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. 2024 Jul 11;19(1):97.
doi: 10.1186/s13000-024-01523-z.

Immunohistochemistry staining of Eag1 and p16/Ki-67 can help improve the management of patients with cervical intraepithelial Neoplasia after cold knife conversion

Shikang Qiu  1 , Qiannan Wang  1 , Huihui Jiang  2 , Limin Feng  3
Affiliations

Immunohistochemistry staining of Eag1 and p16/Ki-67 can help improve the management of patients with cervical intraepithelial Neoplasia after cold knife conversion

Shikang Qiu et al. Diagn Pathol. .

Abstract

Background: Immunohistochemistry (IHC) is widely used in the management of patients with cervical intraepithelial neoplasia (CIN) but still has many limitations in clinical practice. We analyzed the correlation of new biomarkers with the severity of CIN and follow-up outcomes in patients after conization to improve the management of patients with CIN.

Methods: IHC staining of Eag1 and p16/Ki-67 was performed on cervical tissue sections from 234 patients with suspected CIN2/3. After a series of follow-ups, including human papillomavirus (HPV) test and thinprep cytologic test (TCT) for 1-2 years, the outcomes were collected. IHC scores of biomarkers and follow-up results were used to analyze the correlation and assess the diagnostic efficiency of biomarkers.

Results: The IHC staining intensity of Eag1 and p16/Ki-67 was significantly different from that of the CIN1-3 groups (p < 0.05). Eag1 expression scores were significantly different in the distribution between the two follow-up groups (p < 0.001). ROC curves based on the correlations between the follow-up outcomes and the Eag1 scores and IS of p16/ki-67 showed that Eag1 had a greater AUC (0.767 vs. 0.666). Logistic regression analysis of the combination of biomarkers revealed a greater AUC value than any single biomarker.

Conclusions: Eag1 expression was significantly correlated with CIN grade and follow-up outcomes after conization. IHC staining of combinations of biomarkers of Eag1, p16 and Ki-67 may help us to improve the ability to identify risk groups with abnormal follow-up outcomes after treatment for CIN.

Keywords: Cervical intraepithelial neoplasia; Eag1; Follow-up; Ki-67; p16.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart of the study based on the screening cohort
Fig. 2
Fig. 2
IHC score is correlated with CIN grade but not exactly corresponding. Eag1 staining corresponding Ki-67 and p16 stainings show positive predominantly found in the lower one-thirds of the epithelium (Score 1), which is most common in CIN1. Positive in the lower two-thirds of the epithelium (Score 2) is most common in CIN2. Positive in full-thickness of the epithelium (Score 2) is most common in CIN3+
Fig. 3
Fig. 3
ROC curves of IHC score for detecting the results of following-up after CKC. (A) The Eag1 score showed advantages over IS of p16/Ki-67 with higher AUCs. (B)integrated indicator has highest AUCs than other indicators
See this image and copyright information in PMC

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