Abstract
Objective:The aim of the study is to analyse the Immuno-histochemical expression of Ki-67 and P16INK4a in CIN and cervical cancer cases and their utility to determine the accuracy of histological diagnosis and prediction of biological behavior of cervical lesion. Methodology:A retrospective cross-sectional study was carried in 110 numbers of cervical biopsy that included 25 CIN1, 21 CIN2, 12 CIN3, 26 SCC and 01 adenocarcinoma and 25 non neoplastic lesion. The tissue sections were stained with Ki-67 and P16INK4a. Results:Ki-67 expression was seen in 55.5% (61/110) cases of cervical lesion., out of which 3.6% (4/110; cervicitis -2/110 and metaplasia-2/110) cases were non dysplaia, 51.8% (57/110) cases were dysplasia /CIN of varying grade including invasive cancer. P16INK4a expression was noted 51.8% (57/110). There was an increasing trend of the intensity of Ki-67 and P16INK4a from focal positivity in low grade lesion to diffuse intensity in higher grade lesion and is statistically significant. There was strong association between the two variables Ki-67 and P16INK4a positive cases with their histologic grade. Conclusion:Though histopathology remains the ‘‘gold standard’’ for the diagnosis of CIN, both low and high-grade, biomarkers like Ki-67 and P16INK4a have emerged as helpful adjuncts. Their combined use may assist in the histopathologic classification of preinvasive lesions and facilitate the distinction from nondysplasia.
Highlights
Cervical intraepithelial neoplasia(CIN) is a term that describes a continuum of cervical change that begins with mild dysplasia and ends with invasive cancer after passing progressively through the intermediate stages of intraepithelial disease (Richart, 1987)
A retrospective cross-sectional study was carried in 110 numbers of cervical biopsy that included 25 CIN1, 21 CIN2, 12 CIN3, 26 SCC and 01 adenocarcinoma and 25 non neoplastic lesion
Ki-67 expression was seen in 55.5% (61/110) cases of cervical lesion., out of which 3.6% (4/110; cervicitis -2/110 and metaplasia-2/110) cases were non dysplaia, 51.8% (57/110) cases were dysplasia /cervical intraepithelial neoplasia (CIN) of varying grade including invasive cancer
Summary
Cervical intraepithelial neoplasia(CIN) is a term that describes a continuum of cervical change that begins with mild dysplasia and ends with invasive cancer after passing progressively through the intermediate stages of intraepithelial disease (Richart, 1987). Due to high-risk HPV infection, the cytological change may persist and these lesions contain more severe cytological atypia (CIN2 and CIN3), which are thought to be true potential precursors of cancer designated as high-grade CIN. Usha Sarma et al and Ki-67 immunohistochemical markers were applied to post-therapy cases of cervical cancer to detect residual tumour by Desai et al, 2021 with an accuracy of 82.86% (95%CI: 66.4- 93.4) for P16INK4a and 100% (CI:90.0-100.0) for Ki-67 stain. To evaluate the expression of p16 INK4a and Ki-67 in cervical intraepithelial neoplasia (CIN) and cervical cancer and (2) To study their utility to determine the accuracy of histological diagnosis and prediction of biological behaviour of cervical lesion
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