p16^INK4AExpression in Squamous Cell Carcinomas of the Vagina and the Vulva in Tunisian Women

Abstract

Background: The role of p16 INK4A expression in uterine cervix cancer is well established. In the remaining female lower genital tract cancers, the importance of p16 INK4A up-regulation is less clear. In our study, we analyzed the role of p16 INK4A expression and HPV infection in carcinomas of the vulva and the vagina in Tunisian women. Materials and Methods: We conducted a retrospective study of 30 carcinomas including 15 vulvar squamous cell carcinomas (SCCs) and 15 vaginal SCCs. Immunohistochemistry was used to determine p16 INK4A expression. HPV detection and typing was by in situ hybridization. Results: p16 INK4A expression was detected in 86.7% of vaginal SCCs with a strong and diffuse immunostaining in 60% of cases, and also in 73.3% of vulvar SCCs with focal immunoreactivity in 53.3% The association between p16 INK4A expression and HPV infection was significant in vaginal SCCs (p=0.001) but not vulvar SCCs (p>0.05). Conclusions: p16 INK4A expression could be used as a useful marker for HPV positivity in vaginal SCCs similar to that described in uterine cervix cancers. However, our data support the presence of 2 different mechanisms for p16 INK4A expression in HPV-related and HPV-unrelated vulvar carcinomas.

Human papillomavirus and p16 in squamous cell carcinoma and intraepithelial neoplasia of the vagina

“…A comprehensive table of study characteristics is presented in Supporting Information Table S1. The included studies were published between 1989 and 2016 and originated from USA (n = 11), Europe (n = 9) and Asia (n = 9), and one study reported prevalence of HPV and p16 overexpression in samples from several continents …”

“…A comprehensive table of study characteristics is presented in Supporting Information Table S1. The included studies were published between 1989 and 2016 and originated from USA (n = 11), [26][27][28][29][30][31][32][33][34][35][36] Europe (n = 9) 37-45 and Asia (n = 9), [46][47][48][49][50][51][52][53][54] and one study reported prevalence of HPV and p16 overexpression in samples from several continents. 55 The vast majority (n = 19) of studies used formalin fixed paraffin embedded tissue for HPV DNA and/or p16 testing.…”

“…29 Various cut-offs for p16 positivity were applied in the individual studies: diffuse staining of ≥25% 34,38,42,55 or ≥ 10% 29 of the tumor, or any staining intensity above negative control (i.e., ≥1% of cells with staining intensity scored ≥1 on a scale from 0 to 3). 50…”

Prognostic Value of Overexpressed p16INK4a in Vulvar Cancer: A Meta-Analysis

“…As shown in Fig 1 , a total of 17 eligible studies comprising 2309 patients from different countries were included in this meta-analysis, with the number of patients ranging from 4 to 1287 per study[ 16 – 17 , 22 – 36 ].Among them, eight studies dealt with the FIGO stage, and six studies presented data on lymph node metastasis. Three studies presented data classified according to patients’ age (55 years), and seven studies reported histological grade.…”

Current Concepts and Evaluation of Uro-Rectal Diseases by Transrectal Ultrasound: A Review

“…Prostate Cancer [107] Perianal Paget's Disease [108] Myxoid Liposarcoma [109] Malignant Fibrous Histiocytoma [110] Hemangiopericytoma [111] Cauda Equina Syndrome [112] Carcinoma of the Cervix [113] Carcinoma of the Vagina [114] Epidermoid Cysts [115] Prader-Willi Syndrome [116] Colorectal Carcinoma [117] Benign Prostate Hyperplasia [118] Microglandular Hyperplasia [119] Adenocarcinoma of Cervix [120] Adenoma Malignum [121] Adenosquamous Carcinoma of Cervix [122] Glassy Cell Carcinoma of Cervix [123] Adenoid Basal Carcinoma of Cervix [124] Adenomyosis [125] Uterine Fibroids [126] Endometrial Polyps [127] Hematoma [128] Fournier's Gangrene [129] Malakoplakia [130] Aneurysmal bone cyst [131] Ewing Sarcoma [132] Osteosarcoma [133] Chondrosarcoma [134] Neurofibroma [135] Neuroblastoma [136] Schwannoma [137] Chordoma [138] Malignant Schwannoma [139] Hemangioma [140] Myelolipoma [141] Leiomyoma [142] Villous Adenoma [143] Solitary Fibrous tumor [144] Castleman disease [145] Lymphoma [146] Gastrointestinal Stromal Tumor [147] Epithielial Malignancies …”