Immunohistochemical investigation of SOX2 expression in Iraqi patients with high-grade glioma

Background. Gliomas, particularly high-grade gliomas, are aggressive brain tumors with poor prognosis. Sex-determining region Y-box 2 (SOX2) is a transcription factor responsible for stem cell maintenance and differentiation and has been implicated in glioma progression and recurrence. The present study investigated SOX2 expression in Iraqi patients with high-grade glioma and assessed its potential as a diagnostic and prognostic biomarker. Methods. Sixty-four paraffin-embedded samples from the Neurological Hospital in Baghdad were analyzed, including 34 high-grade glioma cases (21 males and 13 females) and 13 benign controls (10 males and 3 females). Immunohistochemical staining for SOX2 was performed, and staining levels were categorized using a scoring system. Statistical analyses were conducted to evaluate differences in SOX2 expression between genders and between patient and control groups. Results. There were highly significant differences in SOX2 expression between patients and controls (p ≤0.01). However, no significant difference was observed between male and female patients (p ≤0.01). Additionally, there were significant differences in SOX2 expression distribution between genders, with p-values of 0.0022 for males and 0.0061 for females. The highest distribution percentages for males were at scores 2 and 3, with values of 38.10 and 47.62%, respectively. In contrast, females had distribution ratios only at scores 2 and 3, with values of 30.77 and 69.23%, respectively. Conclusion. SOX2 is highly expressed in high-grade gliomas, supporting its potential as a diagnostic and prognostic marker. Future studies with larger cohorts and detailed sex-specific analyses are needed to elucidate SOX2's role in glioma pathogenesis and its potential as a therapeutic target.