Triage of LSIL/ASC-US with p16/Ki-67 dual staining and human papillomavirus testing: a 2-year prospective study

Autor: Mark Bates, John J O' Leary, Christine White, Cara Martin, M. Fitzpatrick, Carmel Ruttle, Linda Sharp, Salih Bakhiet, Loretto Pilkington, Helen Keegan, Sharon O’ Toole, Grainne Flannelly
Rok vydání: 2016
Předmět:
Adult
0301 basic medicine
medicine.medical_specialty
Histology
Cytodiagnosis
Population
Cervical intraepithelial neoplasia
Pathology and Forensic Medicine
Young Adult
03 medical and health sciences
0302 clinical medicine
Pregnancy
Cytology
Atypical Squamous Cells of the Cervix
medicine
Humans
Papillomaviridae
Young adult
education
Prospective cohort study
Cyclin-Dependent Kinase Inhibitor p16
Vaginal Smears
Gynecology
Colposcopy
education.field_of_study
biology
medicine.diagnostic_test
business.industry
Papillomavirus Infections
General Medicine
Middle Aged
Uterine Cervical Dysplasia
biology.organism_classification
medicine.disease
female genital diseases and pregnancy complications
Gene Expression Regulation
Neoplastic
Ki-67 Antigen
030104 developmental biology
030220 oncology & carcinogenesis
Ki-67
biology.protein
Female
Squamous Intraepithelial Lesions of the Cervix
Neoplasm Grading
business
Zdroj: Cytopathology. 27:269-276
ISSN: 0956-5507
Popis: Objective To investigate human papillomavirus (HPV) DNA testing and p16/Ki-67 staining for detecting cervical intraepithelial grade 2 or worse (CIN2+) and CIN3 in women referred to colposcopy with minor abnormal cervical cytology low-grade squamous intraepithelial lesions (LSIL) and atypical squamous cells of undermined significance (ASC-US). The clinical performance of both tests was evaluated as stand-alone tests and combined, for detection CIN2+ and CIN3 over 2 years. Methods ThinPrep® liquid-based cytology (LBC) specimens were collected from 1349 women with repeat LSIL or ASC-US. HPV DNA was performed using Hybrid Capture. Where adequate material remained (n = 471), p16/Ki-67 overexpression was assessed. Clinical performance for detection of histologically diagnosed CIN2+ and CIN3 was calculated. Results Approximately 62.2% of the population were positive for HPV DNA, and 30.4% were positive for p16/Ki-67. p16/Ki-67 showed no significant difference in positivity between LSIL and ASC-US referrals (34.3% versus 28.6%; P = 0.189). Women under 30 years had a higher rate of p16/Ki-67 compared to those over 30 years (36.0% versus 26.6%; P = 0.029). Overall HPV DNA testing produced a high sensitivity for detection of CIN3 of 95.8% compared to 79.2% for p16/Ki-67. In contrast, p16/Ki-67 expression offered a higher specificity, 75.2% versus 40.4% for detection of CIN3. Combining p16/Ki-67 with HPV DNA improved the accuracy in distinguishing between CIN3 and
Databáze: OpenAIRE
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