[Evaluation of p16 protein in the managementof cervical dysplasia]

Protein p16 as an important cell-cycle inhibitor is a promising diagnostic and prognostic factor of cervical dysplasia. In our study we evaluate the impact of p16 protein evaluation on management of cervical dysplasia.

Retrospective study.

Department of Obstetrics and Gynecology, Medical Faculty Pilsen, Charles University Prague.

A retrospective study was performed on 122 consecutive patients with colposcopically-directed cervical biopsy (CDB) with following excisional procedure (LEEP or cold-knife conisation). P16 expression in the specimen from CDB was independently evaluated using immunohistochemistry in all patients. Relation among CDB histology, p16 expression, and final histology from excisional procedure was analysed.

In our series, we identified 44 CIN 1 and 61 CIN 2/3 in CDB specimens. In the CIN 1 group, 15 cases (34.1%) were p16 negative and 29 (65.9%) cases were p16 positive. In CIN 1 p16 negative group, only 2 of 15 patients (13.3%) had CIN 2/3 in the final histology comparing to 19 of 29 patients (65.5%) in CIN 1 p16 positive group (statistically signifiant,p < 0,05; Wilcoxon test). In CIN 2/3 group, 60 (98.4%) specimen were p16 positive and 57 patients (93.4%) had also CIN 2/3 in the final histology.

In our study of 122 patients with CDB we found that in group of CIN 1 patients, p16 evaluation had significant predictive value for final histology. In the group of patients with CIN 2/3, 98% specimens were p16 positive and therefore p16 evaluation had no prognostic impact on final histology. Prospective study is needed to confirm this data.