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. 2018 Jul-Sep;35(3):153-158.
doi: 10.4103/JOC.JOC_4_17.

Role of p16/Ki-67 Dual Immunostaining in Detection of Cervical Cancer Precursors

Diya Das  1 , Moumita Sengupta  1 , Keya Basu  1 , Mona Tirkey  1 , Chhanda Datta  1 , Uttara Chatterjee  1
Affiliations

Role of p16/Ki-67 Dual Immunostaining in Detection of Cervical Cancer Precursors

Diya Das et al. J Cytol. 2018 Jul-Sep.

Abstract

Background: Pap-smears-based cytology and human papilloma virus testing have their own limitations in detecting cervical precancerous lesions, and still need further standardization. Co-expression of p16ink4a and Ki-67 can be used as additional biomarker.

Aims: To study the role of liquid-based cytology and the dual immunostaining for p16/Ki-67 in predicting the presence of significant lesion in cases of mild cytological atypia.

Materials and methods: A prospective, cross-sectional study was performed in the Department of Pathology, in collaboration with Department of Obstetrics and Gynecology over 15 months including 545 patients. Immunocytochemistry followed by colposcopy-guided biopsy were performed in 52 cases with epithelial abnormalities.

Results: Thirty-five cases (67%) were dual-stain positive among the cases with epithelial abnormalities. In the ASC-US and LSIL group, the sensitivity and specificity of the immunostaining in diagnosing CIN2+ lesions were 100 and 70% and 87.5 and 100%, respectively. p16/Ki-67 positivity also increased with cytological severity which in turn corresponded with histological findings: it reached from 33% in ASC-US to 100% in both HSIL and SCC categories.

Conclusion: This dual immunostaining may potentially be a useful tool in the triage of the ASC-US and the LSIL group, considering the high sensitivity and specificity values.

Keywords: ASCUS; LSIL; colposcopy guided biopsy; liquid based cytology; p16/Ki-67 immunostaining.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
A case of ASC-US. (a) Conventional cytology (MGG stain, x400); (b) Liquid based cytology showing cluster of atypical squamous cells of undetermined significance (Papanicolaou stain, x400); (c) Positive dual immunostaining (400x); (d) Histology of the same case showing CIN1(H and E, x100)
Figure 2
Figure 2
A case of LSIL. (a) Conventional cytology (MGG stain, x400); (b) Liquid based cytology showing low grade squamous intraepithelial lesion (Papanicolaou stain, x400); (c) Positive dual immunostaining (400x); (d) Histology of the same case showing CIN2 (H and E, x100)
See this image and copyright information in PMC

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