Value of p16(INK4a) as a marker of progression/regression in cervical intraepithelial neoplasia grade 1.
OBJECTIVE
The objective of this study was to evaluate the usefulness of p16(INK4a) staining to classify cervical intraepithelial neoplasia grade 1 according to its progression/regression risk.


METHODS
Patients with a histologic diagnosis of cervical intraepithelial neoplasia grade 1 were prospectively recruited (n = 138). Simultaneous detection of high-risk human papillomaviruses and p16(INK4a) evaluation were performed. Follow-up was conducted every 6 months by cytology and colposcopy and annually by high-risk human papillomavirus testing, for at least 12 months (mean, 29.0). Progression was defined as a histologic diagnosis of cervical intraepithelial neoplasia grades 2-3, regression as a negative cytology and high-risk human papillomaviruses, and persistence as a cytologic result of low-grade squamous intraepithelial lesions and/or a positive test for high-risk human papillomaviruses.


RESULTS
Progression was observed in 14 women (10.1%), 66 (47.6%) regressed, and 58 (42.0%) had a persistent disease. p16(INK4a) was positive in 77 (55.8%) initial biopsy specimens. Progression to cervical intraepithelial neoplasia grades 2-3 was identified in 14 of 77 (18.2%) women with positive and none of 61 (0.00%) women with negative p16(INK4a) immunostaining (P < .001).


CONCLUSIONS
p16(INK4a) negative cervical intraepithelial neoplasia grade 1 lesions rarely progress and may benefit from a less intensive follow-up.
del Pino
Marta
M
Department of Obstetrics and Gynecology, Hospital Clínic, University of Barcelona Faculty of Medicine, Barcelona, Spain.
Garcia
Sònia
S
Fusté
Victòria
V
Alonso
Immaculada
I
Fusté
Pere
P
Torné
Aureli
A
Ordi
Jaume
J
D000328:Adult; D000368:Aged; D015415:Biomarkers; D019941:Cyclin-Dependent Kinase Inhibitor p16 / Q000032:analysis*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D012074:Remission Induction; D002583:Uterine Cervical Neoplasms / Q000737:chemistry* / Q000473:pathology* / Q000601:surgery; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000737:chemistry* / Q000473:pathology* / Q000601:surgery
D015415:Biomarkers; D019941:Cyclin-Dependent Kinase Inhibitor p16