title: The Utility of p16INK4a and Ki-67 as a Conjunctive Tool in Uterine Cervical Lesions.
abstract: BACKGROUND
  Immunohistochemical staining for p16INK4a and Ki-67 has been used to improve the accuracy in making a diagnosis of the uterine cervix cancer on biopsy. This study was conducted to examine the usefulness of these markers in the pathological diagnosis based on cervical biopsy.
  
  
  METHODS
  We selected a consecutive series of 111 colposcopically directed cervical punch biopsies. Using these biopsy samples, we performed an immunohistochemical staining for p16INK4a and Ki-67 to establish a diagnosis. The slides were circulated among four pathologists in a sequential order: the hematoxylin and eosin (H&E) slide, H&E slide and p16INK4a-stained slide, and H&E slide, p16INK4a- and Ki-67-stained slides.
  
  
  RESULTS
  The overall rates of the concordance in the first, the second, and the third diagnoses were 77.5%, 82.0%, and 82.0%, respectively. The rate of the concordance in the diagnosis of cervical intraepithelial neoplasm (CIN) 2/3 was increased from 62.2% to 73.0%. But there was a variability in the rate of the revision of the diagnosis between the pathologists. With the application of criteria for interpreting the expressions of p16INK4a and Ki-67, benign and CIN 1 lesions showed a p16INK4a expression score of 0 or 1. But CIN 2 and CIN 3 lesions showed a p16INK4a expression score of 2 and 3, respectively.
  
  
  CONCLUSIONS
  The immunostain for p16INK4a and Ki-67 might be useful in reducing an inter-observer variability. But criteria for interpreting both markers should be strictly applied.
authors.affiliation: Department of Pathology, Gachon University Gil Hospital, Gachon University of Medicine and Science, Incheon, Korea.
authors.forename: Sangho
authors.initials: S
authors.lastname: Lee
authors.forename: Hyunchul
authors.initials: H
authors.lastname: Kim
authors.forename: Hyesun
authors.initials: H
authors.lastname: Kim
authors.forename: Chulhwan
authors.initials: C
authors.lastname: Kim
authors.forename: Insun
authors.initials: I
authors.lastname: Kim
keywords: Ki-67; Uterine cervix; p16INK4a