Value of p16INK4a as a marker of progression/regression in cervical intraepithelial neoplasia grade 1
Received 24 December 2008; received in revised form 12 February 2009; accepted 26 May 2009. published online 17 August 2009.
Objective
The objective of this study was to evaluate the usefulness of p16INK4a staining to classify cervical intraepithelial neoplasia grade 1 according to its progression/regression risk.
Study Design
Patients with a histologic diagnosis of cervical intraepithelial neoplasia grade 1 were prospectively recruited (n = 138). Simultaneous detection of high-risk human papillomaviruses and p16INK4a evaluation were performed. Follow-up was conducted every 6 months by cytology and colposcopy and annually by high-risk human papillomavirus testing, for at least 12 months (mean, 29.0). Progression was defined as a histologic diagnosis of cervical intraepithelial neoplasia grades 2-3, regression as a negative cytology and high-risk human papillomaviruses, and persistence as a cytologic result of low-grade squamous intraepithelial lesions and/or a positive test for high-risk human papillomaviruses.
Results
Progression was observed in 14 women (10.1%), 66 (47.6%) regressed, and 58 (42.0%) had a persistent disease. p16INK4a was positive in 77 (55.8%) initial biopsy specimens. Progression to cervical intraepithelial neoplasia grades 2-3 was identified in 14 of 77 (18.2%) women with positive and none of 61 (0.00%) women with negative p16INK4a immunostaining (P < .001).
Conclusion
p16INK4a negative cervical intraepithelial neoplasia grade 1 lesions rarely progress and may benefit from a less intensive follow-up.
aDepartment of Obstetrics and Gynecology, IDIBAPS-Hospital Clínic, University of Barcelona Faculty of Medicine, Barcelona, Spain
bDepartment of Pathology, IDIBAPS-Hospital Clínic, University of Barcelona Faculty of Medicine, Barcelona, Spain
Cite this article as: del Pino M, Garcia S, Fusté V, et al. Value of p16INK4a as a marker of progression/regression in cervical intraepithelial neoplasia grade 1. Am J Obstet Gynecol 2009;201:488.e1-7.
ABSTRACT