title: Adjunct p16(INK4a) immunohistochemistry aids the detection of high-grade squamous intraepithelial lesions in endocervical curettage specimens.
abstract: OBJECTIVE
  We questioned whether the use of p16(INK4a) immunohistochemistry in endocervical curettage (ECC) specimens would improve the detection of high-grade squamous intraepithelial lesions (HSIL) in a high-risk patient population.
  
  
  METHODS
  Papanicolaou test results were retrieved in 58 consecutive ECC specimens that were previously diagnosed as no histopathologic abnormality in patients with antecedent HSIL or atypical squamous cells, cannot exclude HSIL. An H&E recut and immunohistochemistry for p16(INK4a) were performed on all cases.
  
  
  RESULTS
  HSIL were found in 18 (31%) ECC specimens originally interpreted as negative. Of these 18 cases, three had moderate-sized fragments of ectocervical epithelium with HSIL seen on the recut H&E with concurrent positivity for p16(INK4a). Fourteen cases had rare to occasional clusters of atypical cells with strong immunoreactivity for p16(INK4a). A single case showed a medium-sized fragment of HSIL on the p16(INK4a)-stained section.
  
  
  CONCLUSIONS
  The use of recuts and adjunct p16(INK4a) should be considered when evaluating ECC specimens in high-risk patient populations.
authors: Dept of Pathology, University of Virginia Health System, Box 8002, Jefferson Park Ave, Charlottesville, VA 22908; edstelow@yahoo.com.
authors: Akeesha A
authors: AA
authors: Shah
authors: Susanne K
authors: SK
authors: Jeffus
authors: Zimin
authors: Z
authors: Zhao
authors: Mark H
authors: MH
authors: Stoler
authors: Edward B
authors: EB
authors: Stelow
mesh_terms: D000328:Adult; D014408:Biomarkers, Tumor / Q000378:metabolism*; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D002584:Cervix Uteri / Q000378:metabolism* / Q000473:pathology; D003475:Curettage; D019941:Cyclin-Dependent Kinase Inhibitor p16 / Q000378:metabolism*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D065006:Papanicolaou Test; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology
chemical_list: D014408:Biomarkers, Tumor; D019941:Cyclin-Dependent Kinase Inhibitor p16
keywords: Cervix; Curettage; Dysplasia; Endocervix; Immunohistochemistry; Intraepithelial lesion; p16INK4a