Abstract—Human papilloma virus (HPV) is the main reason for cervical carcinoma. The viral E7 oncogene induces increasing expression of the cyclin dependent kinase inhibitor p16 INK4a in dysplastic cells. This can be used to identify dysplastic cells in histological slides. The aim of this study was to determine the presence of p16INK4a expression and to evaluate the diagnostic value of p16 immunohistochemical (IHC) investigation in different types of lesions in the uterine cervix. The study was performed on 112 samples of cervical biopsy. All samples were selected from the records of Pathology services in University Hospital-Pleven, Bulgaria. The samples were collected in four separate groups: reactive non dysplastic changes (n=26); different degrees of intraepithelial dysplasia (n=38); invasive squamous cell carcinoma (n=32); endocervical lesions with glandular origin – microglandular hyperplasia, Adenocarcinoma in situ and invasive endocervical adenocarcinoma (n=16). In all samples immunohistochemical analysis using antibodies to p16INK4a was performed. Results. In the cases with dysplastic lesions and invasive carcinomas was found strong correlation between the level of expression of p16INK4a and the level of cervical neoplasia (p<0.01). All 26 cases (100%) of non-dysplastic cervical lesions are negative for p16INK4a. The most cases of CIN III group (14cases-87.5%) showed strong cytoplasmic and nuclear expression of p16INK4a in the whole depth of the epithelium. Strong mainly nuclear overexpression was found in all invasive cervical adenocarcinomas. Conclusions. P16INK4a overexpression is associated to high-grade precancerous lesions and cervical carcinomas. Immunohistochemical evaluation can be useful biomarker in identifying HR-HPV- infected low-grade lesions.
Key words: Cervical dysplasia, Cervical cancer, HPV,p16INK4a
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