The utility of p16INK4a and Ki-67 as a conjunctive tool in uterine cervical lesions

Sangho Lee, Hyunchul Kim, Hyesun Kim, Chul Hwan Kim, Insun Kim

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Abstract

Background: Immunohistochemical staining for p16INK4a and Ki-67 has been used to improve the accuracy in making a diagnosis of the uterine cervix cancer on biopsy. This study was conducted to examine the usefulness of these markers in the pathological diagnosis based on cervical biopsy. Methods: We selected a consecutive series of 111 colposcopically directed cervical punch biopsies. Using these biopsy samples, we performed an immunohistochemical staining for p16INK4a and Ki-67 to establish a diagnosis. The slides were circulated among four pathologists in a sequential order: the hematoxylin and eosin (H&E) slide, H&E slide and p16INK4a-stained slide, and H&E slide, p16INK4a- and Ki-67-stained slides. Results: The overall rates of the concordance in the first, the second, and the third diagnoses were 77.5%, 82.0%, and 82.0%, respectively. The rate of the concordance in the diagnosis of cervical intraepithelial neoplasm (CIN) 2/3 was increased from 62.2% to 73.0%. But there was a variability in the rate of the revision of the diagnosis between the pathologists. With the application of criteria for interpreting the expressions of p16INK4a and Ki-67, benign and CIN 1 lesions showed a p16INK4a expression score of 0 or 1. But CIN 2 and CIN 3 lesions showed a p16INK4a expression score of 2 and 3, respectively. Conclusions: The immunostain for p16INK4a and Ki-67 might be useful in reducing an inter-observer variability. But criteria for interpreting both markers should be strictly applied.

Original languageEnglish
Pages (from-to)253-260
Number of pages8
JournalKorean Journal of Pathology
Volume46
Issue number3
DOIs
Publication statusPublished - 2012 Oct 30
Externally publishedYes

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Keywords

  • Ki-67
  • P16INK4a
  • Uterine cervix

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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