The Utility of p16INK4a and Ki-67 as a Conjunctive Tool in Uterine Cervical Lesions
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ÀÌ»óÈ£ ( Lee Sang-Ho )
Gachon University Gil Hospital Department of Pathology
±èÇöö ( Kim Hyun-Chul )
Kwandong University College of Medicine Department of Pathology
±èÇý¼ø ( Kim Hye-Sun )
Korea University College of Medicine Anam Hospital Department of Pathology
±èöȯ ( Kim Chul-Hwan )
Kwandong University College of Medicine Department of Pathology
±èÀμ± ( Kim In-Sun )
Kwandong University College of Medicine Department of Pathology
KMID : 0357920120460030253
Abstract
Background : Immunohistochemical staining for p16INK4a and Ki-67 has been used to improve the accuracy in making a diagnosis of the uterine cervix cancer on biopsy. This study was conducted to examine the usefulness of these markers in the pathological diagnosis based on cervical biopsy.
Methods : We selected a consecutive series of 111 colposcopically directed cervical punch biopsies. Using these biopsy samples, we performed an immunohistochemical staining for p16INK4a and Ki-67 to establish a diagnosis. The slides were circulated among four pathologists in a sequential order: the hematoxylin and eosin (H&E) slide, H&E slide and p16INK4a-stained slide, and H&E slide, p16INK4a- and Ki-67-stained slides.
Results : The overall rates of the concordance in the first, the second, and the third diagnoses were 77.5%, 82.0%, and 82.0%, respectively. The rate of the concordance in the diagnosis of cervical intraepithelial neoplasm (CIN) 2/3 was increased from 62.2% to 73.0%. But there was a variability in the rate of the revision of the diagnosis between the pathologists. With the application of criteria for interpreting the expressions of p16INK4a and Ki-67, benign and CIN 1 lesions showed a p16INK4a expression score of 0 or 1. But CIN 2 and CIN 3 lesions showed a p16INK4a expression score of 2 and 3, respectively.
Conclusions : The immunostain for p16INK4a and Ki-67 might be useful in reducing an inter-observer variability. But criteria for interpreting both markers should be strictly applied.
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Uterine cervix; p16INK4a; Ki-67
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