From Lesion to Malignancy: A Prospective IHC Profiling of Cervical neoplasia in a Tertiary Care Centre in Coastal Karnataka

Abstract Background Immunohistochemistry (IHC) is a valuable adjunct to histopathology in the diagnosis, classification, and management of cervical neoplasia. It enhances lesion stratification, identifies tumor subtypes, and supports treatment planning and prognostication. Objectives To evaluate the utility of IHC markers in cervical cancer and precancerous lesions in a tertiary care centre in South India particularly, Karnataka. Methods It was a prospective observational study conducted over a period of one year (May 2023–May 2024), involving 62 women with histopathological confirmed cervical cancer or precancerous lesions. IHC markers including p16, p53, p40, p63, ER, vimentin, CK7, and CK20 were assessed. Marker expression patterns were correlated with lesion type and clinical relevance. Results Squamous cell carcinoma was the most common lesion (64.5%), followed by HSIL (17.7%) and adenocarcinoma (11.3%). p16 showed strong positivity across SCC (100%), HSIL (90.9%), and adenocarcinoma (71.4%). p53 was positive in 85.7% of high-grade lesions. p40 was specific to SCC, while ER and vimentin were useful in adenocarcinoma differentiation. CK7/CK20 profiles aided in excluding metastatic disease. Conclusion A panel of IHC markers, particularly p16, p53, and p40, significantly improves the diagnostic and prognostic evaluation of cervical neoplasia. IHC integration into routine pathology enhances precision in clinical decision-making and supports personalized care. Trial Registration CTRI/2023/07/055260, Date of Registration 16/07/2023.