[Indications for p16/Ki-67 in cervical cytology]

Area of Science:

• Gynecologic Oncology
• Cervical Cancer Screening
• Diagnostic Cytology

Background:

• p16/Ki-67 immunocytochemistry is utilized in cervical cytology for detecting transforming HPV infections.
• Established use for over five years in cervical cytology.
• Aims to define clinically relevant indications for the p16/Ki-67 test.

Purpose of the Study:

• To determine practically relevant indications for p16/Ki-67 immunocytochemistry.
• Analyze the clinical course of 1109 patients with varying cytology results and immunocytochemistry.
• Evaluate short-term and long-term prognostic significance separately.

Main Methods:

• Analysis of 1109 patients' clinical courses.
• Simultaneous immunocytochemistry and cytology assessment.
• Separated short-term (n=409) and long-term (n=700) follow-up evaluations.

Main Results:

• p16/Ki-67 immunocytochemistry showed a relative risk (RR) of 3.79 for short-term and 8.72 for long-term follow-up for CIN2+.
• Highest RR observed in group IIID1/LSIL (6.32) and group III-p/ASC-H (3.98).
• Demonstrated significantly higher specificity and positive prediction compared to cytology or HPV DNA tests.

Conclusions:

• p16/Ki-67 immunocytochemistry is valuable for persistent IIID1/LSIL and equivocal III-p/ASC-H findings.
• Can potentially reduce the frequency of colposcopic examinations, especially in the IIID1/LSIL group.
• Improves patient management but positive results alone do not justify treatment.