Document Detail

Immunocytochemistry of p16INK4a in liquid-based cervicovaginal specimens with modified Papanicolaou counterstaining.
MedLine Citation:
PMID:  16467166     Owner:  NLM     Status:  MEDLINE    
AIM: To evaluate the feasibility and value of a modified Papanicolaou counterstain for p16(INK4a) immunostaining in liquid-based cervicovaginal samples. METHODS: Immunocytochemical analyses were carried out with p16(INK4a) and modified Papanicolaou counterstain on 81 liquid-based samples, including 23 of within normal limits (WNL), 6 of low-grade squamous intraepithelial lesion (LSIL), 20 of high-grade squamous intraepithelial lesion (HSIL), 16 of atypical squamous cells of undetermined significance (ASC-US) and 16 of atypical squamous cells, high-grade lesion cannot be excluded (ASC-H). Results were compared with histological or cytological follow-up. For comparison, samples from 29 more cases (10 of LSIL, 10 of ASC-H and 9 of HSIL) were immunostained with p16(INK4a) and conventionally counterstained with haematoxylin. The intensity of immunostaining in cases of squamous intraepithelial lesion (SIL) was assessed using a 0-3 scoring system. Interobserver agreement was calculated by kappa statistics. RESULTS: Expression of p16(INK4a) was detected in 3 of 23 cases of WNL, 4 of 6 cases of LSIL, all cases of HSIL, 5 of 16 cases of ASC-US and 13 of 16 cases of ASC-H. Excluding two cases with no residual dysplastic cells in the immunocytochemistry, all cases of cervical intraepithelial neoplasia (CIN)2 or CIN3 at follow-up expressed p16(INK4a) and none of the p16(INK4a)-negative cases showed a high-grade lesion at follow-up. No evident differences in pattern or intensity of p16(INK4a) expression were observed between the specimens of the study and control groups. Interobserver agreement was significantly better in the study group than in the group with conventional immunostaining (combined kappa 0.773 v 0.549; p<0.05), and still better, albeit statistically not significant, than with conventional immunostaining and cervical smear test together (combined kappa 0.773 v 0.642). CONCLUSION: Immunocytochemistry with p16(INK4a) and modified Papanicolaou counterstain may add to the cervicovaginal cytology the full potentiality of p16(INK4a) without the need of a further slide and the risk of loss of dysplastic cells, yet maintaining the typical morphological features of the smear test.
G Negri; G Moretto; E Menia; F Vittadello; A Kasal; C Mian; E Egarter-Vigl
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Publication Detail:
Type:  Evaluation Studies; Journal Article     Date:  2006-02-07
Journal Detail:
Title:  Journal of clinical pathology     Volume:  59     ISSN:  0021-9746     ISO Abbreviation:  J. Clin. Pathol.     Publication Date:  2006 Aug 
Date Detail:
Created Date:  2006-07-28     Completed Date:  2006-10-10     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  0376601     Medline TA:  J Clin Pathol     Country:  England    
Other Details:
Languages:  eng     Pagination:  827-30     Citation Subset:  AIM; IM    
Department of Pathology, Central Hospital Bolzano, Bolzano, Italy.
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MeSH Terms
Carcinoma, Squamous Cell / diagnosis
Cervical Intraepithelial Neoplasia / diagnosis
Cyclin-Dependent Kinase Inhibitor p16 / analysis*
Diagnosis, Differential
Feasibility Studies
Neoplasm Proteins / analysis
Staining and Labeling / methods
Tumor Markers, Biological / analysis*
Uterine Cervical Dysplasia / diagnosis
Uterine Cervical Neoplasms / diagnosis*
Vaginal Smears / methods
Reg. No./Substance:
0/Cyclin-Dependent Kinase Inhibitor p16; 0/Neoplasm Proteins; 0/Tumor Markers, Biological

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