title: p16/Ki-67 dual-stained cytology testing may predict postpartum outcome in patients with abnormal papanicolaou cytology during pregnancy.
abstract: OBJECTIVE
  To evaluate the use of a new immunocytochemical dual-staining protocol, which allows for the detection of coexpression of the p16(INK4a) (p16) and Ki-67 biomarkers in prenatal care. It was hypothesized that dual-staining cytology may predict postpartum outcome in patients with abnormal cervical Papanicolaou (Pap) smears during pregnancy.
  
  
  METHODS
  In this retrospective pilot study, 27 abnormal Pap smears collected from women during early pregnancy were destained and subsequently stained for p16/Ki-67. RESULTS were correlated with histologic outcome collected during postpartum follow-up.
  
  
  RESULTS
  Fourteen of 20 abnormal Pap smears during pregnancy showed a positive p16/Ki-67 dual-stained cytology result, whereas 6 specimens tested negative. Seven cases were excluded due to technical reasons. All 14 patients who were positive for p16/Ki-67 dual stain had cervical intraepithelial neoplasia (CIN) on postpartum histology. In contrast, 5 out of 6 patients negative for p16/Ki-67 dual-staining had a negative histology postpartum and during follow-up, and the remaining patient showed a CIN1 (p < 0.001).
  
  
  CONCLUSIONS
  p16/Ki-67 dual-stained cytology may provide a valuable novel approach to identify pregnant women with persistent or progressing CIN disease and may help improve the management of abnormal Pap cytology results during pregnancy.
authors.affiliation: Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria.
authors.forename: Gerda
authors.initials: G
authors.lastname: Trutnovsky
authors.forename: Vassiliki
authors.initials: V
authors.lastname: Kolovetsiou-Kreiner
authors.forename: Olaf
authors.initials: O
authors.lastname: Reich
mesh_terms: D000328:Adult; D014408:Biomarkers, Tumor / Q000032:analysis; D019941:Cyclin-Dependent Kinase Inhibitor p16 / Q000032:analysis / Q000378:metabolism*; D003581:Cytodiagnosis; D005260:Female; D006801:Humans; D019394:Ki-67 Antigen / Q000032:analysis / Q000378:metabolism*; D065006:Papanicolaou Test; D010865:Pilot Projects; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis / Q000378:metabolism*; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000378:metabolism*; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000378:metabolism*
chemical_list: D014408:Biomarkers, Tumor; D019941:Cyclin-Dependent Kinase Inhibitor p16; D019394:Ki-67 Antigen