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p16 Immunohistochemistry in Colposcope-Directed and Random Cervical Biopsies of CIN2 and CIN3
Cynthia Arvizo1, Qing Chen, Hui Du
11Women's Health Institute, Cleveland Clinic, Cleveland, OH, USA; 2Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen, China and the Key Laboratory on Technology for Early Diagnosis of Major Gynecological diseases, Shenzhen, PR China; 3Department of Anatomic and Molecular Pathology, Cleveland Clinic, Cleveland, OH, USA; 4Department of Obstetrics and Gynecology, Kaiser Fontana California, Fontana, CA, USA; and 5Preventive Oncology International, Inc., Cleveland Heights, OH, USA.
Objective:
The aim of this study was to determine if there is a different p16 expression pattern between colposcope-directed and random (colposcope-undetectable) biopsies of cervical intraepithelial neoplasia (CIN2) and CIN3.
Methods:
Cervical biopsies that were positive for CIN2 or CIN3 were selected from a database of samples acquired during a large population-based clinical trial in Guangdong Province in China (Shenzhen Cervical Cancer Screening Study II). Blocks were recut, reread, and then immunostained for p16. Biopsies were categorized as either colposcope-directed or random biopsies. Diffuse staining was considered p16 positive, whereas focal or no staining was considered p16 negative. Differences were determined by the Fisher exact test.
Results:
Among the patients with CIN3, there were 232 individual biopsies of CIN3. Sixty were randomly collected, and 172 were colposcopy directed. p16 positivity for the colposcope-directed and random biopsies was 97.7% and 91.7%, respectively (p = 0.052). Like the CIN3 biopsies, colposcope-directed and random CIN2 samples expressed p16 similarly (86.8% [46/53] and 82.6% [19/23], p = .73, respectively).
Conclusions:
Based on our data, even small colposcope-undetectable biopsies of CIN3 are significant. Random biopsies of CIN2 or CIN3 demonstrate similar p16 positivity as visible lesions and therefore might be expected to have a similar natural history.
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