title: Human papillomavirus, p16(INK4A), and Ki-67 in relation to clinicopathological variables and survival in primary carcinoma of the vagina.
abstract: BACKGROUND
  This study aimed to determine human papillomavirus (HPV) status and to investigate p16(INK4A) and Ki-67 expression and their correlation with clinical parameters and survival in women with primary carcinoma of the vagina (PCV).
  
  
  METHODS
  The presence of HPV DNA was evaluated by PCR. Genotyping was performed by Luminex in 68 short-term (2 years) and long-term (8 years) PCV survivors. p16(INK4A) and Ki-67 expression was evaluated by immunohistochemistry.
  
  
  RESULTS
  Human papillomavirus DNA was detected in 43% of patients, the majority (63%) of whom were HPV16 positive. High p16(INK4A) expression was significantly correlated with low histopathological grade (P=0.004), HPV positivity (P=0.032), and long-term survival (P=0.045). High Ki-67 expression was negatively correlated with histopathological grade (P<0.001) and tumour size (P=0.047). There was an association between HPV positivity and low histopathological grade, but not between HPV positivity and survival.
  
  
  CONCLUSIONS
  High p16(INK4A) expression was associated with long-term survival, but the only independent predictors for survival were tumour size and histopathological grade. Our results indicate that p16(INK4A) and Ki-67 expression might be useful in tumour grading, and that it might be possible to use p16(INK4A) expression as a marker for HPV positivity, but this has to be further elucidated.
authors: Gynecological Oncology, Department of Oncology, Radiumhemmet, Karolinska University Hospital, 17176 Stockholm, Sweden.
authors: K
authors: K
authors: Hellman
authors: Oncology Research Laboratory, Department of Radiation Sciences, Umeå University, 901 87 Umeå, Sweden.
authors: D
authors: D
authors: Lindquist
authors: 1] Department of Obstetrics and Gynecology, Västerås Centrallasarett, 721 89 Västerås, Sweden [2] Division of Obstetrics and Gynecology, Department of Women's and Children's Health, Karolinska Institutet, Elevhemmet H2:00, Karolinska University Hospital Solna, 17176 Stockholm, Sweden.
authors: C
authors: C
authors: Ranhem
authors: Departments of Genetics and Pathology and Clinical Pathology and Cytology, Rudbeck Laboratory, Uppsala University Hospital and Uppsala University, 751 85 Uppsala, Sweden.
authors: E
authors: E
authors: Wilander
authors: Division of Obstetrics and Gynecology, Department of Women's and Children's Health, Karolinska Institutet, Elevhemmet H2:00, Karolinska University Hospital Solna, 17176 Stockholm, Sweden.
authors: S
authors: S
authors: Andersson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019941:Cyclin-Dependent Kinase Inhibitor p16; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000096:biosynthesis* / Q000235:genetics / Q000378:metabolism; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000096:biosynthesis* / Q000235:genetics / Q000378:metabolism; D027383:Papillomaviridae / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000235:genetics / Q000378:metabolism / Q000473:pathology / Q000821:virology; D011379:Prognosis; D016019:Survival Analysis; D014625:Vaginal Neoplasms / Q000235:genetics / Q000378:metabolism / Q000473:pathology* / Q000821:virology*
chemical_list: C000614131:CDKN2A protein, human; D019941:Cyclin-Dependent Kinase Inhibitor p16; D019394:Ki-67 Antigen; D009363:Neoplasm Proteins