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Evaluation of Elafin Immunohistochemical Expression as Marker of Cervical Cancer Severity
Adhemar Longatto-Filho1,2,3, José Humberto Fregnani4, Allini Mafra da Costa3,5
1Laboratory of Medical Investigation (LIM) 14, Department of Pathology, School of Medicine, University of São Paulo, São Paulo, São Paulo, Brazil.
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.
