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. 2023 Winter;14(1):69-75.
doi: 10.22088/cjim.14.1.69.

Comparison of Ki67 index and P16 expression in different grades of cervical squamous intraepithelial lesions

Maryam Sadat Hosseini  1 , Maryam Talayeh  2 , Noushin Afshar Moghaddam  3 , Maliheh Arab  2 , Farah Farzaneh  1 , Tahereh Ashrafganjoei  1
Affiliations

Comparison of Ki67 index and P16 expression in different grades of cervical squamous intraepithelial lesions

Maryam Sadat Hosseini et al. Caspian J Intern Med. 2023 Winter.

Abstract

Background: the assessment of P16 expression and Ki-67 proliferative index is now proposed as an adjunct test for the diagnosis of high-risk precursor lesions for cervical cancer. The aim of the present study was to elucidate the quality expression of P16 and quantification Ki-67 index in different types of cervical intraepithelial neoplasia and also to determine the cutoff for Ki67 index to predict the severity of CIN lesions.

Methods: This cross-sectional study was conducted on patients with colposcopic indication. Selected samples with different CIN grades were examined for P16 and Ki-67 index by immunohistochemical (IHC) methods.

Results: All LSIL (CIN I) cases were negative for P16, while in 58.7% of HSIL cases (CIN 2/3), P16 was positive. The mean Ki67 index in the present study was 3.13 ± 2.65 in the upper two/third of the squamous epithelium in the LSIL group and 19.04 ±36.40 in the HSIL group, which was statistically significant. Also, the mean Ki67 index in full thickness squamous epithelium in HSIL group was significantly higher than LSIL. The sensitivity of P16 and Ki67 index in our study was 58.73%, 66.67% and the specificity was 100% and 100%, respectively.

Conclusion: Assessment of P16 expression and Ki67 index can be used to distinguish low grade (CIN1) intraepithelial lesion from high grade (CIN2/3) intraepithelial or precancerous lesions.

Keywords: Cervical Intraepithelial Neoplasia; High Grade Squamous Intraepithelial Lesion; Immunohistochemistry; Ki 67 index; P16.

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Conflict of interest statement

Authors declare no conflict of interest

Figures

Figure 1
Figure 1
A: Photomicrograph of low grade squamous intraepithelial lesion (CIN1) revealed decreased cellular maturation, nuclear enlargement and mild irregularity in lower part of epithelium (H&E staining, ×200). B: Immunostaining for Ki67 in low grade squamous intraepithelial lesion (CIN1) showed low proliferative activity especially absent in upper part of epithelium
Figure 2
Figure 2
A: Photomicrograph of high grade squamous intraepithelial lesion (CIN3) revealed decreased cellular maturation, nuclear enlargement, hyperchromasia and irregularity in full thickness of epithelium (H&E staining, ×200). B: Immunostaining for Ki67 in high grade squamous intraepithelial lesion (CIN3) showed high proliferative activity in full thickness and also in upper part of epithelium
Figure 3
Figure 3
CIN3/diffuse block staining p16
Figure 4
Figure 4
Receiver operating characteristics (ROC) curve of upper 2/3 and full thickness for diagnosis of low grade from high grade CIN
See this image and copyright information in PMC

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