Expression of p16/Ki-67 in ASC-US/LSIL or Normal Cytology with Presence of Oncogenic HPV DNA.
OBJECTIVE
To determine if positive dual staining of p16/Ki-67 in cytology samples from women with atypical squamous cells of undetermined significance (ASC-US), low-grade squamous intraepithelial lesion (LSIL) or normal cytological reports with presence of high-risk human papillomavirus (HPV), helps in predicting the risk of developing high-grade cervical lesions during one-year of follow-up after a normal initial colposcopy.


METHODS
One-hundred and sixty women with ASC-US, LSIL or otherwise normal cytology, but with the presence of high-risk HPV, were referred to the colposcopy Unit of our Hospital. Cytology and HPV testing were repeated and dual staining of p16/Ki-67 performed on a new cytological specimen, and subsequently patients were colposcopically assessed and prospectively followed-up for one year, after which the colposcopy was repeated. An optional intermediate colposcopical assessment after six months was also offered.


RESULTS
Out of 143/160 women with a normal initial colposcopy, 13 were ultimately lost to follow-up. Out of the remaining 130, nine developed histologically verified cervical intraepithelial neoplasia or higher grade (CIN2+) lesions during the one-year follow-up period. Two thirds of them (6/9) were initially p16/Ki-67-positive.


CONCLUSIONS
Biomarker detection may identify women at higher risk of CIN2+, and these women may benefit from early colposcopic assessment. Women who test negatively for the biomarkers could eventually follow a less aggressive protocol.
Obstetrics & Gynecology Service, San Agustín Hospital, Avilés, Spain.
Concepción
C
Solares
Pathology Service, San Agustín Hospital, Avilés, Spain.
Julio
J
Velasco
Obstetrics & Gynecology Service, San Agustín Hospital, Avilés, Spain.
Eduardo
E
Álvarez-Ruiz
Obstetrics & Gynecology Service, San Agustín Hospital, Avilés, Spain.
Laura
L
González-Fernández
Pathology Service, San Agustín Hospital, Avilés, Spain.
Ana-Isabel
AI
Encinas
Pathology Service, Asturias Central Hospital, Oviedo, Spain.
Aurora
A
Astudillo
Faculty of Health Sciences, Rey Juan Carlos University, Alcorcón, Madrid, Spain jose.schneider@urjc.es.
José
J
Schneider
D000293:Adolescent; D000328:Adult; D065309:Atypical Squamous Cells of the Cervix / Q000378:metabolism / Q000473:pathology* / Q000821:virology; D014408:Biomarkers, Tumor / Q000378:metabolism; D016022:Case-Control Studies; D003127:Colposcopy; D019941:Cyclin-Dependent Kinase Inhibitor p16 / Q000378:metabolism*; D003581:Cytodiagnosis; D004279:DNA, Viral / Q000032:analysis*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019394:Ki-67 Antigen / Q000378:metabolism*; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D027383:Papillomaviridae / Q000235:genetics / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000378:metabolism / Q000821:virology; D011379:Prognosis; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000821:virology; D014626:Vaginal Smears; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000378:metabolism / Q000821:virology
D014408:Biomarkers, Tumor; D019941:Cyclin-Dependent Kinase Inhibitor p16; D004279:DNA, Viral; D019394:Ki-67 Antigen
low-grade squamous intraepithelial lesion; oncogenic HPV DNA; p16/ki-67