Usefulness of combining testing for p16 protein and human papillomavirus (HPV) in cervical carcinoma screening

• Published in: Gynecologic oncology Vol. 103; no. 1; pp. 62 - 66
• Main Authors: Ekalaksananan, Tipaya, Pientong, Chamsai, Sriamporn, Supannee, Kongyingyoes, Bunkerd, Pengsa, Prasit, Kleebkaow, Pilaiwan, Kritpetcharat, Onanong, Parkin, D. Max
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.10.2006
• Subjects: Adult; Cohort Studies; Combining test; Cyclin-Dependent Kinase Inhibitor p16 - analysis; DNA, Viral - analysis; Female; HPV; Humans; Immunohistochemistry; Mass Screening - methods; Middle Aged; p16 protein; Papanicolaou Test; Papillomaviridae - genetics; Papillomaviridae - isolation & purification; Papillomavirus Infections - complications; Papillomavirus Infections - metabolism; Papillomavirus Infections - virology; Prospective Studies; Uterine Cervical Neoplasms - diagnosis; Uterine Cervical Neoplasms - metabolism; Uterine Cervical Neoplasms - pathology; Uterine Cervical Neoplasms - virology; Vaginal Smears; Combining test; p16 protein; HPV
• ISSN: 0090-8258; 1095-6859
• DOI: 10.1016/j.ygyno.2006.01.033

To evaluate the value of the combination of p16 and HPV detection in the screening for cervical cancer. 186 patients with previous abnormal cervical lesion were studied. After colposcopic examination, two conventional Pap slides were prepared: the first was Papanicolaou-stained and examined by cytologist; the second was immunocytochemically stained for p16. Cervical cells were collected by brush using for HPV detection by Hybrid Capture II. Biopsy of any colposcopically abnormal lesions was performed. The 186 cervical samples were classified cytologically as normal (148), ASCUS (13), low-grade (11), high-grade (12) dysplasia and squamous cell carcinoma (2). P16 and HPV were found in all high-grade dysplasia and SCC, and in 64% and 27% of low-grade dysplasia, 62% and 0% of ASCUS and 7.4% and 3.4% of normal, respectively. 18 of p16-positive cases (11%) were HPV-negative, 14 of them in the ASCUS and normal group. Compared to histological results, all of the p16-positive cases of squamous metaplasia, CIN II/III and SCC were HR-HPV-positive. Therefore, the cases that were positive for both with normal cytology (5 cases) or low-grade dysplasia (3 cases) may comprise a high-risk group for neoplastic change. The combination of p16 and HPV detection may be useful in cervical cancer screening to identify high-risk patients requiring early and proper management.