Clinical role of p16INK4a expression in liquid-based cervical cytology: correlation with HPV testing and histologic diagnosis.
p16INK4a is overexpressed in high-risk human papillomavirus (HR-HPV)-infected preneoplastic and neoplastic lesions of the uterine cervix. Our aim was to verify whether p16 is a diagnostic marker also in cervical liquid-based cytology. We performed p16 immunocytochemical analysis and the Hybrid Capture 2 (HC2) test (Digene, Gaithersburg, MD) for HR-HPV infection in 471 ThinPrep-processed (Cytyc, Boxborough, MA) cervicovaginal samples and correlated the results with histologic findings. A total of 32.3% of the specimens showed p16 immunoreactivity, whereas the HC2 test was positive in 41.2% of the cases (65.2% concordance rate). Correlating the cytologic, p16, and HPV results with histologic findings revealed HC2 as the most sensitive test for a diagnosis of cervical intraepithelial neoplasia 2 or worse, whereas cytologic examination was the most specific. The positive predictive value was significantly higher for cytologic examination than for p16 and HR-HPV testing. These data suggest that p16 evaluation in ThinPrep samples does not have better clinical effectiveness for identifying high-grade lesions than conventional morphologic examination and HPV testing.
Benevolo
Maria
M
Pathology, Regina Elena Cancer Institute, Rome, Italy.
Vocaturo
Amina
A
Mottolese
Marcella
M
Mariani
Luciano
L
Vocaturo
Giuseppe
G
Marandino
Ferdinando
F
Sperduti
Isabella
I
Rollo
Francesca
F
Antoniani
Barbara
B
Donnorso
Raffaele Perrone
RP
D000293:Adolescent; D000328:Adult; D000368:Aged; D019941:Cyclin-Dependent Kinase Inhibitor p16 / Q000378:metabolism*; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D027383:Papillomaviridae / Q000235:genetics / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000378:metabolism* / Q000821:virology; D011230:Precancerous Conditions / Q000378:metabolism* / Q000821:virology; D011237:Predictive Value of Tests; D014412:Tumor Virus Infections / Q000378:metabolism* / Q000821:virology; D002583:Uterine Cervical Neoplasms / Q000378:metabolism* / Q000821:virology; D014626:Vaginal Smears / Q000379:methods; D002578:Uterine Cervical Dysplasia / Q000378:metabolism* / Q000821:virology
D019941:Cyclin-Dependent Kinase Inhibitor p16; D004279:DNA, Viral