p16 immunostaining as a predictor of anal and cervical dysplasia in women attending a sexually transmitted infection clinic

p16免疫染色作为性传播感染诊所就诊女性肛门和宫颈发育不良的预测指标

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Abstract

BACKGROUND: Carcinogenesis caused by human papillomavirus (HPV) leads to over-expression of p16 protein. p16 may act as a marker of HPV integration with host genome and serve as a surrogate marker of HPV oncogenesis. MATERIALS AND METHODS: A single center study of 75 women (35 HIV-positive and 40 HIV-negative women) was conducted. Anal and cervical specimens were obtained for cytology and p16 immunostaining. RESULTS: The sensitivity of p16 to diagnose anal and cervical dysplasia was 50% and 58.8%, respectively, whereas specificity was 98.6% and 100%, respectively. Positive predictive value for anal and cervical was 75% and 100%, whereas negative predictive value was 95.8% and 89.2%, respectively. A strong relationship between the grade of dysplasia and intensity of p16 immunoscore was observed (Pearson correlation r = 0.666, P < 0.0001 and r = 0.496, P < 0.0001 for anal and cervical, respectively). CONCLUSION: p16 immunostaining with greater specificity for high-grade lesions may improve the diagnostic accuracy, especially for high-grade lesions which have a high risk of progression to malignancy and thereby necessitate treatment.

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