title: p16 immunostaining as a predictor of anal and cervical dysplasia in women attending a sexually transmitted infection clinic.
abstract: BACKGROUND
  Carcinogenesis caused by human papillomavirus (HPV) leads to over-expression of p16 protein. p16 may act as a marker of HPV integration with host genome and serve as a surrogate marker of HPV oncogenesis.
  
  
  METHODS
  A single center study of 75 women (35 HIV-positive and 40 HIV-negative women) was conducted. Anal and cervical specimens were obtained for cytology and p16 immunostaining.
  
  
  RESULTS
  The sensitivity of p16 to diagnose anal and cervical dysplasia was 50% and 58.8%, respectively, whereas specificity was 98.6% and 100%, respectively. Positive predictive value for anal and cervical was 75% and 100%, whereas negative predictive value was 95.8% and 89.2%, respectively. A strong relationship between the grade of dysplasia and intensity of p16 immunoscore was observed (Pearson correlationr= 0.666,P< 0.0001 andr= 0.496,P< 0.0001 for anal and cervical, respectively).
  
  
  CONCLUSIONS
  p16 immunostaining with greater specificity for high-grade lesions may improve the diagnostic accuracy, especially for high-grade lesions which have a high risk of progression to malignancy and thereby necessitate treatment.
authors.affiliation: Department of Dermatology and STD, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, New Delhi, India.
authors.forename: Deepika
authors.initials: D
authors.lastname: Pandhi
authors.affiliation: Department of Dermatology and STD, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, New Delhi, India.
authors.forename: Kavita
authors.initials: K
authors.lastname: Bisherwal
authors.affiliation: Department of Dermatology and STD, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, New Delhi, India.
authors.forename: Archana
authors.initials: A
authors.lastname: Singal
authors.affiliation: Department of Obstetrics and Gynaecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, New Delhi, India.
authors.forename: Kiran
authors.initials: K
authors.lastname: Guleria
authors.affiliation: Department of Pathology, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, New Delhi, India.
authors.forename: Kiran
authors.initials: K
authors.lastname: Mishra
keywords: Anal intraepithelial neoplasia; cervical intraepithelial neoplasia; human papillomavirus; p16 immunohistochemistry; sexually transmitted infection clinic; women