Usefulness of combining testing for p16 protein and human papillomavirus (HPV) in cervical carcinoma screening.
OBJECTIVE
To evaluate the value of the combination of p16 and HPV detection in the screening for cervical cancer.


METHODS
186 patients with previous abnormal cervical lesion were studied. After colposcopic examination, two conventional Pap slides were prepared: the first was Papanicolaou-stained and examined by cytologist; the second was immunocytochemically stained for p16. Cervical cells were collected by brush using for HPV detection by Hybrid Capture II. Biopsy of any colposcopically abnormal lesions was performed.


RESULTS
The 186 cervical samples were classified cytologically as normal (148), ASCUS (13), low-grade (11), high-grade (12) dysplasia and squamous cell carcinoma (2). P16 and HPV were found in all high-grade dysplasia and SCC, and in 64% and 27% of low-grade dysplasia, 62% and 0% of ASCUS and 7.4% and 3.4% of normal, respectively. 18 of p16-positive cases (11%) were HPV-negative, 14 of them in the ASCUS and normal group. Compared to histological results, all of the p16-positive cases of squamous metaplasia, CIN II/III and SCC were HR-HPV-positive. Therefore, the cases that were positive for both with normal cytology (5 cases) or low-grade dysplasia (3 cases) may comprise a high-risk group for neoplastic change.


CONCLUSIONS
The combination of p16 and HPV detection may be useful in cervical cancer screening to identify high-risk patients requiring early and proper management.
Ekalaksananan
Tipaya
T
Department of Microbiology, Faculty of Medicine, Khon Kaen University, Thailand.
Pientong
Chamsai
C
Sriamporn
Supannee
S
Kongyingyoes
Bunkerd
B
Pengsa
Prasit
P
Kleebkaow
Pilaiwan
P
Kritpetcharat
Onanong
O
Parkin
D Max
DM
D000328:Adult; D015331:Cohort Studies; D019941:Cyclin-Dependent Kinase Inhibitor p16 / Q000032:analysis*; D004279:DNA, Viral / Q000032:analysis*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D065006:Papanicolaou Test; D027383:Papillomaviridae / Q000235:genetics / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000150:complications / Q000378:metabolism / Q000821:virology; D011446:Prospective Studies; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology / Q000821:virology; D014626:Vaginal Smears
D019941:Cyclin-Dependent Kinase Inhibitor p16; D004279:DNA, Viral