| Popis: |
s S49 Results: All eighteen cases were found to have adequate cells with good preservation. P16 expression correlated with HR-HPV status in 13 of 15 cases (87% concordance; 3 cases of HSIL did not have HR-HPV testing). In each discordant case (1 ASCUS and 1 ASC-H), the HR-HPV was not detected, while P16 expression was identified. The Ki-67 index scoring was as follows: 6 negative (ASCUS, 3 ASC-H, 1 LSIL, and 1 HSIL), 2 rare (both ASCUS), 4 mild (ASCUS), 0 moderate, and 5 high (1 LSIL, 1 ASCH, and 3 HSIL). The Ki-67 index correlated with HR-HPV in 8 of 15 cases (53% concordance). Discordant cases were as follows: 2 cases of + HRHPV / Ki-67 (one LSIL and one ASC-H), and 5 cases of HR-HPV / + Ki-67 (3 ASCUS, 1 LSIL, 1 ASC-H). In 2 cases (13%), the HR-HPV was not detected, while both P16 and Ki-67 were positive. There were no cases (0%) where HR-HPV was detected and both the P16 and Ki-67 were negative. Histologic follow-up was available in 7 cases: 2 ASCUS (benign and CIN I), 1 LSIL (CIN I), 2 ASC-H (benign and CIN I-II) and 2 HSIL (CIN III). There were 2 cases where HR-HPV was not detected while P16 and Ki-67 were positive, in both cases the corresponding cervical biopsy showed benign findings. Conclusions: The combination of P16 and Ki-67 expression was 100% sensitive for HR-HPV status. In 2 cases (13%) with P16 expression and Ki67 immunoreactivity, HR-HPV was not detected, and the follow-up histology was benign. Although limited by a small sample size, our preliminary findings show a utility for adjunct P16 and Ki-67 in cases of cytologic atypia in addition to HR-HPV testing. Our results indicate that adjunct P16 and Ki-67 testing offers additional benefit in cases that HRHPVs are not detected due to low numbers of DNA copies or missed lesions in small cervical biopsies or endocervical curretings. |
Full Text from ScienceDirect