P16INK4a/ki67 immunocytochemistry in improving the predictive value for high grade cervical intraepithelial (≥CIN2) neoplasia in pap smear
Introduction: Cervical cytology has limited sensitivity to detect cervical pre-cancerous lesions. High-risk human papillomavirus (hr-HPV) DNA testing has high sensitivity but its specificity is limited. This study was done to assess the utility of p16INK4a/ki-67 dual stained cytology in improving th...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2021-01-01
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| Series: | Journal of Cytology |
| Subjects: | |
| Online Access: | http://www.jcytol.org/article.asp?issn=0970-9371;year=2021;volume=38;issue=4;spage=180;epage=185;aulast=Kumar |
| _version_ | 1811343155063160832 |
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| author | G Vinoth Kumar Anne Jennifer Prabhu Ajit Sebastian Raghavendran Priya Abraham Abraham Peedicayil |
| author_facet | G Vinoth Kumar Anne Jennifer Prabhu Ajit Sebastian Raghavendran Priya Abraham Abraham Peedicayil |
| author_sort | G Vinoth Kumar |
| collection | DOAJ |
| description | Introduction: Cervical cytology has limited sensitivity to detect cervical pre-cancerous lesions. High-risk human papillomavirus (hr-HPV) DNA testing has high sensitivity but its specificity is limited. This study was done to assess the utility of p16INK4a/ki-67 dual stained cytology in improving the predictive value for high-grade cervical (CIN2+) lesions. Aim/Objective: To assess the significance of P16/Ki-67 immunocytochemistry in improving the predictive value for high-grade cervical intraepithelial (≥CIN 2+) lesions on Pap smear. Material and Methods: This was a prospective diagnostic study that included 93 patients with ASC-US/LSIL/ASC-H and HSIL on thin prep cervical smears and who also underwent hr-HPV DNA test and colposcopy-guided biopsy. Biopsy was the gold standard against which the performance of P16INK4a/Ki-67 and hr-HPV results were compared. Results: In women of all ages, sensitivity of (96.8%) hr-HPV test and p16/Ki-67 dual immunocytochemistry (≥1 positive cell) were similar and negative predictive value (NPV) was (97.1% vs. 97.9%) but the latter test showed better specificity (69.4% vs. 53.2%) and positive predictive value (PPV, 61.2% vs. 50.8%) for ≥CIN 2 lesions. A higher cut off of at least 10 positive cells gives a higher specificity and PPV, with slightly decreased sensitivity and NPV. Conclusion: Because high-risk HPV test has a high sensitivity and NPV, whereas P16/Ki-67 dual immunocytochemistry (≥10 positive cells) has a high specificity and PPV, the latter can be recommended as an ancillary test in hr-HPV-positive women to reduce the number of women going for colposcopy and biopsies. |
| first_indexed | 2024-04-13T19:24:42Z |
| format | Article |
| id | doaj.art-8fbf47eaf2b14e3c80decfd69481813b |
| institution | Directory Open Access Journal |
| issn | 0970-9371 |
| language | English |
| last_indexed | 2024-04-13T19:24:42Z |
| publishDate | 2021-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Cytology |
| spelling | doaj.art-8fbf47eaf2b14e3c80decfd69481813b2022-12-22T02:33:24ZengWolters Kluwer Medknow PublicationsJournal of Cytology0970-93712021-01-0138418018510.4103/JOC.JOC_245_20P16INK4a/ki67 immunocytochemistry in improving the predictive value for high grade cervical intraepithelial (≥CIN2) neoplasia in pap smearG Vinoth KumarAnne Jennifer PrabhuAjit SebastianRaghavendranPriya AbrahamAbraham PeedicayilIntroduction: Cervical cytology has limited sensitivity to detect cervical pre-cancerous lesions. High-risk human papillomavirus (hr-HPV) DNA testing has high sensitivity but its specificity is limited. This study was done to assess the utility of p16INK4a/ki-67 dual stained cytology in improving the predictive value for high-grade cervical (CIN2+) lesions. Aim/Objective: To assess the significance of P16/Ki-67 immunocytochemistry in improving the predictive value for high-grade cervical intraepithelial (≥CIN 2+) lesions on Pap smear. Material and Methods: This was a prospective diagnostic study that included 93 patients with ASC-US/LSIL/ASC-H and HSIL on thin prep cervical smears and who also underwent hr-HPV DNA test and colposcopy-guided biopsy. Biopsy was the gold standard against which the performance of P16INK4a/Ki-67 and hr-HPV results were compared. Results: In women of all ages, sensitivity of (96.8%) hr-HPV test and p16/Ki-67 dual immunocytochemistry (≥1 positive cell) were similar and negative predictive value (NPV) was (97.1% vs. 97.9%) but the latter test showed better specificity (69.4% vs. 53.2%) and positive predictive value (PPV, 61.2% vs. 50.8%) for ≥CIN 2 lesions. A higher cut off of at least 10 positive cells gives a higher specificity and PPV, with slightly decreased sensitivity and NPV. Conclusion: Because high-risk HPV test has a high sensitivity and NPV, whereas P16/Ki-67 dual immunocytochemistry (≥10 positive cells) has a high specificity and PPV, the latter can be recommended as an ancillary test in hr-HPV-positive women to reduce the number of women going for colposcopy and biopsies.http://www.jcytol.org/article.asp?issn=0970-9371;year=2021;volume=38;issue=4;spage=180;epage=185;aulast=Kumarasc-hasc-uscervical intraepithelial neoplasia – cin 2+hr-hpv dnahsillsilp16ink4a/ki-67 |
| spellingShingle | G Vinoth Kumar Anne Jennifer Prabhu Ajit Sebastian Raghavendran Priya Abraham Abraham Peedicayil P16INK4a/ki67 immunocytochemistry in improving the predictive value for high grade cervical intraepithelial (≥CIN2) neoplasia in pap smear Journal of Cytology asc-h asc-us cervical intraepithelial neoplasia – cin 2+ hr-hpv dna hsil lsil p16ink4a/ki-67 |
| title | P16INK4a/ki67 immunocytochemistry in improving the predictive value for high grade cervical intraepithelial (≥CIN2) neoplasia in pap smear |
| title_full | P16INK4a/ki67 immunocytochemistry in improving the predictive value for high grade cervical intraepithelial (≥CIN2) neoplasia in pap smear |
| title_fullStr | P16INK4a/ki67 immunocytochemistry in improving the predictive value for high grade cervical intraepithelial (≥CIN2) neoplasia in pap smear |
| title_full_unstemmed | P16INK4a/ki67 immunocytochemistry in improving the predictive value for high grade cervical intraepithelial (≥CIN2) neoplasia in pap smear |
| title_short | P16INK4a/ki67 immunocytochemistry in improving the predictive value for high grade cervical intraepithelial (≥CIN2) neoplasia in pap smear |
| title_sort | p16ink4a ki67 immunocytochemistry in improving the predictive value for high grade cervical intraepithelial ≥cin2 neoplasia in pap smear |
| topic | asc-h asc-us cervical intraepithelial neoplasia – cin 2+ hr-hpv dna hsil lsil p16ink4a/ki-67 |
| url | http://www.jcytol.org/article.asp?issn=0970-9371;year=2021;volume=38;issue=4;spage=180;epage=185;aulast=Kumar |
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