ASC-H 환자의 p16INK4a 면역세포화학염색 검사의 유용성
The Usefulness of p16INK4a Immunocytochemical Staining in ASC-H Patients
임광일, 강여주, 김태은, 박경신, 정은선, 최영진, 이교영, 강창석, 이아원,
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임광일 ( Yim Kwang-Il )
가톨릭대학교 의과대학 병원병리학교실
강여주 ( Kang Yeo-Ju )
가톨릭대학교 의과대학 병원병리학교실
김태은 ( Kim Tae-Eun )
가톨릭대학교 의과대학 병리학교실
박경신 ( Park Gyeong-Sin )
가톨릭대학교 의과대학 병원병리학교실
정은선 ( Jung Eun-Sun )
가톨릭대학교 의과대학 병원병리학교실
최영진 ( Choi Yeong-Jin )
가톨릭대학교 의과대학 병원병리학교실
이교영 ( Lee Kyo-Young )
가톨릭대학교 의과대학 병원병리학교실
강창석 ( Kang Chang-Suk )
가톨릭대학교 의과대학 병원병리학교실
이아원 ( Lee Ah-Won )
가톨릭대학교 의과대학 병원병리학교실
KMID : 0357920110450030290
Abstract
Background : The grey zone of cervical cytology, and in particular atypical squamous cells, cannot exclude HSIL (ASC-H) causes diagnostic difficulties and increases medical expenses. We analyzed p16INK4a expression in ASC-H liquid-based cytology specimens (LBCS) to develop more effective methods for the management of ASC-H patients.
Methods : We carried out p16INK4a immunostaining with 57 LBCS of ASC-H diagnostic categories, all of which were histologically cofirmed and 43 cases of which were compared with the results of a human papillomavirus (HPV) chip test.
Results : p16INK4a immunostaining with ASC-H LBCS was positive in 20% (3/15) of cervicitis, 25.0% (3/12) of tissue-low-grade squamous intraepithelial lesion, 75.0% (18/24) of tissue-high grade squamous intraepithelial lesion (HSIL), and 100% (6/6) of invasive cancer cases. The positivity of p16INK4a in LBCS was correlated with higher grade of histologic diagnosis (r=0.578, p=0.000). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of p16INK4a immunostaining for the prediction of tissue-HSIL+ were 80.0%, 77.8%, 80.0%, and 77.8%, respectively. The sensitivity, specificity, PPV, and NPV of p16INK4a immunostaining plus HPV chip test for predicting tissue-HSIL+ were 71.2%, 86.4%, 84.2%, and 79.2%.
Conclusions : p16INK4a immunostaining as well as HPV chip testing with remaining LBCS with ASC-H are useful objective markers for the prediction of tissue-HSIL+.
키워드
Cervical cancer; Cervical intraepithelial neoplasia; p16INK4a; DNA probes; HPV
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