Efficacy of p16 and ProExC Immunostaining in the Detection of High-Grade Cervical Intraepithelial Neoplasia and Cervical Carcinoma

• Published in: American journal of clinical pathology Vol. 135; no. 2; pp. 212 - 220
• Main Authors: MING GUO, BARUCH, Amy C, SILVA, Elvio G, YEE JEE JAN, LIN, E, SNEIGE, Nour, DEAVERS, Michael T
• Format: Journal Article
• Language: English
• Published: Chicago, IL American Society of Clinical Pathologists 01.02.2011
• Subjects: Adolescent; Adult; Aged; Biological and medical sciences; Biomarkers, Tumor - analysis; Cervical Intraepithelial Neoplasia - pathology; Cervix Uteri - pathology; Cyclin-Dependent Kinase Inhibitor p16 - analysis; DNA, Viral - analysis; Female; Female genital diseases; Gynecology. Andrology. Obstetrics; Humans; Immunohistochemistry; Infectious diseases; Investigative techniques, diagnostic techniques (general aspects); Medical sciences; Middle Aged; Papillomaviridae - genetics; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Reagent Kits, Diagnostic; Staining and Labeling; Tumors; Uterine Cervical Neoplasms - pathology; Viral diseases; Immunohistochemistry; Papovaviridae; CDKN2 gene; HPV; Papillomavirus; Human papillomavirus; Cervical dysplasia; p16; Cervical intraepithelial neoplasia; Diagnosis; Cervical carcinoma; ProExC; Tumor suppressor gene; Premalignant lesion; Treatment efficiency; CIN; Malignant tumor; Female genital diseases; High grade; Infection; Virus; Anatomic pathology; Viral disease; Cervix carcinoma; Detection; Uterine cervix diseases; Cervical cancer; Cancer; High malignancy
• ISSN: 0002-9173; 1943-7722
• DOI: 10.1309/ajcp1llx8qmdxhho

We compared the efficacy of p16 and ProExC immunostaining in detecting cervical intraepithelial neoplasia (CIN) 2+ in 136 formalin-fixed, paraffin-embedded cervical tissue specimens with consensus diagnoses of normal cervix, CIN 1, CIN 2, CIN 3, and carcinoma. Diffuse staining patterns of more than half the thickness of CINs and more than 10% of carcinoma cells were scored as positive. The positivity of p16 and ProExC increased significantly with the severity of cervical lesion (P < .001). For CIN 2+ or CIN 3+, p16 immunostaining was more sensitive (79% for CIN 2+; 90% for CIN 3+) than ProExC immunostaining (67% for CIN 2+; 84% for CIN 3+). ProExC showed higher specificity for CIN 3+ compared with p16. Specimens with p16+/ProExC+ results showed the highest specificity (100% for CIN 2+; 93% for CIN 3+), suggesting that these 2 biomarkers can be used together to distinguish CIN 2/3 from its mimics in cervical biopsy specimens.