2011•Zhonghua zhongliu fangzhi zazhiRequires access
Expressions of p16~(INK4a),p53 and Ki-67 in cervical intraepithelial lesion by immunohistochemistry and their diagnostic and clinic significance
Yi Shen
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Abstract
OBJECTIVE:To explore immunohistochemistry staining for p16INK4a,p53 and Ki-67 as adjunct indicators for cervical intraepithelial neoplasia(CIN) diagnosis,improving the routine interpretation of cervical histopathology.METHODS:Totally 133 cases of CIN were involoved in this study,which consisted of 31 CIN 1,37 CIN 2,65 CIN 3 from archival data in our hospital.The average age was 44 years(range 20-86 years).All hematoxylin-eosin slides were reexamined independently by three senior pathologists.Nineteen cases of chronic cervicitis and 20 cases of invasive squamous cell carcinoma were involved as controls.Immunostains for p16INK4a,p53 and Ki-67 were performed.The expressions of immunostain were scored independent of the corresponding SP stained sections and clinical data except age.Statistical analysis was performed by Univariate χ2 tests and Spearman analysis.RESULTS: The expression of p16 was located in nucleus and cytoplasm.For p53 and Ki-67,were located in nucleus.All three biomarkers correlated positively with the grading of CIN(r were 0.789,0.554 and 0.749,P0.001).In 153 cases of CIN1+,raw agreement between the expression of p16,p53 and Ki-67,and histological diagnosis was 96.7%(148/153),71.9%(110/153) and 88.2%(135/153),respectively.In 102 cases with CIN 2+,sensitivity for p16,p53 and Ki-67 immunostain was 97.1%(99/102),74.5%(76/102) and 97.1%(99/102),respectively.And specificity for these biomarkers was 94.7%(18/19),84.2%(16/19) and 73.7%(14/19),respectively.Combined the three biomarkers,the sensitivity and specificity of CIN 2+ was 98.0%(100/102) and 68.4%(13/19),respectively.CONCLUSIONS: Immunohistochemical staining for p16 is a high degree of sensitivity,and specificity appears to be a useful and reliable diagnostic adjunct for distinguishing high-grade CIN.It appears that conjunctive interpretation of p16,p53 and Ki-67 can significantly improve the routine interpretation of cervical histopathology.