An evaluation of p16INK4a expression in cervical intraepithelial neoplasia specimens, including women with HIV-1

• Autor(a) principal: Nicol,Alcina F
• Data de Publicação: 2012
• Outros Autores: Golub,Jonathan E, Silva,José R Lapa e, Cunha,Cynthia B, Amaro-Filho,Sergio M, Oliveira,Nathalia S, Menezes,Willker, Andrade,Cecília Viana, Russomano,Fabio, Tristão,Aparecida, Grinsztejn,Beatriz, Friedman,Ruth Khalili, Oliveira,Marcia P, Pires,Andrea, Nuovo,Gerard J
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Memórias do Instituto Oswaldo Cruz
• Texto Completo: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0074-02762012000500001
• topic: CIN; p16INK4a; HPV; HIV; TMA; ROC

Although several studies have evaluated the role of p16INK4a as a diagnostic marker of cervical intraepithelial neoplasia (CIN) and its association with disease progression, studies regarding the role of p16INK4a in human immunodeficiency virus (HIV)-infected patients remain scarce. The present study was designed to determine the potential utility of p16INK4a as a diagnostic marker for CIN and invasive cervical cancer in HIV-positive and negative cervical specimens. An immunohistochemical analysis of p16INK4a was performed in 326 cervical tissue microarray specimens. Performance indicators were calculated and compared using receiving operating characteristics curve (ROC)/area under the curve. In HIV-1-negative women, the percentage of cells that was positive for p16INK4a expression was significantly correlated with the severity of CIN (p < 0.0001). A ROC curve with a cut-off value of 55.28% resulted in a sensitivity of 89%, a specificity of 81%, a positive predictive value of 91% and a negative predictive value of 78%. HIV-seropositive women exhibited decreased expression of p16INK4a in CIN2-3 specimens compared with HIV-negative specimens (p = 0.031). The ROC data underscore the potential utility of p16INK4a under defined conditions as a diagnostic marker for CIN 2-3 staging and invasive cervical cancer. HIV-1 infection, however, is associated with relatively reduced p16INK4a expression in CIN 2-3.