Study of the Expression of Sex-Determining Region Y-box 2 (SOX2) in Squamous Cell Carcinoma of the Cervix

Background: Cervical cancer remains a major health concern among women, particularly in low-resource settings. Sex-determining region Y-box 2 (SOX2), a transcription factor involved in cellular self-renewal and differentiation, has been implicated in tumor progression and malignancy. Objective: This study aimed to evaluate and correlate the immunohistochemical expression of SOX2 across the spectrum of cervical squamous lesions and its association with clinicopathological parameters. Methods: This cross-sectional observational study was conducted at Gandhi Medical College and Associated Hospitals, Bhopal, between May 2023 and October 2024. Eighty cervical specimens, including 63 biopsies and 17 hysterectomy samples, were classified as normal cervical epithelium (n = 20), cervical intraepithelial neoplasia (n = 20), and squamous cell carcinoma (SCC) (n = 40). SOX2 expression was evaluated by immunohistochemistry using a semiquantitative H-score based on staining intensity and percentage positivity. Statistical significance was assessed using the chi-square test with p < 0.05. Results: SOX2 expression showed a significant progressive increase from normal cervical epithelium to malignant lesions (p = 0.0001). A higher proportion of SOX2-positive cases was observed in SCC cases (55%) than in premalignant (30%) and normal (0%) cases. A significant (p = 0.01) association was found between SOX2 expression and age groups and menopausal status (p = 0.01). No significant association was reported with SCC differentiation (p = 0.99) or International Federation of Gynecology and Obstetrics staging (p = 0.60). Conclusion: SOX2 expression increases significantly with disease progression from normal epithelium to invasive carcinoma, suggesting its potential role as a biomarker for malignant transformation in cervical lesions. Further large-scale studies are required to establish its prognostic utility.