No abstract

Radiation/chemotherapy used for cervical cancer often causes alterations in cells, including stromal fibrosis, atypical fibroblasts and endothelial cells, or multinucleated giant cells. Evaluation of IHC to analyze human papillomavirus (HPV) in women after radiation for cervical squamous cell carcinoma (SCC) has yet to be studied. The study purpose is to evaluate women with radiation-treated cervical cancer using the dual IHC stain, p16INK4a/Ki-67, to detect recurrent HPV infection. We hypothesize HPV changes will be noted by IHC, not evident on Pap tests. Pap tests in women after radiation for cervical SCC or adenocarcinoma and a history of cervical dysplasia without cancer or radiation were selected from July 1, 2010 to March 1, 2011. Pap tests were performed using a liquid-based method, and unstained slides were prepared according to the p16INK4a/Ki-67 method. Statistical analysis was performed using Excel. Fourteen control subjects were randomly selected for Paps with high-grade squamous intraepithelial lesion (HSIL), prior cervical SCC, or abnormal Paps without a history of radiation. Positive staining was seen in 10 women diagnosed with HSIL. Negative staining was seen in 1 HSIL, 1 Low-grade SIL (LSIL), and 2 SCCs. Seventy-one cases were identified with 56 after radiation for cervical SCC and 6 for cervical adenocarcinoma. Ten of these women had positive staining, but 7 were diagnosed as normal, radiation effect, or atrophy. Three were diagnosed as LSIL, HSIL, and SCC. The cervical adenocarcinomas showed positivity in 2 of 5 cases. Nine cases with radiation for endometrial adenocarcinoma showed positivity. Of 12 cases diagnosed as radiation change, 2 were positive, as were 3 of 6 cases diagnosed as LSIL. Two were diagnosed with HSIL and SCC showing strong correlation supporting the usefulness of IHC in the evaluation of Paps in these cases. Category:Cytopathology