Virchows Archiv

, Volume 463, Issue 5, pp 689–696

Dual immunostaining of cervical cytology specimens with atypical squamous cells for p16/Ki-67 does not exclude the existence of a high-grade squamous intraepithelial lesion

  • Yu-Jin Koo
  • Ho-Suap Hahn
  • In-Ho Lee
  • Kyung-Taek Lim
  • Ki-Heon Lee
  • Hye-Sun Kim
  • Tae-Jin Kim
  • Yi-Kyeong Chun
  • Hy-Sook Kim
  • Sung-Ran Hong
Original Article

DOI: 10.1007/s00428-013-1483-4

Cite this article as:
Koo, YJ., Hahn, HS., Lee, IH. et al. Virchows Arch (2013) 463: 689. doi:10.1007/s00428-013-1483-4

Abstract

This study was conducted to evaluate the accuracy of p16/Ki-67 dual immunostaining compared to high-risk human papillomavirus (HR-HPV) DNA testing for cervical intraepithelial neoplasia (CIN) in women with atypical squamous cells, cytology not excluding high-grade squamous intraepithelial lesion (ASC-H). Data were collected from 73 patients diagnosed to have ASC-H on a Pap smear who were HPV genotyped and had histological examination of a cervical biopsy. The CINtec®PLUS kit was used on residual liquid-based material, and the immunoreactivity of dual-stained cells was graded according to the number as follows: G1 (1–5 positive cells), G2 (6–10), G3 (11–20), and G4 (> 20). Accuracy was evaluated based on the histological examination of colposcopy-guided biopsy or cervical conization on follow-up. Of the 70 patients with available data, positive p16/Ki-67 was associated with histological severity as follows: 15 % in negative histology, 67 % in CIN 1, 90 % in CIN 2, and 100 % in CIN 3. The average grade of positive p16/Ki-67 staining also increased from 0.2 in histologically negative cases to 1.2 in CIN 1, 2.4 in CIN 2, and 2.9 in CIN 3 (p < 0.01). For patients with CIN 2 or higher, p16/Ki-67 had a sensitivity of 94.6 % and a specificity of 75.8 %, while HR-HPV testing showed a sensitivity of 67.6 % and a specificity of 66.7 %. p16/Ki-67 immunostaining demonstrated better accuracy than HR-HPV for detecting CIN 2 or higher in patients with ASC-H cytology. Given the higher concordance with histological diagnosis, the grading system of positive p16/Ki-67 can be a useful adjunct for predicting high-grade lesions in clinical practice.

Keywords

p16/Ki-67 dual immunostaining Cervical intraepithelial neoplasia High-risk human papillomavirus genotyping 

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Yu-Jin Koo
    • 1
  • Ho-Suap Hahn
    • 1
  • In-Ho Lee
    • 1
  • Kyung-Taek Lim
    • 1
  • Ki-Heon Lee
    • 1
  • Hye-Sun Kim
    • 2
  • Tae-Jin Kim
    • 1
  • Yi-Kyeong Chun
    • 2
  • Hy-Sook Kim
    • 2
  • Sung-Ran Hong
    • 2
  1. 1.Department of Obstetrics and Gynecology, Cheil General Hospital and Women’s Healthcare CenterKwandong University College of MedicineSeoulSouth Korea
  2. 2.Department of Pathology, Cheil General Hospital and Women’s Healthcare CenterKwandong University College of MedicineSeoulSouth Korea

Personalised recommendations