Srpski arhiv za celokupno lekarstvo 2015 Volume 143, Issue 1-2, Pages: 42-49
https://doi.org/10.2298/SARH1502042G
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Significance of immunohistochemical expression of p16INK4a in the differentiation of inflammatory and preneoplastic cervical lesions
Gajanin Živorad (Healthcare Center, Kotor Varoš, Republic of Srpska, Bosnia and Herzegovina)
Vilendečić Rade (Clinical Center Banja Luka, Republic of Srpska, Banja Luka, Bosnia and Herzegovina)
Ećim-Zlojutro Vesna (Clinical Center Banja Luka, Republic of Srpska, Banja Luka, Bosnia and Herzegovina)
Gajanin Radoslav (Clinical Center Banja Luka, Republic of Srpska, Banja Luka, Bosnia and Herzegovina)
Budakov Pavle (Clinical Center of Vojvodina, Department of Pathology, Novi Sad)
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