The role of P16ink4a and P53 immunostaining in predicting recurrence of HG-CIN after conization treatment.
OBJECTIVE
Io evaluate the expression of p16INK4a and p53 biomarkers in conization specimens from patients with high grade cervical intraepithelial neoplasia (HG-CIN), correlating them with the ability to predict the recurrence.


METHODS
we conducted a retrospective study of patients with HG-CIN in cervical biopsy treated with conization between January 1999 and January 2006 who had a minimum follow-up of 18 months. The expression of the p16 and p53 was assessed by tissue microarrays and correlated with disease recurrence. For analysis, we used the test of proportions (chi-square), considering value p<0.05, 95% CI and calculations of sensitivity, specificity and accuracy of these immunomarkers in predicting recurrence.


RESULTS
the series comprised 83 patients aged between 16 and 86 years (35±11.7), divided into two groups: 30 with HG-CIN recurrence (study group) and 53 without recurrence (control group). Mean age, parity, smoking and conization technique were similar in both groups. The p53 expression was present in 43% of the study group and 57% of the control group, and the p16 was present in 43% of the study group and in 57% of the control group (p>0.05). p53 had a positive predictive value (PPV) of 42% and negative predictive value (NPV) of 73%, sensitivity 70%, specificity of 47% and accuracy of 59%. The p16, PPV 42%, NPV 72%, sensitivity 66%, specificity of 49% and accuracy of 56%.


CONCLUSIONS
immunohistochemistry expression of p53 and p16 showed low sensitivity and low specificity as predictors of HG-CIN recurrence after conization treatment.
Hospital Erasto Gaertner, Curitiba, PR, Brasil.
Fernanda Villar
FV
Fonseca
Universidade Federal do Paraná, Curitiba, PR, Brasil.
Flávio Daniel S
FD
Tomasich
Hospital Erasto Gaertner, Curitiba, PR, Brasil.
Juliana Elizabeth
JE
Jung
Hospital Erasto Gaertner, Curitiba, PR, Brasil.
Carlos Afonso
CA
Maestri
Departamento de Tocoginecologia, Universidade Federal do Paraná, Brasil.
Newton Sérgio de
NS
Carvalho
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019092:Conization; D019941:Cyclin-Dependent Kinase Inhibitor p16 / Q000032:analysis*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D016159:Tumor Suppressor Protein p53 / Q000032:analysis*; D002583:Uterine Cervical Neoplasms / Q000737:chemistry* / Q000473:pathology / Q000601:surgery; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000737:chemistry* / Q000473:pathology / Q000601:surgery
C000614131:CDKN2A protein, human; D019941:Cyclin-Dependent Kinase Inhibitor p16; D016159:Tumor Suppressor Protein p53