title: Diagnostic performance of p16 staining in atypical squamous cells 'cannot exclude high-grade squamous epithelial lesion' in predicting high-grade cervical pathology.
abstract: Atypical squamous cells 'cannot exclude high-grade squamous epithelial lesion' (ASC-H) cytology represents clear risk and has been a controversial issue in clinical practice. The objective of this study is to investigate the diagnostic performance of p16(INK4A) immunohistochemistry (IHC) among ASC-H Pap smears in predicting high-grade cervical intraepithelial lesions. Decolourisation and staining process with p16(INK4A) is applied to 27 ASC-H diagnosed conventional Pap smears, which were all managed with colposcopy-directed cervical biopsy priorly. Staining characteristics of ASC-H Pap smears were compared with histopathological data and sensitivity-specificity values of p16 triage to detect CIN2 + histopathology were determined. The sensitivity and specificity of positive p16(INK4A) immune staining to detect CIN2 + histopathology were as 87.5% and 68%, respectively. The positive predictive value of p16 triage is found as 53.8% and negative predictive value was as 92.8%. p16(INK4A) IHC seems applicable for conventional Pap smears and may provide an alternative triage option in ASC-H category.
authors.affiliation: Department of Obstetrics and Gynecology, Ankara University School of Medicine , Ankara , Turkey.
authors.forename: E G
authors.initials: EG
authors.lastname: Pabuccu
authors.forename: S
authors.initials: S
authors.lastname: Taskin
authors.forename: H
authors.initials: H
authors.lastname: Ustun
authors.forename: M
authors.initials: M
authors.lastname: Gungor
authors.forename: R
authors.initials: R
authors.lastname: Aytac
authors.forename: I
authors.initials: I
authors.lastname: Yalcin
authors.forename: F
authors.initials: F
authors.lastname: Ortac
mesh_terms: D000328:Adult; D002584:Cervix Uteri / Q000737:chemistry / Q000473:pathology*; D019941:Cyclin-Dependent Kinase Inhibitor p16 / Q000032:analysis*; D005260:Female; D006801:Humans; D008875:Middle Aged; D065006:Papanicolaou Test; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000737:chemistry / Q000473:pathology*; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000737:chemistry / Q000473:pathology*
chemical_list: D019941:Cyclin-Dependent Kinase Inhibitor p16
keywords: ASC-H; HPV; Pap smear; immunohistochemistry; p16