Author/Editor		Strojan Fležar, Margareta; Nedelko, Neža; Poljak, Mario; Oštrbenk Valenčak, Anja; Gutnik, Helena
Title		Stratified mucin-producing intraepithelial lesion (SMILE) of the uterine cervix
Type		članek
Vol. and No.		Letnik 10, št. 8
Publication year		2021
Volume		str. 1-10
ISSN		2073-4409 - Cells (Basel, Switzerland)
Language		eng
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.
Keywords		predrakava lezija materničnega vratu intraepitelijske lezije genotipizacija HPV cervical precancerous lesion intraepithelial lesions HPV genotyping