ATL. Issue 9 (1st November 2013)

• Record Type: Journal Article
• Authors: Cortecchia, Stefania; Galanti, Giuseppe; Sgadari, Cecilia; Costa, Silvano; De Lillo, Margherita; Caprara, Licia; Barillari, Giovanni; Monini, Paolo; Nannini, Roberto; Ensoli, Barbara; Bucchi, Lauro
• Is Part Of: International journal of gynecological cancer. Volume 23:Issue 9(2013)
• Page Start: 1663
• Page End: 1669
• Publication Date: 2013-11-01
• Subjects: p16Ink4a -- Cervical intraepithelial neoplasia -- Progression -- Regression; Generative organs, Female -- Cancer -- Periodicals; 616.99465
• DOI: 10.1097/IGC.0b013e3182a80b14
• Languages: English
• ISSNs: 1048-891X

Abstract

Abstract : Objective: The p16 Ink4a (p16) tumor-suppressor protein is a biomarker for activated expression of human papillomavirus oncogenes. However, data are insufficient to determine whether p16 overexpression predicts the risk for progression of low-grade cervical intraepithelial neoplasia (CIN). This study was aimed at evaluating the risk for progression to CIN2 or worse during a 3-year follow-up of an unselected series of 739 patients with CIN1 biopsy specimens tested for p16 expression. Methods: Positivity of p16 was defined as a diffuse overexpression in the basal/parabasal cell layers. Selection biases were ruled out using a control group of 523 patients with CIN1 biopsies not tested for p16 expression. Analysis was based on the ratio of progression rates. Results: In the first year of follow-up, the 216 patients (29%) with p16-positive CIN1 had a higher progression rate (12.3%) than did the 523 patients with p16-negative CIN1 (2.2%) (rate ratio, 5.5; 95% confidence interval [CI], 2.59–11.71). In the second and third years, differences were smaller (rate ratio, 1.32 and 1.14, respectively) and not significant. The patients with p16-positive CIN1 also had a lower risk for regression to normal in the first year of follow-up (rate ratio, 0.55; 95% confidence interval, 0.42–0.71) and nonsignificant changes in the second and third years (rate ratio, 0.81 and 0.84, respectively). Conclusions: The patients with p16-positive CIN1 had an increased risk for progression that was concentrated in the first year of follow-up. Immunostaining of p16 could have a role in short-term surveillance of patients with CIN1. Further research should focus on midterm/long-term outcomes of p16-positive CIN1.