Immunocytochemical expression of p16(INK4A) and Ki-67 in cytologically negative and equivocal Pap smears positive for oncogenic human papillomavirus

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dc.contributor.authorLongatto, A.
dc.contributor.authorUtagawa, M. L.
dc.contributor.authorShirata, N. K.
dc.contributor.authorPereira, SMM
dc.contributor.authorNamiyama, G. M.
dc.contributor.authorKanamura, C. T.
dc.contributor.authorSantos, G. D.
dc.contributor.authorOliveira, M. A. de
dc.contributor.authorWakamatsu, A.
dc.contributor.authorNonogaki, S.
dc.contributor.authorRoteli-Martins, C.
dc.contributor.authordi Loreto, C.
dc.contributor.authorFerraz, MDMD
dc.contributor.authorMaeda, MYS
dc.contributor.authorAlves, VAF
dc.contributor.authorSyrjanen, K.
dc.contributor.institutionAdolfo Lutz Inst
dc.contributor.institutionUniv Minho
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.contributor.institutionLeonor Mendes Barros Hosp
dc.contributor.institutionUniversidade de São Paulo (USP)
dc.contributor.institutionTurku Univ
dc.date.accessioned2016-01-24T12:37:47Z
dc.date.available2016-01-24T12:37:47Z
dc.date.issued2005-04-01
dc.description.abstractThis study was designed to analyze the cross-sectional comparison of the p16(INK4A) and Ki-67 immunocytochemical expression in negative and equivocal (atypical squamous cells of undetermined significance (ASC-US)) liquid-based cytology (LBQ samples testing positive for high-risk human papillomavirus (HPV) types with HC2 assay or polymerase-chain reaction (PCR). A series of 199 consecutive LBC specimens derived from the same number of women participating in the ongoing Latin American Screening Study at Leonor Mendes de Barros Hospital, São Paulo, were analyzed using immunocytochemistry for expression of p16(INK4A) and Ki-67 in negative and equivocal LBC samples testing positive for high-risk HPV types with hybrid capture 11 test (HC2) or PCR. All patients with at least one test positive (cytology, PCR, and/or HC2) were followed each 6 months for 3 years. the follow-up procedure consisted of visual examination, colposcopic inspection, cytology, and HC2 assay. Among the negative cytologic samples, 101 were HPV-positive and 55 HPV-negative. of the HPV-positive group, 59 of 101 cases (58.4%) were positive for both p16 and M67 inummostaining, and 17 of 101 (16.8%) were negative for both. the proportion of Ki-67-positivity increased almost in parallel with the increasing grade of p16-positivity (p = 0.0001 for linear trend). in the HPV-negative group, both markers were negative in 41 of 55 cases (74.5%), and no statistical relationship was observed between the two markers (Pearson, p = 0.595). HPV-positive ASC-US samples demonstrated a simultaneous positive immunoreaction for p 16 and Ki67 in 11 of 16 cases (68.7%), whereas 3 (18.7%) were concurrently negative. the relationship between the two markers was of borderline significance (Pearson, p = 0.053), but no linear relationship was found between the graded p16 and Ki-67 expression (p = 0.065 for linear trend). in the HPV-negative ASGUS group, there was no statistical association between the graded p16 and Ki-67 positivity (Pearson, p = 0.28 1). After 36 months of follow-up of the ASC-US patients, 6 women still displayed ASC-US smear, of which 4 of 6 were HPV-positive and expressed both p16 and Ki-67 markers. Two of 43 ASC-US smears had high-grade intraepithelial lesion (2.3%). All of those were positive for HPV, p16 and Ki-67. Patients with ASC-US diagnosis and positive high-risk HPV status and positive for p16(INK4A) Ki67 should be carefully observed to exclude occurrence of a squamous intraepithelial lesion. the combination of these two markers can be a useful implement for management of women with equivocal cytology.en
dc.description.affiliationAdolfo Lutz Inst, Div Pathol, BR-01246902 São Paulo, Brazil
dc.description.affiliationUniv Minho, Sch Hlth Sci, Braga, Portugal
dc.description.affiliationUniversidade Federal de São Paulo, Dept Pathol, Sch Med, São Paulo, Brazil
dc.description.affiliationLeonor Mendes Barros Hosp, São Paulo, Brazil
dc.description.affiliationUniv São Paulo, Sch Med, Dept Pathol, São Paulo, Brazil
dc.description.affiliationTurku Univ, Cent Hosp, Dept Radiotherapy & Oncol, Turku, Finland
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Dept Pathol, Sch Med, São Paulo, Brazil
dc.description.sourceWeb of Science
dc.format.extent118-124
dc.identifierhttp://dx.doi.org/10.1097/01.RCT.0000157092.44680.25
dc.identifier.citationInternational Journal of Gynecological Pathology. Philadelphia: Lippincott Williams & Wilkins, v. 24, n. 2, p. 118-124, 2005.
dc.identifier.doi10.1097/01.RCT.0000157092.44680.25
dc.identifier.issn0277-1691
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/28239
dc.identifier.wosWOS:000227883400002
dc.language.isoeng
dc.publisherLippincott Williams & Wilkins
dc.relation.ispartofInternational Journal of Gynecological Pathology
dc.rightsinfo:eu-repo/semantics/restrictedAccess
dc.subjectp16en
dc.subjectKi67en
dc.subjectcervical canceren
dc.subjecthuman papillomavirusen
dc.subjectliquid-based cytologyen
dc.titleImmunocytochemical expression of p16(INK4A) and Ki-67 in cytologically negative and equivocal Pap smears positive for oncogenic human papillomavirusen
dc.typeinfo:eu-repo/semantics/article
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