Abstract
Background & Objective:Cervical cancer is the most common cancer in women worldwide with high mortality, necessitating quicker diagnostic methods. We wish to enhance the existing cervical biopsies of Squamous Intraepithelial Lesions (SIL) using p16 and Ki67 as surrogate markers to assess correlation between its positivity and histological grade of the lesion.Methods:Analysis of p16 and Ki67 expression was done on 31 histopathologically diagnosed cases of SILs. Positive expression of p16 was assessed based on a scoring system and compared with histology and cytology. Ki67 expression was studied and the correlation was observed with degree of dysplasia. Twenty cases of chronic cervicitis was assigned to the control group for comparison.Results:Cases of HSIL showed greater expression of p16 as compared to LSIL. Sensitivity of p16 for HSIL was higher than that for LSIL. The specificity for HSIL and LSIL was 100%. Ki67 expression correlated well with the degree and level of dysplasia with a significant P-value of 0.002.Conclusion:p16 and Ki67 positivity of SILs should point towards further evaluation. The expressions of p16 and Ki67 are useful markers for confirmation of SILs and in predicting HPV infection which can be further confirmed by HPV DNA testing.
Highlights
Carcinoma cervix is one of the most common cancers among women worldwide and is the second most frequent type of cancer among Indian women [1]
With the introduction of the two-tiered system to classify precursor lesions as squamous intraepithelial lesion (SIL), high grade or low grade reproducibility improved, but the quest to improve diagnostic accuracy has led to research with various immunohistochemical markers that target the basic mechanism in the pathogenesis of premalignant lesions of the cervix [9,10] The Human papilloma virus (HPV) infection is responsible for Squamous Intraepithelial Lesions (SIL) and its progression to invasive carcinoma has been well established
Thirty-one cases were selected with histopathological diagnosis of cervical intraepithelial lesion (CIN 1,2,3) or squamous intraepithelial lesion (HSIL or LSIL)
Summary
Carcinoma cervix is one of the most common cancers among women worldwide and is the second most frequent type of cancer among Indian women [1]. The Papanicolaou (pap) cervical cytology test has been routinely used since 1960 to screen precursor lesions of the cervix and the diagnostic criteria have been updated since the introduction of the Bethesda system of reporting cervical cytology [5]. With the introduction of the two-tiered system to classify precursor lesions as squamous intraepithelial lesion (SIL), high grade or low grade reproducibility improved, but the quest to improve diagnostic accuracy has led to research with various immunohistochemical markers that target the basic mechanism in the pathogenesis of premalignant lesions of the cervix [9,10] The Human papilloma virus (HPV) infection is responsible for SIL and its progression to invasive carcinoma has been well established. Cervical cancer is the most common cancer in women worldwide with high mortality, necessitating quicker diagnostic methods. We wish to enhance the existing cervical biopsies of Squamous Intraepithelial Lesions (SIL) using p16 and Ki67 as surrogate markers to assess correlation between its positivity and histological grade of the lesion
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