Clinical role of p16INK4a expression in liquid-based cervical cytology: correlation with HPV testing and histologic diagnosis

Am J Clin Pathol. 2008 Apr;129(4):606-12. doi: 10.1309/BEPQXTCQD61RGFMJ.

Abstract

p16INK4a is overexpressed in high-risk human papillomavirus (HR-HPV)-infected preneoplastic and neoplastic lesions of the uterine cervix. Our aim was to verify whether p16 is a diagnostic marker also in cervical liquid-based cytology. We performed p16 immunocytochemical analysis and the Hybrid Capture 2 (HC2) test (Digene, Gaithersburg, MD) for HR-HPV infection in 471 ThinPrep-processed (Cytyc, Boxborough, MA) cervicovaginal samples and correlated the results with histologic findings. A total of 32.3% of the specimens showed p16 immunoreactivity, whereas the HC2 test was positive in 41.2% of the cases (65.2% concordance rate). Correlating the cytologic, p16, and HPV results with histologic findings revealed HC2 as the most sensitive test for a diagnosis of cervical intraepithelial neoplasia 2 or worse, whereas cytologic examination was the most specific. The positive predictive value was significantly higher for cytologic examination than for p16 and HR-HPV testing. These data suggest that p16 evaluation in ThinPrep samples does not have better clinical effectiveness for identifying high-grade lesions than conventional morphologic examination and HPV testing.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cyclin-Dependent Kinase Inhibitor p16 / metabolism*
  • DNA, Viral / analysis
  • Female
  • Humans
  • Immunohistochemistry
  • Middle Aged
  • Papillomaviridae / genetics
  • Papillomaviridae / isolation & purification*
  • Papillomavirus Infections / metabolism*
  • Papillomavirus Infections / virology
  • Precancerous Conditions / metabolism*
  • Precancerous Conditions / virology
  • Predictive Value of Tests
  • Tumor Virus Infections / metabolism*
  • Tumor Virus Infections / virology
  • Uterine Cervical Dysplasia / metabolism*
  • Uterine Cervical Dysplasia / virology
  • Uterine Cervical Neoplasms / metabolism*
  • Uterine Cervical Neoplasms / virology
  • Vaginal Smears / methods

Substances

  • Cyclin-Dependent Kinase Inhibitor p16
  • DNA, Viral