Expressão de p16, p53, GATA3 e CK17 nas neoplasias intraepiteliais vulvares
DOI:
https://doi.org/10.5327/2237-4574-154Palavras-chave:
vulva, lesões intraepiteliais escamosas, neoplasia intraepitelial vulvar, líquen escleroso vulvar, imunohistoquímicaResumo
Objetivo: Este estudo compara os padrões de expressão imunohistoquímica de p16, p53, CK17 e GATA3na lesão intraepitelial escamosa vulvar de alto grau (HSIL), na neoplasia intraepitelial vulvardiferenciada (dVIN) e no líquen escleroso (LS), a fim de identificar potenciais marcadores para o diagnóstico diferencial. Método: um total de 115 espécimes de biópsias vulvares (HSIL=81; dVIN=11; LS=23) foi revisado por um patologista ginecológico, e áreas representativas foram incluídas em microarranjos teciduais. A imunomarcação para p16, p53, CK17 e GATA3 foi avaliada de acordo com critérios padronizados baseados em padrões de expressão. Fragmentos sem epitélio de espessura completa ou sem controle interno foram excluídos das análises específicas de cada marcador. Resultados: a expressão do tipo block de p16 ocorreu em 91,1% dos casos de HSIL, mas não foi observada em nenhum caso de dVIN e esteve presente em apenas 10% dos casos de LS. Padrões aberrantes de p53 foram identificados em 30% dos casos de dVIN e em 2,7% dos casos de HSIL. A HSIL apresentou mais frequentemente expressão superficial ou focal de CK17, enquanto o LS demonstrou expressão difusa. A dVIN apresentou redução da expressão de GATA3 (padrão 2) em 81,8% dos casos, em comparação com 15% dos casos de HSIL. Conclusões: um painel combinado incluindo p16, p53, CK17 e GATA3 auxilia na distinção entre HSIL e dVIN, particularmente em casos com morfologia ambígua. Entretanto, a sobreposição dos padrões observados entre dVIN e LS limita sua utilidade para essa comparação. Estudos de validação utilizando cortes histológicos completos são necessários
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