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Tissue microarray validation in cervical carcinoma studies: A methodological approach
Örebro University, School of Medical Sciences. Maputo Central Hospital, Maputo, Mozambique; Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique.ORCID iD: 0000-0002-0218-6190
Maputo Central Hospital, Maputo, Mozambique; Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique.
Örebro University, School of Health Sciences.ORCID iD: 0000-0002-4669-1367
2025 (English)In: Histology and Histopathology, ISSN 0213-3911, E-ISSN 1699-5848, Vol. 40, no 3, p. 317-325Article in journal (Refereed) Published
Abstract [en]

Tissue microarrays (TMAs) are a cost-effective tool to study biomarkers in clinical research. Cervical cancer (CC) is one of the most prevalent in women worldwide, with the highest prevalence in low-middle-income countries due to a lack of organized screening. CC is associated with persistent high-risk human papillomavirus infection. Several biomarkers have been studied for diagnostic, therapeutic, and prognostic purposes. We aimed to evaluate and validate the effectiveness of TMA in CC compared to whole slide images (WSs). We selected and anonymized twenty cases of CC. P16, cytokeratin 5 (CK5), cytokeratin 7 (CK7), programmed death-ligand 1 (PD-L1), and CD8 expression were immunohistochemically investigated. All WS were scanned and 10 representative virtual TMA cores with 0.6 mm diameter per sample were selected. Ten random combinations of 1-5 cylinders per case were assessed for each biomarker. The agreement of scoring between TMA and WS was evaluated by kappa statistics. We found that three cores of 0.6 mm on TMA can accurately represent WS in our setting. The Kappa value between TMA and WS varied from 1 for p16 to 0.61 for PD-L1. Our study presents an approach to address TMA sampling that could be generalized to TMA-based research, regardless of the tissue and biomarkers of interest.

Place, publisher, year, edition, pages
University of Murcia, Murcia, Spain , 2025. Vol. 40, no 3, p. 317-325
Keywords [en]
Cervical cancer, Tissue microarray, Immunohistochemistry, Heterogeneity, Validation
National Category
Cancer and Oncology
Identifiers
URN: urn:nbn:se:oru:diva-115391DOI: 10.14670/HH-18-796ISI: 001445948600005PubMedID: 39086316Scopus ID: 2-s2.0-85219494809OAI: oai:DiVA.org:oru-115391DiVA, id: diva2:1889509
Available from: 2024-08-15 Created: 2024-08-15 Last updated: 2025-03-27Bibliographically approved
In thesis
1. Human papillomavirus in cervical carcinoma in an HIV endemic milieu, Moçambique
Open this publication in new window or tab >>Human papillomavirus in cervical carcinoma in an HIV endemic milieu, Moçambique
2024 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Cervical cancer (CC) is the fourth most frequent cancer and cause of death related to cancer in women worldwide. CC is mainly caused by a persistent infection with human papillomaviruses (HPV). Mozambique is one of the African countries with high prevalence of HPV and HIV. The development of CC may be different in HIV immuno-compromised patients. In this thesis we investigated both the pathogenetic perspective of HPV, and the expression of immunotherapeutic target concerning the possible impacts in an HIV endemic milieu. In paper I, virtual tissue microarrays (TMA) were used to validate the representativity to study biomarkers in CC compared to whole slide images. Our study presents an approach to address TMA sampling that could be generalized to TMA-based research. In paper II, the immunoregulatory programmed deathligand 1 (PD-L1) was immunohistochemically assessed in cervical squamous carcinomas (SCC) in TMA. 575 cases of SCC were included, HIV status was available in 46% cases. Our findings indicated that the immunotherapeutic target of PD-L1 is not influenced by HIV status. In paper III, 40 cases of endocervical adenocarcinomas (ECA) were included. HIV status was established, and HPV was detected in all cases. In paper IV, 260 cases of SCC with known HIV status, were assessed concerning HPV genotype differences between HIV positive and negative cases. With a combination of HPV detection methods, almost all cases of our series were HPV positive. Our results in paper III and IV indicate that the newly established vaccination scheme in Mozambique, using quadrivalent vaccine would have the same potential to prevent morbidity and reduce mortality of CC regardless of a concomitant HIV infection or not.

Place, publisher, year, edition, pages
Örebro: Örebro University, 2024. p. 79
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 300
Keywords
Cervical cancer, HPV, HIV, Tissue microarray, vaccine, PD-L1
National Category
Other Basic Medicine
Identifiers
urn:nbn:se:oru:diva-116081 (URN)9789175295862 (ISBN)9789175295879 (ISBN)
Public defence
2024-11-19, Örebro universitet, Campus USÖ, hörsal X1, Södra Grev Rosengatan 32, Örebro, 09:00 (English)
Opponent
Supervisors
Available from: 2024-09-17 Created: 2024-09-17 Last updated: 2024-11-22Bibliographically approved

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