Expression of the stem cell markers NANOG and SOX2 in the cervical squamous carcinogenesis Cover

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Expression of the stem cell markers NANOG and SOX2 in the cervical squamous carcinogenesis

Radiology and Oncology

Volume 59 (2025): Issue 2 (June 2025)

By: Miha Koren, Margareta Zlajpah, Mario Poljak, Kristina Fujs Komlos and Margareta Strojan Flezar

Open Access

|Apr 2025

Figures & Tables

Representative images of p16 (b, g, l, q, v), Ki-67 (c, h, m r, w), NANOG (d, i, n, s, x) and SOX2 (e, j, o, t, y) immunohistochemical staining in a control (a-e), low-grade squamous intraepithelial lesion (LSIL) (f-j), high-grade squamous intraepithelial lesion/cervical intraepithelial neoplasia grade 2 (HSIL/CIN 2) (k-o), high-grade squamous intraepithelial lesion/cervical intraepithelial neoplasia grade 3 (HSIL/CIN 3) (p-t) and cervical squamous cell carcinoma (CSCC) (u-y).
HE = haematoxylin and eosin stain — Representative images of p16 (b, g, l, q, v), Ki-67 (c, h, m r, w), NANOG (d, i, n, s, x) and SOX2 (e, j, o, t, y) immunohistochemical staining in a control (a-e), low-grade squamous intraepithelial lesion (LSIL) (f-j), high-grade squamous intraepithelial lesion/cervical intraepithelial neoplasia grade 2 (HSIL/CIN 2) (k-o), high-grade squamous intraepithelial lesion/cervical intraepithelial neoplasia grade 3 (HSIL/CIN 3) (p-t) and cervical squamous cell carcinoma (CSCC) (u-y). HE = haematoxylin and eosin stain

Comparison of NANOG and SOX2 staining between squamous lesions and their adjacent control non-dysplastic squamous epithelium

NANOG SIxP score, a ± SD		p-value¹	SOX2 SIxP score, a ± SD		p-value¹
C (LSIL)	LSIL		C (LSIL)	LSIL
2.30 ± 0.95	7.50 ± 2.46	0.000	3.00 ± 1.41	5.40 ± 2.63	0.054
C (HSIL/CIN 2)	HSIL/CIN 2		C (HSIL/CIN 2)	HSIL/CIN 2
3.30 ± 2.06	9.20 ± 3.79	0.002	2.20 ± 1.48	7.70 ± 2.75	0.000
C (HSIL/CIN 3)	HSIL/CIN 3		C (HSIL/CIN 3)	HSIL/CIN 3
2.00 ± 0.94	10.40 ± 2.07	0.000	2.30 ± 1.16	10.10 ± 3.84	0.002
C (CSCC)	CSCC		C (CSCC)	CSCC
1.44 ± 1,01	11.56 ± 1.33	0.000	2.44 ± 0,53	10.22 ± 2.73	0.000
C (HSIL)	HSIL		C (HSIL)	HSIL
2.65 ± 1.65	9.80 ± 2.96	0.000	2.25 ± 1.26	8.90 ± 3.39	0.000

Comparison of NANOG and SOX2 staining between squamous lesions

NANOG SIxP score, a ± SD		p-value¹	SOX2 SIxP score, a ± SD		p-value¹
LSIL	HSIL/CIN 2		LSIL	HSIL/CIN 2
7.50 ± 2.46	9.20 ± 3.79	0.101	5.40 ± 2.63	7.70 ± 2.75	0.114
HSIL/CIN 2	HSIL/CIN 3		HSIL/CIN 2	HSIL/CIN 3
9.20 ± 3.79	10.40 ± 2.07	0.547	7.70 ± 2.75	10.10 ± 3.84	0.031
HSIL/CIN 3	CSCC		HSIL/CIN 3	CSCC
10.40 ± 2.07	11.56 ± 1.33	0.165	10.10 ± 3.84	10.22 ± 2.73	0.805
LSIL	HSIL		LSIL	HSIL
7.50 ± 2.46	9.80 ± 2.96	0.018	5.40 ± 2.63	8.90 ± 3.39	0.009
HSIL	CSCC		HSIL	CSCC
9.80 ± 2.96	11.56 ± 1.33	0.078	8.90 ± 3.39	10.22 ± 2.73	0.370

Results of human papillomavirus (HPV) genotyping in squamous lesions

HPV type	HPV 16	HPV 18	HPV 31	HPV 39	HPV 51	HPV 52	HPV 53	HPV 56	HPV 58	HPV 59	HPV 68	HPV 66	HPV 70	HPV 42
LSIL, n	4	0	0	3	2	0	3	1	0	1	2	5	2	2
HSIL/CIN 2, n	4	1	1	0	1	2	0	1	2	0	0	1	0	0
HSIL/CIN 3, n	8	0	3	0	0	0	1	0	0	1	0	0	0	0
CSCC, n	6	2	2	0	3	0	0	0	0	0	0	0	1	0

Evaluation of SOX2 staining in controls and squamous lesions

	SOX2 SI, n (%)				SOX2 P, n (%)					SOX2 T, n (%)
Score	0	1	2	3	0	1	2	3	4	0	1	2	3
Controls (n = 40)	2 (5)	33 (82.5)	5 (12.5)	0 (0)	2 (5)	1 (2.5)	26 (65)	10 (25)	0 (0)	2 (5)	1 (2.5)	31 (77.5)	6 (15)
LSIL (n = 10)	0 (0)	4 (40)	6 (60)	0 (0)	0 (0)	0 (0)	2 (20)	4 (40)	4 (40)	0 (0)	0 (0)	4 (40)	6 (60)
HSIL/CIN 2 (n = 10)	0 (0)	1 (10)	7 (70)	2 (20)	0 (0)	0 (0)	0 (0)	4 (40)	6 (60)	0 (0)	0 (0)	1 (10)	9 (90)
HSIL/CIN 3 (n = 10)	0 (0)	1 (10)	1 (10)	8 (80)	1 (10)	0 (0)	0 (0)	1 (10)	8 (80)	0 (0)	0 (0)	0 (0)	10 (100)
CSCC (n = 10)	0 (0)	0 (0)	3 (30)	7 (70)	0 (0)	0 (0)	0 (0)	2 (20)	8 (80)	Not applicable¹

Evaluation of NANOG staining in controls and squamous lesions

	NANOG SI, n (%)				NANOG P, n (%)					NANOG T, n (%)
Score	0	1	2	3	0	1	2	3	4	0	1	2	3
Controls (n = 40)	3 (7.5)	32 (80)	5 (12.5)	0 (0)	3 (7.5)	6 (15)	22 (55)	8 (20)	1 (2.5)	3 (7.5)	4 (10)	28 (70)	5 (12.5)
LSIL (n = 10)	0 (0)	2 (20)	7 (70)	1 (10)	0 (0)	0 (0)	0 (0)	1 (10)	9 (90)	0 (0)	0 (0)	0 (0)	10 (100)
HSIL/CIN 2 (n = 10)	1 (10)	0 (0)	4 (40)	5 (50)	1 (10)	0 (0)	0 (0)	0 (0)	9 (90)	1 (0)	0 (0)	0 (0)	9 (90)
HSIL/CIN 3 (n = 10)	0 (0)	0 (0)	1 (10)	9 (90)	0 (0)	0 (0)	0 (0)	0 (0)	10 (10)	0 (0)	0 (0)	0 (0)	10 (100)
CSCC (n = 10)	0 (0)	0 (0)	1 (10)	9 (90)	0 (0)	0 (0)	0 (0)	0 (0)	10 (100)	Not applicable¹

DOI: https://doi.org/10.2478/raon-2025-0026 | Journal eISSN: 1581-3207 | Journal ISSN: 1318-2099

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Language: English

Page range: 213 - 224

Submitted on: Mar 5, 2025

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Accepted on: Mar 26, 2025

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Published on: Apr 24, 2025

Published by: Association of Radiology and Oncology

In partnership with: Paradigm Publishing Services

Publication frequency: 4 issues per year

Keywords:

cervical cancer,

cervical intraepithelial neoplasia,

squamous intraepithelial lesion,

cancer stem cell,

Related subjects:

Clinical medicine,

Internal medicine,

Haematology, oncology,

© 2025 Miha Koren, Margareta Zlajpah, Mario Poljak, Kristina Fujs Komlos, Margareta Strojan Flezar, published by Association of Radiology and Oncology
This work is licensed under the Creative Commons Attribution 4.0 License.

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