Three-tiered score for Ki-67 and p16ink4a improves accuracy and reproducibility of grading CIN lesions

Autor: Renske D.M. Steenbergen, Annemiek Leeman, Peter J.F. Snijders, Marjolein van Zummeren, Maaike C G Bleeker, Wieke W. Kremer, Chris J.L.M. Meijer, Johannes Berkhof, Daniëlle A.M. Heideman, Miekel M. van de Sandt, David G. Jenkins, Wim Quint
Jazyk: angličtina
Rok vydání: 2018
Předmět:
0301 basic medicine
HPV
Scoring system
cervical cancer
diagnosis
Ki 67
Biopsy
Uterine Cervical Neoplasms
Cervical intraepithelial neoplasia
Pathology and Forensic Medicine
Majority consensus
03 medical and health sciences
0302 clinical medicine
P16 ink4a
Predictive Value of Tests
Medicine
Humans
Grading (tumors)
Papillomaviridae
Cyclin-Dependent Kinase Inhibitor p16
Retrospective Studies
Cervical cancer
Observer Variation
Reproducibility
biology
business.industry
Papillomavirus Infections
Reproducibility of Results
General Medicine
Reference Standards
medicine.disease
Uterine Cervical Dysplasia
Immunohistochemistry
female genital diseases and pregnancy complications
030104 developmental biology
Cross-Sectional Studies
Ki-67 Antigen
030220 oncology & carcinogenesis
Ki-67
biology.protein
Original Article
Female
Neoplasm Grading
Nuclear medicine
business
Zdroj: Journal of Clinical Pathology
ISSN: 1472-4146
0021-9746
Popis: AimsTo investigate the accuracy and reproducibility of a scoring system for cervical intraepithelial neoplasia (CIN1–3) based on immunohistochemical (IHC) biomarkers Ki-67 and p16ink4a.Methods115 cervical tissue specimens were reviewed by three expert gynaecopathologists and graded according to three strategies: (1) CIN grade based on H&E staining only; (2) immunoscore based on the cumulative score of Ki-67 and p16ink4a only (0–6); and (3) CIN grade based on H&E supported by non-objectified IHC 2 weeks after scoring 1 and 2. The majority consensus diagnosis of the CIN grade based on H&E supported by IHC was used as the Reference Standard. The proportion of test positives (accuracy) and the absolute agreements across pathologists (reproducibility) of the three grading strategies within each Reference Standard category were calculated.ResultsWe found that immunoscoring with positivity definition 6 yielded the highest proportion of test positives for Reference Standard CIN3 (95.5%), in combination with the lowest proportion of test positives in samples with CIN1 (1.8%). The proportion of test positives for CIN3 was significantly lower for sole H&E staining (81.8%) or combined H&E and IHC grading (84.8%) with positivity definition ≥CIN3. Immunoscore 6 also yielded high absolute agreements for CIN3 and CIN1, but the absolute agreement was low for CIN2.ConclusionsThe higher accuracy and reproducibility of the immunoscore opens the possibility of a more standardised and reproducible definition of CIN grade than conventional pathology practice, allowing a more accurate comparison of CIN-based management strategies and evaluation of new biomarkers to improve the understanding of progression of precancer from human papillomavirus infection to cancer.
Databáze: OpenAIRE
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