Evaluation of Vimentin as a Marker of Cervical Carcinogenesis in Women Infected with Human Papillomavirus and Chlamydia trachomatis with Cervical Pathology

Abstract

<b>Background</b>: Among the co-factors contributing to human papillomavirus (HPV)-related cervical carcinogenesis, genital chlamydial infection is considered a very strong risk factor. The molecular mechanisms by which this organism contributes to HPV-related cervical carcinogenesis remain unknown. This study aimed to evaluate the role of vimentin in cervical carcinogenesis in women infected with human papillomavirus and <i>Chlamydia trachomatis.</i> <b>Materials and Methods:</b> A total of 200 formalin-fixed paraffin-embedded (FFPE) cervical tissue samples were collected from women with pre-invasive and invasive cervical disease in northern Nigeria during July 2022 to September 2023. Samples were screened for both high-risk human papillomavirus (hrHPV) and <i>C. trachomatis</i> antigen using GeneXpert^® and rapid tests, respectively. Samples that were positive for hrHPV, <i>C. trachomatis</i>, and cervical cancer underwent immunohistochemistry assay for vimentin detection. <b>Results</b>: The results showed that 47 (23.5%) samples had hrHPV, while 17 (8.5%) samples had <i>C. trachomatis</i> antigen. A total of 103 samples were assayed for vimentin expression, of which 16 (15.5%) samples expressed vimentin at varying degrees. It was observed that vimentin expression increased significantly with increasing tumor severity. <b>Conclusion</b>: The strong statistical association between vimentin expression and hrHPV-<i>C. trachomatis</i> co-infection in cervical carcinogenesis suggests the potential application of vimentin expression assays for early detection of cervical cancer, monitoring disease progression, and implementing prompt treatment approaches. This study findings implicate epithelial-mesenchymal transition (EMT) as a possible molecular mechanism for cervical carcinogenesis in women infected with hrHPV and <i>C. trachomatis</i> and highlight vimentin as a poor prognostic indicator, given its observed correlation with tumor severity.