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P16INK4A as an adjunct test in liquid-based cytology
Marluce Bibbo1, Jennifer DeCecco, Albert J Kovatich
1Division of Cytopathology and Immunopathology, Department of Pathology, Thomas Jefferson University, 132 South 10th Street, Room 260, Main Building, Philadelphia, Pennsylania 19107, USA.
Analytical and Quantitative Cytology and Histology
|March 13, 2003
Summary
P16INK4A testing in liquid-based cytology aids in diagnosing equivocal high-grade squamous intraepithelial lesions (HSIL). Positive P16INK4A results in ThinPrep specimens correlated well with biopsy findings, improving diagnostic accuracy for cervical intraepithelial neoplasia (CIN).
Area of Science:
- Gynecologic Pathology
- Cervical Cytology
- Molecular Diagnostics
Background:
- Equivocal morphologic changes in liquid-based cytology (LBC) for high-grade squamous intraepithelial lesions (HSIL) present diagnostic challenges.
- Accurate differentiation of HSIL is crucial for timely management and prevention of cervical cancer.
- P16INK4A is a biomarker associated with human papillomavirus (HPV) infection and cellular dysplasia.
Purpose of the Study:
- To evaluate the diagnostic utility of P16INK4A immunocytochemistry as an adjunct test in ThinPrep specimens with equivocal HSIL morphology.
- To correlate P16INK4A expression in cytology with corresponding biopsy findings.
Main Methods:
- P16INK4A immunoreactivity was assessed in 30 ThinPrep cases with equivocal HSIL diagnoses and available follow-up biopsies.
- Residual ThinPrep material and corresponding biopsy tissues were stained for P16INK4A.
- Cytology specimens were scored positive if >10 abnormal cells showed nuclear and cytoplasmic staining; biopsies were scored for staining intensity (negative, sporadic, focal, diffuse).
Main Results:
- P16INK4A was positive in 63.3% (19/30) of equivocal ThinPrep cases.
- Of these, 89.4% (17/19) of corresponding biopsies showed P16INK4A positivity in dysplastic regions, including CIN 1, CIN 2, and CIN 3.
- 17 of 18 (94.4%) ThinPrep cases later confirmed as high-grade lesions by biopsy demonstrated P16INK4A positivity.
Conclusions:
- P16INK4A testing of ThinPrep specimens with equivocal HSIL cytology is a valuable adjunct for improving diagnostic accuracy.
- Positive P16INK4A staining in cytology correlates well with biopsy-confirmed cervical intraepithelial neoplasia.
- Further studies with larger cohorts and exploration of HPV's role are warranted.