Significance of immunohistochemical expression of p16INK4a in the differentiation of inflammatory and preneoplastic cervical lesions

Abstract

Introduction. Most studies point at the main role of humanpapilloma virus (HPV) in the development of dysplasia and cervical cancer. Due to the low specificity and sensitivity of morphological diagnostic methods it is necessary to find an adequate marker which would be introduced in the screening program for cervical cancer. Most research suggests that p16INK4a is a specific and sensitive marker. Objective. The aim of this research was to determine the presence of p16INK4a expression in inflammatory and preneoplastic lesions of the cervix. Methods. The study was performed on 73 samples of cervical biopsy. In 34 patients a preneoplastic change (dysplasia) in the stratified squamous cervix epithelium was found, and in 39 a non-specific inflammatory process was disclosed. In all samples, immunohistochemical analysis using antibodies to p16INK4a was performed. Results. The expression of p16INK4a was verified in 67.65% of cases in dysplastic cervical lesions and 38.5% of the inflammatory lesions. A statistically significant difference was determined in the presence and grade of expression between dysplastic and inflammatory lesions of the cervix (χ2=24.16; p<0.001). The expression was more frequent and had a higher grade in dysplastic lesions with high grade and showed a statistically significant difference compared to the expression in low-grade dysplasia (χ2=21.48; p<0.001). Conclusion. The analysis of the presence of p16INK4a can differentiate non-neoplastic from preneoplastic changes in the cervix. It is recommended to use immunocytochemical and immunohistochemical analysis using p16INK4a in interpreting borderline lesions of the cervix.

Keywords

• cervical intraepithelial neoplasia
• cervicitis
• immunohistochemistry
• p16INK4a
• differentiation