title: Evaluation of the p16 and Ki-67 Biomarkers as Predictors of the Recurrence of Premalignant Cervical Cancer Lesions after LEEP Conization.
abstract: ObjectiveTo evaluate the expressions of biomarkers p16 and Ki-67 in low-grade (LG) or high-grade (HG) lesions, and to relate them to risk factors and the recurrence of these lesions.MethodsA retrospective case-control study of 86 patients with LG and HG lesions who underwent a loop electrosurgical excision procedure (LEEP) between 1999 and 2004. The control group was composed of 69 women with no recurrence, and the study group, of 17 patients with recurrence. All patients were followed-up over a two-year period after surgery, and screened every six months, including cytology and colposcopy. Biopsy samples collected from LEEP were submitted to immunohistochemical analysis for p16 and Ki-67. The statistical analysis was performed using the Statistical Package for the Social Sciences software (SPSS, IBM-SPSS, Inc., Chicago, IL, US), with a significant p ​​< 0.05.ResultsThe biomarkers p16 and Ki-67, separately or combined, showed no relation to recurrence on the total analysis. However, evaluating specifically HG lesions, the positive expression (2+ and 3+) of p16/Ki-67 was associated with recurrence (0.010). In addition, p16 isolated was also more expressive in HG lesions (2+ and 3 + ,p= 0.018), but it was unrelated to recurrence.ConclusionProteins p16 and Ki-67, both isolated and combined, are not reliable primary markers for the recurrence of cervical lesions in the majority of LG lesions. However, analyzing only the group with prior diagnosis of HG lesions, the expressions of p16 and of p16/Ki-67 were associated with recurrence, and they may be useful in monitoring these cases.
authors.affiliation: Instituto de Ensino e Pesquisa, Santa Casa Belo Horizonte (IEP/SCBH), Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Paulo Macêdo de Oliveira
authors.initials: PMO
authors.lastname: Leite
authors.affiliation: Instituto de Ensino e Pesquisa, Santa Casa Belo Horizonte (IEP/SCBH), Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Luciene
authors.initials: L
authors.lastname: Tafuri
authors.affiliation: Hospital São João de Deus, Fundação Geraldo Corrêa, Divinópolis, Minas Gerais, Brazil.
authors.forename: Maria Zélia de Oliveira
authors.initials: MZO
authors.lastname: Costa
authors.affiliation: Instituto de Ensino e Pesquisa, Santa Casa Belo Horizonte (IEP/SCBH), Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Maria Inês de Miranda
authors.initials: MIM
authors.lastname: Lima
authors.affiliation: Instituto de Ensino e Pesquisa, Santa Casa Belo Horizonte (IEP/SCBH), Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Renata Toscano
authors.initials: RT
authors.lastname: Simões
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis*; D016022:Case-Control Studies; D019092:Conization / Q000379:methods; D019941:Cyclin-Dependent Kinase Inhibitor p16 / Q000032:analysis*; D004598:Electrosurgery; D005260:Female; D006801:Humans; D019394:Ki-67 Antigen / Q000032:analysis*; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D011230:Precancerous Conditions / Q000175:diagnosis*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D002583:Uterine Cervical Neoplasms / Q000737:chemistry* / Q000175:diagnosis* / Q000601:surgery
chemical_list: D014408:Biomarkers, Tumor; C000614131:CDKN2A protein, human; D019941:Cyclin-Dependent Kinase Inhibitor p16; D019394:Ki-67 Antigen