@article { author = {Charoonwatana, Tipnaree and Boonlikit, Sathone and Yanaranop, Marut}, title = {Progression of Precancerous Cervical Lesion Predicted by p16 Protein Immunohistochemistry in Rajavithi Hospital}, journal = {Asian Pacific Journal of Cancer Prevention}, volume = {20}, number = {6}, pages = {1809-1815}, year = {2019}, publisher = {West Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter.}, issn = {1513-7368}, eissn = {2476-762X}, doi = {10.31557/APJCP.2019.20.6.1809}, abstract = {Objective: To assess the association of p16 immunohistochemical (IHC) staining in cervical squamous intraepitheliallesions (SIL) and progression of cervical intraepithelial neoplasia (CIN) 1 to CIN2+ or recurrence of CIN2+. Materialand Methods: A retrospective cohort study of women with newly diagnosed SIL from colposcopy-directed biopsy atRajavithi Hospital, 2013-2017. Pathologic specimens were reviewed and submitted to p16-IHC staining. Adjusted hazardratios (HR) of disease-free interval (DFI) and 95% confidence intervals (CI) were carried out using the Cox proportionalhazard regression model. Results: A total of 187 women was recruited, 91 cases of positive p16-IHC staining and 96cases of negative staining. With the median follow-up time of 22 months, women with positive p16-IHC had significantlylower 1-year DFI than those with negative p16-IHC (86.8% vs. 96.6%, p = 0.006). Women with CIN 1 had 22.6% ofpositive p16-IHC, while those with CIN2-3 had 86.7%. From multivariate analysis, the positive p16-IHC and age >35 years were the significant prognostic factors of progression/recurrent CIN2+ (adjusted HR 5.33, 95%CI 1.77-16.01,p = 0.003; and adjusted HR 5.80, 95%CI 1.34-25.08, p = 0.019, respectively). From subgroup analysis, the positivep16-IHC was the significant prognostic factor in women with initial CIN1 (HR 5.29, 95%CI 1.18-23.76, p = 0.030), butwas not associated with prognosis in women with initial CIN 2-3 (HR 2.13, 95%CI 0.28-16.38, p = 0.468). Conclusion:Overexpression of p16 protein has the prognostic significance of SIL. Using p16-IHC may help stratify patients aslow-risk and high-risk groups to progression/recurrence CIN2+.}, keywords = {p16 protein immunohistochemistry,cervical intraepithelial neoplasia,precancerous cervical lesion}, url = {https://journal.waocp.org/article_88623.html}, eprint = {https://journal.waocp.org/article_88623_8f2ebed388ca0419d32e28f988f8ea57.pdf} }