（89%）。添加SOX2并未进一步提高诊断准确性。
结论
总之，除了p53之外，CK17和SOX2对于准确诊断HPV非依赖性VIN均有价值。
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