title: P16(INK4a) expression as a potential prognostic marker in cervical pre-neoplastic and neoplastic lesions.
abstract: An immunohistochemical analysis with monoclonal antibody p16(INK4a) was performed in formalin-fixed, paraffin-embedded samples of 60 cases. The aim was to investigate in biopsies the expression of p16(INK4a) of normal uterine cervical tissue, pre-cancerous and cancerous lesions, and their relation with human papilloma virus (HPV) and HIV status. Three parameters were evaluated: percentage of p16(INK4a) positive cells, reaction intensity, and cell staining pattern. All of these parameters were statistically different when compared among different histological groups. However, logistic regression model showed that the reaction intensity was the best indicator of the expression of p16(INK4a). This expression increases from normal to invasive squamous carcinoma. Sixty-six percent of the patients with CIN grade 1 (CIN1) expressed p16(INK4a) (all these cases were infected with high risk HPV). Our study supports the hypothesis that p16(INK4a) expression in pre-cancerous lesions and cancers can be used to identify HPV-transformed cells. Of great interest for routine diagnostic use is the fact that immunohistochemical testing for p16(INK4a) seems to be capable of identifying HPV-positive cells and potentially recognizing those lesions with an increased risk of progression to high-grade lesions.
authors.affiliation: Department of Gynecology and Obstetrics, Medical School, and Mathematics and Statistic School, Federal University of Bahia, Salvador, Bahia, Brazil. cmpq@globo.com
authors.forename: Conceição
authors.initials: C
authors.lastname: Queiroz
authors.forename: Tânia Correia
authors.initials: TC
authors.lastname: Silva
authors.forename: Venâncio A F
authors.initials: VA
authors.lastname: Alves
authors.forename: Luisa L
authors.initials: LL
authors.lastname: Villa
authors.forename: Maria Cecília
authors.initials: MC
authors.lastname: Costa
authors.forename: Ana Gabriela
authors.initials: AG
authors.lastname: Travassos
authors.forename: José Bouzas Araújo
authors.initials: JB
authors.lastname: Filho
authors.forename: Eduardo
authors.initials: E
authors.lastname: Studart
authors.forename: Tatiana
authors.initials: T
authors.lastname: Cheto
authors.forename: Luiz Antonio R
authors.initials: LA
authors.lastname: de Freitas
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis*; D002277:Carcinoma / Q000175:diagnosis; D002584:Cervix Uteri / Q000378:metabolism; D019941:Cyclin-Dependent Kinase Inhibitor p16 / Q000378:metabolism*; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000175:diagnosis; D006801:Humans; D007150:Immunohistochemistry; D030361:Papillomavirus Infections / Q000150:complications / Q000175:diagnosis; D011230:Precancerous Conditions / Q000175:diagnosis*; D011379:Prognosis; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D002578:Uterine Cervical Dysplasia / Q000150:complications / Q000175:diagnosis*
chemical_list: D014408:Biomarkers, Tumor; D019941:Cyclin-Dependent Kinase Inhibitor p16