P16INK4A overexpression predicts lymph node metastasis in cervical carcinomas. Issue 2 (19th October 2011) - Huang, Lee-Wen
Abstract : Background: The p16 INK4A protein (p16) is a cyclin-dependent kinase inhibitor that arrests the cell cycle in the G1 phase. Aim: To explore the potential of p16 as a predictive marker for lymph node (LN) metastasis and prognosis in cervical carcinomas. Methods: 145 patients diagnosed with FIGO stage I to IV cervical carcinoma were studied; 95 underwent LN dissection. The expression of p16 protein was studied by immunohistochemistry using tissue microarrays. Results: Overexpression of p16 was seen in 108 of 145 (74.5%) invasive carcinomas. There was a significant correlation between p16 expression and LN metastasis (p=0.007). Patients with p16 overexpression had poorer survival than patients with p16 underexpression (59.3% vs 83.8% 5-year survival rate, log-rank p=0.015). In univariate analysis, p16 expression was a significant predictor of survival (RR 2.76, p=0.02). Conclusions: Results suggest that p16 expression is an important predictive factor of LN metastasis in cervical cancer patients. Moreover, p16 overexpression is associated with a poor prognosis. Therefore, immunohistochemical evaluation of p16 expression is of potential value for treatment planning in cervical carcinomas.