Human papillomavirus detection and p16INK4a expression in cervical lesions: a comparative study

Area of Science:

• Gynecologic Pathology
• Oncovirology
• Biomarker Research

Background:

• p16(INK4a) expression correlates with high-risk human papillomavirus (HR-HPV) in cervical dysplasia.
• Immunohistochemical detection of p16(INK4a) can improve diagnostic reproducibility and prognostic assessment in cervical biopsies.
• Understanding p16(INK4a) expression patterns is crucial for managing cervical intraepithelial neoplasia (CIN).

Purpose of the Study:

• To investigate the immunohistochemical expression of p16(INK4a) in various grades of cervical intraepithelial neoplasia (CIN).
• To correlate p16(INK4a) expression with HR-HPV detection and genotyping in dysplastic cervical lesions.
• To evaluate the diagnostic and prognostic implications of p16(INK4a) negativity in CIN-I and CIN-II lesions.

Main Methods:

• Analysis of 86 cervical lesions (54 CIN-I, 23 CIN-II, 9 CIN-III) for p16(INK4a) expression using immunohistochemistry.
• Detection and genotyping of HR-HPV in all studied lesions.
• Follow-up assessment of p16-negative CIN-I and CIN-II cases to monitor lesion progression.

Main Results:

• HR-HPV was detected in a high percentage of CIN-II (21/23) and CIN-III (9/9) cases, and a significant proportion of CIN-I (19/54) cases.
• p16(INK4a) immunoreactivity was observed in all CIN-III cases, most HR-HPV-positive CIN-II cases, and a subset of HR-HPV-positive CIN-I cases.
• Follow-up revealed progression to high-grade lesions in some p16-negative CIN-I and CIN-II cases, indicating that p16 negativity does not always signify regression.

Conclusions:

• p16(INK4a) negativity in CIN-I and CIN-II biopsies should not be interpreted as definitive lesion regression.
• Diagnosis of CIN-II should not rely exclusively on p16(INK4a) results, emphasizing the need for comprehensive evaluation.
• p16(INK4a) remains a valuable adjunct in assessing cervical dysplasia, but its limitations in predicting regression must be acknowledged.