Objective: To assess the association of p16 immunohistochemical (IHC) staining in cervical squamous intraepithelial lesions (SIL) and progression of cervical intraepithelial neoplasia (CIN) 1 to CIN2+ or recurrence of CIN2+. Material and Methods: A retrospective cohort study of women with newly diagnosed SIL from colposcopy-directed biopsy at Rajavithi Hospital, 2013-2017. Pathologic specimens were reviewed and submitted to p16-IHC staining. Adjusted hazard ratios (HR) of disease-free interval (DFI) and 95% confidence intervals (CI) were carried out using the Cox proportional hazard regression model. Results: A total of 187 women was recruited, 91 cases of positive p16-IHC staining and 96 cases of negative staining. With the median follow-up time of 22 months, women with positive p16-IHC had significantly lower 1-year DFI than those with negative p16-IHC (86.8% vs. 96.6%, p = 0.006). Women with CIN 1 had 22.6% of positive 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 positive p16-IHC was the significant prognostic factor in women with initial CIN1 (HR 5.29, 95%CI 1.18-23.76, p = 0.030), but was 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 as low-risk and high-risk groups to progression/recurrence CIN2+.
Charoonwatana, T., Boonlikit, S., & Yanaranop, M. (2019). Progression of Precancerous Cervical Lesion Predicted by p16 Protein Immunohistochemistry in Rajavithi Hospital. Asian Pacific Journal of Cancer Prevention, 20(6), 1809-1815. doi: 10.31557/APJCP.2019.20.6.1809
MLA
Tipnaree Charoonwatana; Sathone Boonlikit; Marut Yanaranop. "Progression of Precancerous Cervical Lesion Predicted by p16 Protein Immunohistochemistry in Rajavithi Hospital". Asian Pacific Journal of Cancer Prevention, 20, 6, 2019, 1809-1815. doi: 10.31557/APJCP.2019.20.6.1809
HARVARD
Charoonwatana, T., Boonlikit, S., Yanaranop, M. (2019). 'Progression of Precancerous Cervical Lesion Predicted by p16 Protein Immunohistochemistry in Rajavithi Hospital', Asian Pacific Journal of Cancer Prevention, 20(6), pp. 1809-1815. doi: 10.31557/APJCP.2019.20.6.1809
VANCOUVER
Charoonwatana, T., Boonlikit, S., Yanaranop, M. Progression of Precancerous Cervical Lesion Predicted by p16 Protein Immunohistochemistry in Rajavithi Hospital. Asian Pacific Journal of Cancer Prevention, 2019; 20(6): 1809-1815. doi: 10.31557/APJCP.2019.20.6.1809
)