Evaluation of Elafin Immunohistochemical Expression as Marker of Cervical Cancer Severity

• Published in: Acta cytologica Vol. 65; no. 2; pp. 165 - 174
• Main Authors: Longatto-Filho, Adhemar, Fregnani, José Humberto, Mafra da Costa, Allini, de Araujo-Souza, Patricia Savio, Scapulatempo-Neto, Cristovam, Herbster, Suellen, Boccardo, Enrique, Termini, Lara
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland 01-03-2021
• Subjects: Biomarkers, Tumor - analysis; Biomarkers, Tumor - genetics; Carcinoma - chemistry; Carcinoma - genetics; Carcinoma - pathology; Databases, Genetic; Elafin - analysis; Elafin - genetics; Female; Gynecologic Cytopathology; Humans; Immunohistochemistry; Neoplasm Grading; Neoplasm Staging; Predictive Value of Tests; Retrospective Studies; Severity of Illness Index; Up-Regulation; Uterine Cervical Neoplasms - chemistry; Uterine Cervical Neoplasms - genetics; Uterine Cervical Neoplasms - pathology; HPV-induced cancer; Tumorigenesis; Cervical carcinoma; Elafin
• ISSN: 0001-5547; 1938-2650
• DOI: 10.1159/000512010

Introduction: The main risk factor for the development of cervical cancer (CC) is persistent infection by human papillomavirus (HPV) oncogenic types. In order to persist, HPV exhibits a plethora of immune evasion mechanisms. PI3/Elafin (Peptidase Inhibitor 3) is an endogenous serine protease inhibitor involved in epithelial protection against pathogens. PI3/Elafin’s role in CC is still poorly understood. Materials and Methods: In the present study, we addressed PI3/Elafin protein detection in 123 CC samples by immunohistochemistry and mRNA expression in several datasets available at Gene Expression Omnibus and The Cancer Genome Atlas platforms. Results: We observed that PI3/Elafin is consistently downregulated in CC samples when compared to normal tissue. Most of PI3/Elafin-positive samples exhibited this protein at the plasma membrane. Besides, high PI3/Elafin expression at the cellular membrane was more frequent in in situ stages I + II than in invasive cervical tumor stages III + IV. This indicates that PI3/Elafin expression is gradually lost during the CC progression. Of note, advanced stages of CC were more frequently associated with a more intense PI3/Elafin reaction in the nuclei and cytoplasm. Conclusion: Our results suggest that PI3/Elafin levels and subcellular localization may be used as a biomarker for CC severity.