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Cells
Volume 10
Issue 8
10.3390/cells10082039
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Article

Stratified Mucin-Producing Intraepithelial Lesion (SMILE) of the Uterine Cervix: High-Risk HPV Genotype Predominance and p40 Immunophenotype

by
Margareta Strojan Fležar
1,*,
Neža Nedelko
1,
Mario Poljak
2,
Anja Oštrbenk Valenčak
2 and 1,†
1
Institute of Pathology, Faculty of Medicine, University of Ljubljana, Korytkova 2, 1000 Ljubljana, Slovenia
2
Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška Cesta 4, 1000 Ljubljana, Slovenia
*
Author to whom correspondence should be addressed.
†
The author passed away.
Academic Editor: Maria Vincenza Carriero
Cells 2021, 10(8), 2039; https://doi.org/10.3390/cells10082039
Received: 30 June 2021 / Revised: 28 July 2021 / Accepted: 5 August 2021 / Published: 10 August 2021
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Abstract

Stratified mucin-producing intraepithelial lesion (SMILE) is a rare high-grade cervical precancerous lesion designated a variant of adenocarcinoma in situ (AIS) in the WHO classification. We aimed to determine HPV genotypes, immunohistochemical phenotype and mucin presence in SMILE. Between 2010 and 2018, SMILE was diagnosed in 34 out of 6958 (0.5%) cervical biopsies, in 23 patients. Twenty-six tissue samples from twenty-one patients were available for further analysis, including 13 with SMILE alone, 12 with SIL and/or AIS and one with HSIL, AIS and endocervical adenocarcinoma. HPV genotyping was performed using the Seegene Anyplex II HPV 28 assay. Of the 26 samples, a single HPV genotype was identified in the majority of cases (n = 22), including 12/13 SMILEs associated with SIL/AIS. All but one were high-risk HPV genotypes (23/24; 96.8%). We identified seven different HPV genotypes, the most common being HPV16 (n = 10; 43.5%), HPV18 (n = 8, 34.8%) and HPV 31 (n = 5, 21.7%). All SMILEs showed a strong positive reaction to p16, CK7, CK19 and high Ki67 expression comparable to adjacent HSIL and/or AIS if present. SMILE showed variable mucin presence and p40-positive squamous differentiation suggesting phenotypic diversity in cervical precancerous lesions infected by single HPV. View Full-Text
Keywords: cervical precancerous lesion; stratified mucin-producing intraepithelial lesions; HPV genotyping; immunohistochemistry; high-risk HPV types; HPV genotyping cervical precancerous lesion; stratified mucin-producing intraepithelial lesions; HPV genotyping; immunohistochemistry; high-risk HPV types; HPV genotyping
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MDPI and ACS Style

Strojan Fležar, M.; Nedelko, N.; Poljak, M.; Oštrbenk Valenčak, A.; Gutnik, H. Stratified Mucin-Producing Intraepithelial Lesion (SMILE) of the Uterine Cervix: High-Risk HPV Genotype Predominance and p40 Immunophenotype. Cells 2021, 10, 2039. https://doi.org/10.3390/cells10082039

AMA Style

Strojan Fležar M, Nedelko N, Poljak M, Oštrbenk Valenčak A, Gutnik H. Stratified Mucin-Producing Intraepithelial Lesion (SMILE) of the Uterine Cervix: High-Risk HPV Genotype Predominance and p40 Immunophenotype. Cells. 2021; 10(8):2039. https://doi.org/10.3390/cells10082039

Chicago/Turabian Style

Strojan Fležar, Margareta, Neža Nedelko, Mario Poljak, Anja Oštrbenk Valenčak, and Helena Gutnik. 2021. "Stratified Mucin-Producing Intraepithelial Lesion (SMILE) of the Uterine Cervix: High-Risk HPV Genotype Predominance and p40 Immunophenotype" Cells 10, no. 8: 2039. https://doi.org/10.3390/cells10082039

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