Clinicopathological and Prognostic Significance of TROP2 and HER3 Expression in Early-Stage Cervical Carcinoma

Background: Our objective was to evaluate the prognostic value of TROP2 and HER3 expression in patients with early-stage cervical carcinoma undergoing primary surgical treatment. Methods: We retrospectively analyzed 54 patients with FIGO 2018 stage IA–IIA cervical carcinoma who underwent radical surgery between January 2016 and December 2025. TROP2 and HER3 expression were assessed using immunohistochemistry and a standardized immunoreactivity scoring system. Associations with clinicopathological characteristics were examined, and survival outcomes were analyzed using Kaplan–Meier estimates and Cox proportional hazards models. Results: High TROP2 and HER3 expression was identified in 63.0% and 37.0% of tumors, respectively. Neither biomarker was associated with the conventional clinicopathological variables. After a median follow-up of 88.2 months, 22 patients (40.7%) developed recurrent disease and 18 (33.3%) died. Patients with high TROP2 expression had significantly shorter overall and disease-free survival than those with low expression. After adjustment for established prognostic factors, high TROP2 expression remained independently associated with disease recurrence (HR 5.00, 95% CI 1.28–19.57; p = 0.021). In contrast, HER3 expression was not independently associated with overall or disease-free survival rates. Older age and advanced FIGO stage were independently associated with poorer outcomes. Conclusions: TROP2 expression identifies a subgroup of patients with early-stage cervical carcinoma who are at an increased risk of recurrence despite primary surgical treatment. Unlike HER3, TROP2 provided prognostic information beyond conventional clinicopathological factors, supporting its potential role in postoperative risk stratification. These findings also reinforce the rationale for further investigation of TROP2 as a therapeutic target in cervical carcinoma.