Argentophilic nucleolus organizer region as a proliferation marker in cervical intraepithelial neoplasia grade 1 of the uterine cervix. Issue 6 (June 2014)

• Record Type: Journal Article
• Authors: Guerra, Fernando; Rocher, Adriana Esther; Villacorta Hidalgo, José; Díaz, Lilí; Vighi, Susana; Cardinal, Lucía; Tatti, Silvio; Cúneo, Nicasio; Prat Gay, Gonzalo; Camporeale, Gabriela; Palaoro, Luis Alberto
• Is Part Of: Journal of obstetrics and gynaecology research. Volume 40:Issue 6(2014:Jun.)
• Page Start: 1717
• Page End: 1724
• Publication Date: 2014-06
• Subjects: Gynecology -- Periodicals; Obstetrics -- Periodicals; 618.1005
• DOI: 10.1111/jog.12380
• Languages: English
• ISSNs: 1341-8076

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="jog12380-sec-0001" sec-type="section"> <title>Aim</title> <p>p16INK4a and argentophilic nucleolus organizer region (AgNOR) can be used as markers for progression of cervical intraepithelial neoplasia grade 1 (CIN1) of the uterine cervix. Our objective was to study the predictive value of the AgNOR technique as a progression marker of CIN1 and its correlation with p16INK4A.</p> </sec> <sec id="jog12380-sec-0002" sec-type="section"> <title>Material and Methods</title> <p>One uterine cervix biopsy from each of 75 patients with diagnosis of CIN1 was selected. All of these patients underwent a second biopsy, and these were also used for the study.</p> </sec> <sec id="jog12380-sec-0003" sec-type="section"> <title>Results</title> <p>The second biopsies showed: regression (20 patients), persistent CIN1 (38 patients), progression to CIN2 (10 patients) and progression to CIN3 (seven patients). p16INK4A showed reactivity in 67 of the 75 first CIN1 biopsies: 12 of the 20 cases that cleared the lesions and the 55 cases with persistent or progressive lesions were positive for p16INK4a (specificity: 40%; sensitivity: 100%; positive predictive value [PPV]: 82%; negative predictive value [NPV]: 100%). Samples with AgNOR areas less than 3.0 μ<sup>2</sup> returned in all cases, but patients whose lesions persisted or progressed to CIN2/CIN3, showed AgNOR areas greater than 3.0 μ<sup>2</sup> in 50/55 cases (specificity: 100%; sensitivity: 91%; PPV: 100%; NPV: 80%).</p> </sec> <sec id="jog12380-sec-0004" sec-type="section"> <title>Conclusions</title> <p>p16INK4a is expressed in a high percentage of returning lesions. AgNOR might be a better marker of proliferation of CIN1 than p16INK4a (PPV = 100%), which means that a value greater than 3.0 μ<sup>2</sup> indicates the persistence or progression of the lesion. As its NPV is 80%, a value of AgNOR area less than 3.0 μ<sup>2</sup> in CIN1 leaves a margin of doubt about the future behavior of the lesion.</p> </sec> </abstract>