According to the 2014 World Health Organization Classification of Tumors of Female Reproductive Organs, patients with cervical intraepithelial neoplasia 2 (CIN2) have an equivocal diagnosis, but p16 is considered as the reference index for CIN2. Positive p16 expression in CIN2 is associated with high-grade squamous intraepithelial lesions (HSIL), whereas p16 negative lesions are low-grade squamous intraepithelial lesions. The purpose of the present study was to examine the clinical value of p16 and human papillomavirus (HPV) E6/E7 mRNA in the prognostication of patients with CIN2. From January 2013 to January 2016, 108 patients were diagnosed with CIN2 by biopsy and followed up at 6-month intervals at Peking University People's Hospital (Beijing, China). The expression of HPV E6/E7 mRNA was detected by in situ hybridization, while the expression of p16 and Ki-67 proteins was detected by immunohistochemistry. Of the 108 CIN2 cases, 20 progressed to HSIL/CIN3, 36 cases demonstrated persistence with CIN2 after the follow-up and 52 cases achieved regression (≤CIN1). Of the p16-positive 82 cases, 20 cases were detected to have progressed, whereas in the p16-negative group, no progression was observed. There were statistically significant differences among the p16-positive and negative groups (P<0.05). In the HPV E6/E7 mRNA-positive 69 cases, 18 cases were detected to have progressed, whereas in the HPV E6/E7 mRNA-negative 39 cases, progression was detected in only 2 cases. There were statistically significant differences among the HPV E6/E7 mRNA-positive and negative groups (P<0.05). The area under the receiver operating characteristics curve was plotted; the area under the curve for HPV E6/E7 mRNA was 0.745, that for p16 was 0.546 and that for Ki-67 was 0.501. The detection of HPV E6/E7 mRNA may provide important predictive information for the prognosis of CIN2, however p16 and Ki-67 proteins may provide little value.

BackgroundNeuroendocrine carcinoma of the cervix (CNECC) is a rare variant of cervical cancer. The prognosis of women with CNECC is poor and there is no standardized therapy for this type of malignancy. To discuss the clinical and pathological features and prognosis of CNECC.MethodsTwenty one patients diagnosed as CNECC of cervix from May 2008 to September 2021 were retrospectively analyzed at Peking University people's hospital, were analyzed retrospectively including hematoxylin-eosinstaining （HE）slides review, immunohistochemistry results,Thinprep cytology test(TCT) and human papillomavirus (HPV) Hybrid Capture 2(HC2) assay. and their data were analyzed retrospectively. Telephone and medical records were followed up for 3-160 months with an average follow-up time of 49.8 month.ResultsThe patient's average age was 48.6 years old (range: 33–69 years). The first symptoms of 11 cases had vaginal bleeding, 2 cases had vaginal discharge, and the others were asymptomatic. Among the 21 patients, 17 cases were diagnosed as neuroendocrine carcinoma by biopsy. There were 9 cases with TCT examination and HC2 tests before biopsy, TCT results of 4 cases were positive. High-risk HPV of 7 cases were positive. The morphology of cancer cells were relatively consistent, the cytoplasm was sparse, the nuclei were obviously blue stained, and accompanied by extensive neoplastic necrosis. 13 cases were pure CNECC(61.9%), 8 cases were mix types of CNECC(38.1%).There were 3 cases accompanied by squamous cell carcinoma,5 cases accompanied by adenocarcinoma.The positive detection rate of Syn, CgA, CD56,p16 and TTF1 were 85.7%(18/21), 42.9%(9/21), 85.7% (18/21), 81%(17/21) 52.4%(11/21),respectively.The overall survival rate of 21 NECC cases was 71.4%(15/21).ConclusionsCNECC was a extremely rare primary tumor.The tumor was associated with HPV infection. Combined examination of TCT and HPV could significantly improve the detection rate of neuroendocrine carcinoma before biopsy.Pthology diagnosis was based on histological and immunohistochemical examination. It was considered to be highly aggressive malignancy with very poor prognosis.