Immunohistochemical expression of Stem Cell Marker, Sex-Determining Region Y-Box2 (SOX2) in Endometrial Carcinoma

Sex-determining region Y-box 2 (SOX2), a member of the SOX family, plays a critical role in the regulation of cancerous stem cells. SOX2 can affect embryonic stem cells' capacity for self-renewal and pluripotency. The aim of this study is to assess SOX2 expression and correlation of this expression with different pathological variables in endometrial carcinoma. For 85 endometrial cancer cases that underwent total hysterectomy with bilateral salpingo-oophorectomy, immunohistochemical staining for SOX2 was done. In tumor cells, SOX-2 expression was evaluated. SOX2 expression was detected in 18% of cases, of which undifferentiated and serous endometrial carcinoma showed the highest expression and showed statistically significant relation with high grade, high FIGO stage, high pathological (T) stage, cervical, adnexal and/or serosal, parametrial and/or vaginal involvement, nodal metastasis, lymphovascular space invasion (LVSI), omental tumor deposits and advanced metastatic risk tumor, according to ESGO-ESTRO-ESP system for risk stratification (P value 0.045, 0.011, 0.024, 0.012, 0.004, 0.003, 0.013, 0.032, 0.031 and 0.021), respectively. SOX2 expression was related to high-risk endometrial carcinomas with poor clinicopathological parameters. Thus, SOX2 may be considered as a potential marker for poor prognosis and could be useful in identifying cases that require closer follow-up and aggressive treatment. KEYWORDS Tumor grade, tumor stage, oncogenic marker, stem cells, tumor progression, tumor risk