p16 INK4A is a strong biomarker for cervical intraepithelial neoplasia and invasive cervical carcinoma: a reappraisal.
To assess the role of p16( INK4A), bcl-2, and p53 in cervical cancer screening, we conducted a retrospective trial of prospectively collected data. Sixty two women with abnormal Pap smears were subjected to colposcopy and biopsies from any abnormal lesion. Human papillomavirus (HPV)-DNA typing, histology, and immunochemistry for p16(INK4A), bcl-2, and p53 were performed for these women. Histologic diagnosis was that of low grade squamous intraepithelial lesion (LSIL), high grade squamous intraepithelial lesion (HSIL), or cancer in all cases. Human papillomavirus strains were identified in 56 patients (90.3%). All HSIL and invasive cancer cases were HPV positive. p16(INK4A) immunostaining yielded 100% sensitivity, 76% specificity, 61% positive predictive value, and 100% negative predictive value in cancer patients. The corresponding performance indicators for HSIL patients were 75%, 62%, 32%, and 91%. bcl-2 and p53 expression did not correlate with worsening grades of cervical disease. We conclude that p16(INK4A) seems to be a sensitive biomarker of high grade cervical intraepithelial neoplasia and cancer.
Department of Obstetrics and Gynecology, Alexandra Hospital, University of Athens, Medical School, Athens, Greece.
Dimitrios
D
Haidopoulos
George A
GA
Partsinevelos
George D
GD
Vlachos
Alexandros
A
Rodolakis
Sonia
S
Markaki
Zannis
Z
Voulgaris
Emmanuel
E
Diakomanolis
Aris
A
Antsaklis
D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis*; D019941:Cyclin-Dependent Kinase Inhibitor p16 / Q000032:analysis*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011446:Prospective Studies; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000737:chemistry* / Q000175:diagnosis*; D002578:Uterine Cervical Dysplasia / Q000737:chemistry* / Q000175:diagnosis*
D014408:Biomarkers, Tumor; D019941:Cyclin-Dependent Kinase Inhibitor p16