Expression of p16, p53, GATA3 and CK17 in vulvar intraepithelial neoplasia
DOI:
https://doi.org/10.5327/2237-4574-154Keywords:
vulva, squamous intraepithelial lesions, vulvar intraepithelial neoplasia, vulvar lichen sclerosus, immunohistochemistryAbstract
Objective: This study compares the immunohistochemical expression patterns of p16, p53, CK17, and GATA3 in vulvar high-grade squamous intraepithelial lesion (HSIL), differentiated vulvar intraepithelial neoplasia (dVIN), and lichen sclerosus (LS) to identify potential markers for differential diagnosis. Methods: A total of 115 vulvar biopsy specimens (HSIL=81; dVIN=11; LS=23) were reviewed by a gynecologic pathologist, and representative cores were included in tissue microarrays. Immunohistochemical staining for p16, p53, CK17, and GATA3 was assessed according to standardized pattern-based criteria. Cores lacking full-thickness epidermis or internal control were excluded from marker-specific analyses. Results: Block-type p16 expression occurred in 91.1% of HSILs, but in none of the dVINs and in 10% of LS cases. Aberrant p53 patterns were present in 30% of dVINs and 2.7% of HSILs. HSIL most frequently exhibited superficial or focal CK17 staining, whereas LS showed diffuse expression. The dVIN demonstrated GATA3 reduction (pattern 2) in 81.8% of cases compared with 15% of HSILs. Conclusions: A combined panel including p16, p53, CK17, and GATA3 aids in distinguishing HSIL from dVIN, particularly when morphology is ambiguous. However, the overlap of observed patterns between dVIN and LS limits their utility for this comparison. Validation in whole-section studies is warranted.
Keywords: vulva; squamous intraepithelial lesions; vulvar intraepithelial neoplasia; vulvar lichen sclerosus; immunohistochemistry.
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