IJCEP Copyright © 2007-All rights reserved.
Int J Clin Exp Pathol 1(5):419-425;2008

Original Article
Expression of 14-3-3σ, P16 and P53 Proteins in Anal Squamous Intraepithelial Neoplasm
and Squamous Cell Carcinoma

Andres A. Roma, John R. Goldblum, Victor Fazio and Bin Yang

Department of Anatomic Pathology, Cleveland Clinic Foundation, Cleveland, Ohio and Department of Colorectal Surgery, Division of Surgery,
Cleveland Clinic Foundation, Cleveland, Ohio.

Received 16 Nov 2007; Accepted with revision 4 Jan 2008; Available online 10 Jan 2008

Abstract: 14-3-3σ is a p53-regulated G2/M inhibitor involved in numerous cellular signaling pathways related to cell cycle, DNA repair and
apoptosis. Recent studies have showed that 14-3-3σ was silenced transcriptionally through promoter hypermethylation mainly in HPV-negative
vulvar squamous cell carcinoma (SCC). However, the expression of 14-3-3σ protein has not yet been studied in anal SCC and its precursor,
anal intraepithelial neoplasm (AIN). In this study, we evaluated the expression of 14-3-3σ, p16 and p53 in 34 cases of normal perianal
squamous mucosa, 5 cases of squamous hyperplasia and 62 cases of AIN, including 54 bowenoid and 8 differentiated AINs. Fourteen cases
of invasive anal SCC were also included in the study, including 8 cases associated with bowenoid AIN and 6 cases associated with
differentiated AIN. Expression of p16, p53 and 14-3-3σ proteins was not seen in normal squamous epithelium. Weak staining for 14-3-3σ was
seen in anal squamous hyperplasia. Strong and diffuse p16 immunoreactivity was seen in 98.1% of bowenoid AIN, but only in 12.5% of
differentiated AIN. In contrast, increased basal staining with suprabasal extension of p53 was seen in 100% of differentiated AIN, but in none of
the bowenoid AIN. Expression of p16 and p53 was essentially mutually exclusive except in one case. Overexpression of 14-3-3σ was detected
in 97% (60/62) of AIN cases, including 96.3% of bowenoid AIN and 100% of differentiated AIN. Expression of 14-3-3σ was independent of
immunoreactivity status for p16 and p53. In conclusion, two histopathologic types of AIN, bowenoid and differentiated, have distinct
immunoprofiles for p16 and p53, which suggests dual molecular pathways during anal carcinogenesis. Increased expression of 14-3-3σ
protein was found in approximately 97% of AIN lesions, regardless of histopathologic type and independent of p16 and p53 expression. Our
study indicates that immunohistochemical detection of 14-3-3σ in conjunction with p16 and p53 may be useful in histopathologic recognization
of AIN. (IJCEP711001).

Key Words: Anal intraepithelial neoplasm, AIN, Bowenoid, differentiated, simplex, p53, p16, 14-3-3σ

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Address all correspondence to: Bin Yang, M.D., Ph.D., Department of Anatomic Pathology, L25, Cleveland Clinic Foundation, Cleveland, Ohio.