Expression of epithelial–mesenchymal transition markers in squamous cell carcinoma of the uterine cervix: A cross-sectional study

Abstract

Background: Cervical cancer is the fourth most common cancer in women worldwide. Epithelial– mesenchymal transition (EMT) is a phenomenon related to carcinogenesis, which is characterized by morphological changes from neoplastic epithelial cells to mesenchymal cells, resulting in increased motility and invasiveness of neoplastic cells. To observe the expression of three EMT markers (cytokeratin 19 [CK1]), vimentin, and Ras homolog gene family member C [RhoC]) in individuals with a normal cervix, patients with high-grade squamous intraepithelial lesion (HSIL), and patients with squamous cell carcinoma (SCC) and determine the association with the histological grade and clinical/radiological stage of cervical cancer.

Methods: Seventy participants were included in the study: 10 individuals with a normal cervix, 30 patients with HSIL, and 30 patients with newly diagnosed SCC. Immunohistochemistry for CK19, vimentin, and RhoC was performed in all groups. The association of the expressions of the three markers between the groups was analyzed. P values of < 0.005 were considered statistically significant.

Results: The mean age of the normal cervix, HSIL, and SCC groups was 46.2 ± 16.12, 49.10 ± 10.13, and 56.27 ± 9.29 years, respectively. CK19 showed a weak basal cell positivity in 80% of the individuals with a normal cervix. Meanwhile, 93.3% and 100% of the patients with HSIL and SCC, respectively, were positive for CK19; the association of the expressions between the groups was insignificant. Vimentin was negative in the normal cervix group and positive in the HSIL (33.3%) and SCC (73.3%) groups; the association of the expressions between the groups was significant. RhoC was positive in the normal cervix, HSIL, and SCC groups (10%, 20%, and 83.33%, respectively), and the association of the expressions between them was significant. There was no significant association found between the expression of vimentin or RhoC and the histopathological grade or FIGO stage.

Conclusion: An increased expression of CK19 in patients with HSIL and SCC of the cervix highlights the role of basal cells in cervical carcinogenesis. The expression of vimentin and RhoC in individuals with a normal cervix and patients with HSIL and SCC indicates EMT.