Evaluation of Telomerase (hTert), Ki67 and p16ink4a expressions in low and high-grade cervical intraepithelial lesions

Abstract

Objective : to study the association between the histological grading of cervical intraepithelial neoplasia (CIN I, CIN II and CIN III) and the immunohistochemical expression for p16ink4a, hTert and Ki67, as well as to evaluate the relationship of these markers with the risk of recurrence after surgical treatment. Methods : we studied a historical cohort of 94 women with intraepithelial lesions CIN I (low grade), CIN II and CIN III (high grades) submitted to conization or electrosurgical excision of the transformation zone. We evaluated all surgical specimens for immunohistochemical expression of p16ink4a, hTert and Ki67. Results : the mean age was 38.2 years; p16ink4a was absent in most CIN I cases. In patients with CIN II or I/II (association of low and high-grade lesions), we observed p16ink4a ≤10%. In patients with CIN III, we found a higher expression frequency of p16ink4a >50%. In CIN I, the majority had Ki67≤10% and low frequency of Ki67>50%. In the CIN III category, there were fewer patients with Ki67≤10%, and Ki67 was absent in most patients of CIN II and III groups. There was no association between hTert expression and histologic grade. There were no statistically significant differences between the expression of the markers in patients with and without recurrence. Conclusion : there was a statistically significant association of p16ink4a and Ki67 with histological grade. The markers' expression, as for disease recurrence, was not statistically significant in the period evaluated.

Analysis of factors affecting the prognosis of patients with cervical intraepithelial neoplasia 2

“…Certain evidence indicated that spontaneous regression occurs in ~40% of cases of CIN2 ( 1 ), suggesting that these lesions probably have characteristics of being less aggressive compared to CIN3 or more severe lesions. The regression rate of CIN2 is similar to that of CIN1 in a 2-year follow-up period ( 2 ). At present, histopathological assessment is unable to differentiate high-grade CIN lesions from others and predict whether they may regress spontaneously.…”

Human papillomavirus self-sampling and urine-sampling tests and the management and short-term outcomes of cervical intraepithelial neoplasia: A prospective observational study

“…Therefore, a predictive marker for CIN progression is crucial. The regression rates of CIN grades 1 and 2 were similar in the 2-year follow-up period [10,11]. Currently, histopathological assessment cannot differentiate high-grade CIN lesions from other lesions or predict whether they may regress spontaneously [10,11].…”

“…The regression rates of CIN grades 1 and 2 were similar in the 2-year follow-up period [10,11]. Currently, histopathological assessment cannot differentiate high-grade CIN lesions from other lesions or predict whether they may regress spontaneously [10,11]. Hence, certain prognostic biomarkers may be helpful in this differentiation [10,12].…”

Human Papillomavirus E7 and p16INK4a mRNA Multiplexed Quantification by a QuantiGeneTM Proof-of-Concept Assay Sensitively Detects Infection and Cervical Dysplasia Severity

“…The addition of further biomarkers in the multivariate model could balance these problems and stabilize the model. Along with to p16 INK4a , other cellular biomarkers such as Ki67, MCM2, Topo2α, and hTERT have been described as potential markers for cervical dysplasia detection, triage, and diagnosis [ 44 , 45 ]. Furthermore, there are more hrHPV genotypes that are responsible for CxCa development and could therefore be informative for dysplasia detection and characterization [ 4 ].…”