Histopathology of cervical lesions and their association with biomarker Ki-67

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Introduction: Histomorphological grading of cervical malignancy is important for clinical management. Ki-67, a proliferation marker known as predictive factor for tumor development, is a nuclear antigen expressed during all active phases of the cell cycle. In normal cervical squamous mucosa, Ki-67 is detected essentially in parabasal epithelial layers. Ki-67 immunohistochemistry positivity demonstrates the increasing proliferation in low and high grades of intraepithelial lesions. Objectives: To analyse the expression of Ki-67 immunostains on nonneoplastic, dysplastic and neoplastic specimens and to study their role in increasing the diagnostic accuracy in equivocal cases on histopathology. Materials and Methods: It was a cross sectional study done over a period of seven months after Institutional Ethics Committee permission. Histopathological examination and clinical diagnosis of all included patients was done. Immuno-histochemical staining for Ki-67 was performed and evaluated light-microscopically. A tumor was considered positive with significant proliferating activity only if nuclear Ki-67 accumulation was identified in at least 10% of all malignant cells in a tissue section. Observations: Histopathological examination and clinical diagnosis shows cervical carcinoma was the commonest and was seen in 82.50% of patients. Followed by chronic cervicitis (7.5%), prolapse (5%) and Non-neoplastic cervical growth (5%). Ki-67 grading 50% (score 3) was seen in 40(50.0%) of cervical biopsies. Ki-67 immunostaining was negative in chronic cervicitis cases. Conclusion: Histological diagnosis of cervical biopsy samples, is observed to have significant inter-observer discrepancies. Therefore, there is a need for additional sensitive and specific biomarkers to improve cervical cancer screening which can improve standardization and quality control of histopathological diagnosis. Keywords: Neoplastic and non-neoplastic cervical lesions, Histopathological examination, Ki-67