title: Effect of Lower Anogenital Squamous Terminology Recommendations on the Use of p16 Immunohistochemistry and the Proportion of High-Grade Diagnoses in Cervical Biopsy Specimens.
abstract: OBJECTIVE
  The Lower Anogenital Squamous Terminology (LAST) group has recommended that cervical intraepithelial neoplasia (CIN) terminology be replaced by squamous intraepithelial lesion (SIL) terminology, with p16 immunohistochemistry used to separate lesions formerly diagnosed as CIN grade 2 into high-grade SILs (HSILs) and low-grade SILs. This study investigated the impact of these changes on the frequency of p16 testing and the diagnosis of high-grade lesions.
  
  
  METHODS
  Pathology reports for all cervical biopsy specimens in the 1 year before and after the introduction of LAST recommendations (July 2011 to June 2013) were examined.
  
  
  RESULTS
  Before and after the implementation of LAST, 365 (15.4%) of 2,376 cases were diagnosed as high grade (CIN 2/3) vs 486 (17.6%) of 2,761 cases diagnosed as HSILs (P = .0343), and p16 was performed 79 (3.3%) times vs 383 (13.9%) times (P < .0001).
  
  
  CONCLUSIONS
  Immunohistochemistry for p16 increased dramatically as a result of LAST recommendations, and high-grade diagnoses increased.
authors.affiliation: From the Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, TX, and Weill Medical College of Cornell University, New York, NY. mjthrall@houstonmethodist.org.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Thrall
mesh_terms: D000328:Adult; D014408:Biomarkers, Tumor / Q000032:analysis*; D019941:Cyclin-Dependent Kinase Inhibitor p16 / Q000032:analysis*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry / Q000706:statistics & numerical data; D008875:Middle Aged; D060787:Neoplasm Grading / Q000379:methods; D017410:Practice Guidelines as Topic; D065310:Squamous Intraepithelial Lesions of the Cervix / Q000473:pathology*; D009626:Terminology as Topic; D002583:Uterine Cervical Neoplasms / Q000473:pathology*; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D019941:Cyclin-Dependent Kinase Inhibitor p16
keywords: Cervical biopsy; High-grade squamous intraepithelial lesion; Lower anogenital squamous terminology; p16 immunohistochemistry