Korean J Pathol.  2012 Jun;46(3):253-260. 10.4132/KoreanJPathol.2012.46.3.253.

The Utility of p16INK4a and Ki-67 as a Conjunctive Tool in Uterine Cervical Lesions

• Lee S
• Kim H
• Kim H
• Kim C
• Kim I

• KMID: 1246258
• DOI: http://doi.org/10.4132/KoreanJPathol.2012.46.3.253

Abstract

BACKGROUND
Immunohistochemical staining for p16INK4a and Ki-67 has been used to improve the accuracy in making a diagnosis of the uterine cervix cancer on biopsy. This study was conducted to examine the usefulness of these markers in the pathological diagnosis based on cervical biopsy.
METHODS
We selected a consecutive series of 111 colposcopically directed cervical punch biopsies. Using these biopsy samples, we performed an immunohistochemical staining for p16INK4a and Ki-67 to establish a diagnosis. The slides were circulated among four pathologists in a sequential order: the hematoxylin and eosin (H&E) slide, H&E slide and p16INK4a-stained slide, and H&E slide, p16INK4a- and Ki-67-stained slides.
RESULTS
The overall rates of the concordance in the first, the second, and the third diagnoses were 77.5%, 82.0%, and 82.0%, respectively. The rate of the concordance in the diagnosis of cervical intraepithelial neoplasm (CIN) 2/3 was increased from 62.2% to 73.0%. But there was a variability in the rate of the revision of the diagnosis between the pathologists. With the application of criteria for interpreting the expressions of p16INK4a and Ki-67, benign and CIN 1 lesions showed a p16INK4a expression score of 0 or 1. But CIN 2 and CIN 3 lesions showed a p16INK4a expression score of 2 and 3, respectively.
CONCLUSIONS
The immunostain for p16INK4a and Ki-67 might be useful in reducing an inter-observer variability. But criteria for interpreting both markers should be strictly applied.

Keyword

Uterine cervix; p16INK4a; Ki-67

MeSH Terms

Observer Variation
Biopsy