Perspectives in Medical Research

Volume: 6 Issue: 2

  • Open Access
  • Original Article

Study of p16ink4a expression in cervical intraepithelial lesions and cervical carcinoma

L.Krishna1,B.Sridhar Reddy2,J.Ranjani3,B.H.P.C.Sekhar4,P.Madhusudana5

1Professor and H.O.D(Retd..),2Associate Professor,3,4Assistant Professor, Department of Pathology, 5Scientist,MDRU, Sri Venkateswara Medical College, Tirupathi, Chittoor District, Andhra Pradesh, India.
Address for correspondence: Dr. L. Krishna Professor and H.O.D.(Retired) S.V.Medical College. Tirupathi. 5-12-121/1, Mangapuram,H B Colony, Moulali, Hyderabad, T.S.
Email: [email protected]

Year: 2018, Page: 51-56,

Abstract

Background: Cervical cancer ranks as the second cause of female cancer in India. In India about 122,844 new cervical cancer cases are diagnosed annually. Many lines of evidence have demonstrated that HPV contributes to neoplastic progression through the action of two viral oncoproteins, namely E6 and E7, which interact with various cell cycle regulatory proteins. The p16Ink4a is a tumour suppressor protein and it’s over expression highlights the possible potential of a marker for cervical intraepithelial lesions and cervical cancer.
Objectives: The present study was done to establish the ability of P16INK4A as a marker of dysplastic and neoplastic alteration in the cervical epithelium.
Materials & Methods: Surgical biopsy specimens of uterine cervix received at the Department of Pathology S.V. Medical College Tirupati from November 2014 to October 2016 were analyzed in a Prospective interventional study. 163 cases diagnosed as LSIL, HSIL, SCC, Adenocarcinoma on H&E stained sections were immunohistochemically stained for p16Ink4a using the BiogenexLifesystems Histology Kit. All sections that showed either strong nuclear and/or cytoplasmic staining were considered positive and graded qualitatively.
Also 20 random normal cervical biopsies were immunohistochemically stained for p16Ink4a and studied to confirm the negative association.
Results: Low Grade Squamous Intraepithelial (LSIL) is more associated with IHC grade 1, whereas High Grade Squamous Intraepithelial (HSIL) and Squamous cell carcinoma (SCC) were more associated with IHC grade 3.
Conclusion: The present study concludes that p16Ink4a is a specific marker for dysplastic and neoplastic alteration in the cervical epithelium and thereby significantly improves cervical precancer and cancer detection.

Keywords: Cervix Cancer, E7-Oncoprotein, HPV, IHC-p16Ink4a

References

1) Bruin L, Barrio Nuevo-Rosas L, Serrano B, Britons M, Albert G, Cosine R, et al. ICO Information Centre on HPV and Cancer (HPV Information Centre). Human Papillomavirus and Related Diseases in India. Summary Report 2014; 8:22.
2) Klaus R, Friedrich T, Spitkovsky D. Over expression of P16Ink4a as a specific marker for dysplastic and neoplastic epithelial cells of the cervix uteri. International Journal of Cancer 2001; 84: 276.
3) Lulin Hu1, Ming Guo, Zhi He. Human papillomavirus genotyping and P16Ink4a expression in cervical intraepithelial neoplasia of adolescents. Modern Pathology 2005; 18:267–73.
4) Eun Ji Nam. Expression of the P16Ink4a and Ki-67 in relation to the grade of cervical intraepithelial neoplasia and highrisk human papillomavirus infection.J Gynecol. Oncol 2008 Sep; 19(3):162-8.
5) Ishikawa M, Fujii T, Saito M, Nindl I, Ono A, Kubushiro K, et al. Overexpression of P16Ink4a as an indicator for human papillomavirus oncogenic activity in cervical squamous neoplasia. Int J Gynecol Cancer 2006;16:34753.
6) Márcia CM Guimaraes. Immunohistochemical Expression of P16Ink4a and bcl-2 According to HPV Type and to the Progression of Cervical Squamous Intraepithelial Lesions. Journal of Histochemistry and Cytochemistry 2005; 53(4):509–16.
7) Volgareva G, Zavalishina L, Andreeva Y. p16 as a marker of dysplastic and neoplastic alteration in cervical epithelial cells. BMC Cancer 2004; 4:58.
8) Tan. Immunohistochemical study of P16Ink4a and surviving expressions in cervical squamous neoplasm. Indian Journal of Pathology and Microbiology 2010 Jan-Mar; 53(1).
9) Nieh S, Chen SF, Chu TY, Lai HC, Lin YS, Fu E, et al. Is P16Ink4a expression more useful than human papillomavirus test to determine the outcome of atypical squamous cells of undetermined significance categorized Pap smear? A comparative analysis using abnormal cervical smears with follow up biopsies. Gynecol. Oncol. 2005;97:3540.
10) Gupta R, Srinivasan R, Nijhawan R, Suri V, Uppal R. Protein P16Ink4a expression in cervical intraepithelial neoplasia and invasive squamous cell carcinoma of uterine cervix.IndianJPathol. Microbiol 2010;53:711.
11) Tripathi A, Banerjee S, Roy A, Roychowdhury S, Panda CK. Alterations of the P16 gene in uterine cervical carcinoma from Indian patients. Int J Gynecol Cancer 2003;13:4729.
12) Branca M, Giorgi C, Santini D, Di Bonito L, Ciotti M, Costa S, et al. HPV Pathogen ISS Study Group. Survivin as a marker of cervical intraepithelial neoplasia and high risk human papillomavirus and a predictor of virus clearance and prognosis in cervical cancer. Am J Clin. Pathol 2005;124:113-21.
13) Ozgul N, Cil AP, Bozdayi G, Usubutun A, Bulbul D, Rota S, et al. Staining characteristics of P16Ink4a. Is there a correlation with lesion grade or high risk human papillomavirus positivity? J ObstetGynaecol Res 2008;34:86571.

Cite this article

Krishna L,Sridhar B , Ranjani J, Sekhar B H P C, Madhusudana P. Study of p16ink4a expression in cervical intraepithelial lesions and cervical carcinoma. Perspectives in Medical Research 2018;6(2):51-56.

Views
239
Downloads
197