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 |
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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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