title: P16 and Ki-67 expression improves the diagnostic accuracy of cervical lesions but not predict persistent high risk human papillomavirus infection with CIN1.
abstract: OBJECTIVE
  To determine the association between the expression of p16 and Ki-67 and cervical lesions, and to evaluate the role of p16 and Ki-67 as prognostic markers for persistent high risk human papillomavirus (hr-HPV) infection.
  
  
  METHODS
  Totally 1,154 cases of cervical biopsies were enrolled, 331 cases with negative for dysplasia (NEG), 462 with cervical intraepithelial neoplasia 1 (CIN1), 176 with CIN2, 163 with CIN3 and 22 with cervical squamous cell carcinoma (SCC). Furthermore, 283 women with CIN1 were recruited into 12-month follow-up, and HPV specific gene detection by polymerase chain reaction was used to detect hr-HPV of cervical secretions at 6-month-interval for 12-month follow-up period. 40 women were infected with persistent hr-HPV, 182 with transient infection and 61 unfected with hr-HPV. The expression of p16 and Ki-67 were evaluated by immunohistochemical method. The immunostaining results of p16 and Ki-67 were classified into four categories: negative, 1+, 2+ and 3+.
  
  
  RESULTS
  There was significant increase in the expression of p16 (P<0.001) and Ki-67 (P<0.001) from NEG to SCC. The expression of Ki-67 (P<0.001) but not p16 (P=0.254) significantly increased in CIN2, CIN3. Ratio of p16 (P=0.215) and Ki-67 (P=0.495) positivity were not correlated with persistent hr-HPV infection.
  
  
  CONCLUSIONS
  P16 and Ki-67 can improve the diagnostic accuracy of cervical lesions but can not predict persistent hr-HPV infection with CIN1.
authors.affiliation: Department of Pathology, Haidian Maternal & Child Health Hospital Beijing, P. R. China.
authors.forename: Pingping
authors.initials: P
authors.lastname: Zhong
authors.affiliation: Department of Respiratory and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University Beijing, P. R. China.
authors.forename: Jifeng
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Pathology, Haidian Maternal & Child Health Hospital Beijing, P. R. China.
authors.forename: Yiqun
authors.initials: Y
authors.lastname: Gu
authors.affiliation: Department of Pathology, Capital Medical University Beijing, P. R. China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Pathology, Haidian Maternal & Child Health Hospital Beijing, P. R. China.
authors.forename: Aichun
authors.initials: A
authors.lastname: Wang
authors.affiliation: Department of Pathology, Haidian Maternal & Child Health Hospital Beijing, P. R. China.
authors.forename: Yunfei
authors.initials: Y
authors.lastname: Sun
authors.affiliation: Department of Pathology, Haidian Maternal & Child Health Hospital Beijing, P. R. China.
authors.forename: Lijuan
authors.initials: L
authors.lastname: Lu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis*; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000821:virology; D015331:Cohort Studies; D019941:Cyclin-Dependent Kinase Inhibitor p16 / Q000032:analysis / Q000096:biosynthesis; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000032:analysis / Q000096:biosynthesis; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000175:diagnosis*; D016133:Polymerase Chain Reaction; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000821:virology; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000821:virology
chemical_list: D014408:Biomarkers, Tumor; D019941:Cyclin-Dependent Kinase Inhibitor p16; D019394:Ki-67 Antigen
keywords: Cervical intraepithelial neoplasia (CIN); Ki-67; human papillomavirus (HPV); immunohistochemistry; p16