title: p16 Immunohistochemistry in Colposcope-Directed and Random Cervical Biopsies of CIN2 and CIN3.
abstract: OBJECTIVE
  The aim of this study was to determine if there is a different p16 expression pattern between colposcope-directed and random (colposcope-undetectable) biopsies of cervical intraepithelial neoplasia (CIN2) and CIN3.
  
  
  METHODS
  Cervical biopsies that were positive for CIN2 or CIN3 were selected from a database of samples acquired during a large population-based clinical trial in Guangdong Province in China (Shenzhen Cervical Cancer Screening Study II). Blocks were recut, reread, and then immunostained for p16. Biopsies were categorized as either colposcope-directed or random biopsies. Diffuse staining was considered p16 positive, whereas focal or no staining was considered p16 negative. Differences were determined by the Fisher exact test.
  
  
  RESULTS
  Among the patients with CIN3, there were 232 individual biopsies of CIN3. Sixty were randomly collected, and 172 were colposcopy directed. p16 positivity for the colposcope-directed and random biopsies was 97.7% and 91.7%, respectively (p = 0.052). Like the CIN3 biopsies, colposcope-directed and random CIN2 samples expressed p16 similarly (86.8% [46/53] and 82.6% [19/23], p = .73, respectively).
  
  
  CONCLUSIONS
  Based on our data, even small colposcope-undetectable biopsies of CIN3 are significant. Random biopsies of CIN2 or CIN3 demonstrate similar p16 positivity as visible lesions and therefore might be expected to have a similar natural history.
authors: 1Women's Health Institute, Cleveland Clinic, Cleveland, OH, USA; 2Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen, China and the Key Laboratory on Technology for Early Diagnosis of Major Gynecological diseases, Shenzhen, PR China; 3Department of Anatomic and Molecular Pathology, Cleveland Clinic, Cleveland, OH, USA; 4Department of Obstetrics and Gynecology, Kaiser Fontana California, Fontana, CA, USA; and 5Preventive Oncology International, Inc., Cleveland Heights, OH, USA.
authors: Cynthia
authors: C
authors: Arvizo
authors: Qing
authors: Q
authors: Chen
authors: Hui
authors: H
authors: Du
authors: Chun
authors: C
authors: Wang
authors: Jinlong
authors: J
authors: Tang
authors: Bin
authors: B
authors: Yang
authors: Robert G
authors: RG
authors: Pretorius
authors: Ruifang
authors: R
authors: Wu
authors: Jerome Leslie
authors: JL
authors: Belinson
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis*; D001706:Biopsy / Q000379:methods*; D002681:China; D003127:Colposcopy; D019941:Cyclin-Dependent Kinase Inhibitor p16 / Q000032:analysis*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods*; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000473:pathology; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000473:pathology
chemical_list: D014408:Biomarkers, Tumor; C000614131:CDKN2A protein, human; D019941:Cyclin-Dependent Kinase Inhibitor p16