Effect of P16ink4a Immunohistochemistry on Screening of Carcinoma Cervix
Journal Title: PARIPEX-Indian Journal of Research - Year 2016, Vol 5, Issue 4
Abstract
Background: Currently the primary screening test for cervical cancer in most countries is Papanicoaou cytology. But sensitivity with cervical cytology is low (approximately 72% %) . Detecting the viral DNA is a highly sensitive test for early detection of cervical cancers and precancerous lesions. But it is costly and can detect presence of virus but not the cellular alterations. p16INK4a is a specific biomarker helping in detection of transforming HPV disease . Also it can differentiate non-neoplastic from low grade lesions and also low and/or high grade lesions from neoplastic ones. The objective of this study is to detect overall positivity of p16INK4a immunohistochemistry in suspected cases of cancer cervix and compare it with other methods of screening like cytology and histopathology. Material and Methods: One hundred patients with strong clinical suspicion of carcinoma cervix were included in the study. In all patients, papanicolaou smear test, biopsy and p16INK4a immunostain were done. The results of cytology was compared with histopathology and p16 immunostain and analyzed to find out the accuracy of each method alone and in combination by taking histopathology as gold standard. Results: 70% cases were abnormal in cytology, out of which 66 were abnormal in biopsy comprising of 38% precancerous lesions and 28% carcinoma. All cases with carcinoma in papanicolaou smears, were proved as carcinoma on biopsy and also were positive for p16INK4a. But in precancerous lesions like CIN 1/2, there was discrepancy between biopsy and IHC. p16INK4a was positive in 5.6% (4/70) patients with abnormal pap and normal biopsy. But by combining IHC with biopsy the specificity and the positive predictive value of pap test was increased from around 80 % to 100%. Conclusion: There is a definite place of p16INK4a IHC in diagnosing and deciding the treatment modalities of low grade cervical precancerous lesions with ambiguous biopsy results.
Authors and Affiliations
Dr. Tushar Jyoti Kumar Kar, Dr. Bidyut Prava Das, Dr. Asaranti Kar, Dr. Lipsa Mishra, Dr. Priyadarshini Biswal, Dr. Shelly Poddar, Dr. Manmohan Biswal
Keywords
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