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Prediction of clinical outcome using p16INK4a immunocytochemical expression in low-grade squamous intraepithelial lesions and high-risk HPV-positive atypical squamous cells of undetermined significance in patients with and without colposcopic evident cervical disease

  • Authors:
    • Ankica Lukic
    • Giorgio Sbenaglia
    • Elisabetta Carico
    • Matilde di Properzio
    • Enrico Giarnieri
    • Antonio Frega
    • Flavia Nobili
    • Massimo Moscarini
    • Maria Rosaria Giovagnoli

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  • Published online on: July 1, 2011     https://doi.org/10.3892/etm.2011.316
  • Pages: 853-858
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Abstract

p16INK4a as a diagnostic marker of a cervical intraepithelial neoplasia of grade 2+ (CIN2+) in atypical squamous cells of undetermined significance (ASC-US) and low-grade squamous intraepithelial lesion (LSIL) cytological samples has been analyzed, but has not yet been included in clinical routine practice. One hundred and ninety-one patients with an abnormal Pap test (84 ASC-US and 107 LSILs) who underwent colposcopy were selected for this study. At enrollment, 96 patients (Group 1) had a positive colposcopy and therefore underwent a cervical biopsy, while 95 (Group 2) had a negative colposcopy and were followed up for up to 1 year. Both groups were tested for p16INK4a using immunocytochemical methods, and the p16INK4a results were correlated with histology or follow-up outcome. In Group 1 ASC-US cases, 82% of lesions less than CIN2 were p16INK4a-negative and all CIN2 cases were p16INK4a-positive (p=0.00044). In Group 1 LSIL cases, 71% of lesions less than CIN2 were p16INK4a-negative and 87% of CIN2/3 were p16INK4a-positive (p=0.00033). Seventy-seven percent of Group 2 ASC-US patients with a negative 1-year follow-up (NF-U) were p16INK4a-negative at enrollment, while all patients with positive follow-up (PF-U) were p16INK4a-positive (p=0.00113). In Group 2 LSIL cases, 83% of patients with NF-U were p16INK4a-negative, while 65% of patients with PF-U were p16INK4a-positive at enrollment (p=0.0014). In fact, 39% of the positive p16INK4a LSIL patients had CIN2+ histological lesions. The positive predictive value of p16INK4a for CIN2+ was 50% in ASC-US and 52% in LSIL cases; the negative predictive value was 100 and 94%, respectively. In conclusion, in our patients, a negative p16INK4a appears to be a marker of the absence of CIN3, while a positive p16INK4a can be correlated with the presence of histological CIN2+ found at enrollment or during the subsequent follow-up. Thus, its clinical predictive value is independent from the colposcopic aspect at enrollment.
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September-October 2011
Volume 2 Issue 5

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Spandidos Publications style
Lukic A, Sbenaglia G, Carico E, di Properzio M, Giarnieri E, Frega A, Nobili F, Moscarini M and Giovagnoli MR: Prediction of clinical outcome using p16INK4a immunocytochemical expression in low-grade squamous intraepithelial lesions and high-risk HPV-positive atypical squamous cells of undetermined significance in patients with and without colposcopic evident cervical disease. Exp Ther Med 2: 853-858, 2011.
APA
Lukic, A., Sbenaglia, G., Carico, E., di Properzio, M., Giarnieri, E., Frega, A. ... Giovagnoli, M.R. (2011). Prediction of clinical outcome using p16INK4a immunocytochemical expression in low-grade squamous intraepithelial lesions and high-risk HPV-positive atypical squamous cells of undetermined significance in patients with and without colposcopic evident cervical disease. Experimental and Therapeutic Medicine, 2, 853-858. https://doi.org/10.3892/etm.2011.316
MLA
Lukic, A., Sbenaglia, G., Carico, E., di Properzio, M., Giarnieri, E., Frega, A., Nobili, F., Moscarini, M., Giovagnoli, M. R."Prediction of clinical outcome using p16INK4a immunocytochemical expression in low-grade squamous intraepithelial lesions and high-risk HPV-positive atypical squamous cells of undetermined significance in patients with and without colposcopic evident cervical disease". Experimental and Therapeutic Medicine 2.5 (2011): 853-858.
Chicago
Lukic, A., Sbenaglia, G., Carico, E., di Properzio, M., Giarnieri, E., Frega, A., Nobili, F., Moscarini, M., Giovagnoli, M. R."Prediction of clinical outcome using p16INK4a immunocytochemical expression in low-grade squamous intraepithelial lesions and high-risk HPV-positive atypical squamous cells of undetermined significance in patients with and without colposcopic evident cervical disease". Experimental and Therapeutic Medicine 2, no. 5 (2011): 853-858. https://doi.org/10.3892/etm.2011.316