Comparative analysis of stromal inflammatory cell infiltration and HPV infection status in cervical dysplasia and squamous cell carcinoma using the Klintrup-Mäkinen Scoring method
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HIGHLIGHTS
- KM score is a reliable method to help determine the diagnosis of cervical dysplasia and squamous cell carcinoma.
- KM score cannot be used to differentiate infection status in cervical dysplasia and squamous cell carcinoma.
ABSTRACT
Objective: Cervical cancer is the second most common malignancy in women, with 604,127 new cases reported globally in 2020. Persistent high-risk human papillomavirus (HPV) infection is the primary cause. This study aimed to evaluate the relationship between stromal inflammatory cell infiltration using the Klintrup-Mäkinen (KM) score and HPV infection status in cervical dysplasia and squamous cell carcinoma (SCC).
Materials and Methods: A cross-sectional study was conducted using secondary data from formalin-fixed paraffin-embedded (FFPE) cervical tissue samples diagnosed as dysplasia or SCC at Atma Jaya Catholic University of Indonesia from 2014 to 2022. HPV status was determined using PCR-based assays, while stromal inflammatory cell infiltration was assessed microscopically at 100× magnification and graded according to the KM scoring system by two blinded observers. Statistical analyses, including Chi-square and Spearman’s correlation tests, were performed using STATA/IC 15, with p < 0.05 considered significant.
Results: A total of 38 samples were analyzed, comprising 20 (52.63%) cases of dysplasia and 18 (47.37%) cases of SCC. HPV positivity was identified in 70% of dysplasia and 94.44% of SCC cases. KM scores of 2/3, indicating moderate to severe inflammatory infiltration, were significantly more frequent in SCC (77.78%) compared to dysplasia (20%), showing a strong association with pathological diagnosis (p = 0.0019). However, no significant correlation was observed between KM score and HPV status in either lesion type.
Conclusion: The KM scoring method provides a reliable and cost-effective approach for assessing stromal inflammatory cell infiltration in cervical lesions, aiding histopathological diagnosis, although it does not predict HPV infection status.
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