Introduction: Cancer of the uterine cervix is the fourth most common cancer among women worldwide, with a higher burden in the low- and middle-income countries. Human Papilloma Virus (HPV) is the foremost aetiological factor which integrates into the genome of the epithelial cells at the cervical transformation zone leading to neoplasia.

Aim: This study was undertaken to demonstrate overexpression of p16INK4a as a biomarker for HPV infection in cervical biopsies; to know its frequency of occurrence in cases of cervicitis, low grade squamous intraepithelial lesion (LSIL), high grade squamous intraepithelial lesion (HSIL) and invasive cancer; to establish marker’s specificity and the ability to differentiate between cervical dysplasia from benign morphological mimickers.

Materials and Methods: Totally 75 cervical biopsies were studied between 2014 to 2016, and categorized as inflammatory, precancerous and cancerous lesions. Routine histopathological examination was combined with Immunohistochemistry (IHC) using p16INK4a antibody. Grading of immuno-positivity was made depending on the number of cells exhibiting strong nuclear and/or cytoplasmic positivity.

Results: Age of the patients ranged between 24 to 80years and the commonest clinical complaint was vaginal discharge. Of the 75 biopsies studied, 32% were diagnosed as cervicitis, 12% as LSIL and 16% as HSIL. Totally 30(40%) cases of invasive cancers were studied which included 26 cases procured from a cancer hospital to conduct a pilot study. p16INK4a was positive in all invasive cancers (100%) and negative in all cases of cervicitis. Statistically significant results were noted between histopathological diagnoses and the grades of immunopositivity with p16INK4a.

Conclusion: This study reiterates the usefulness of p16INK4a as a reliable biomarker for HPV induced cervical lesions and unnecessary follow-up can be avoided in immune-negative cases. The fact that all cervical cancers were positive for HPV is alarming, signifying that developing nations have to give utmost importance to the primary prevention of cervical cancer with vaccination for HPV.

Keywords: Cervical Carcinoma; Human Papilloma Virus; Immunohistochemistry; p16INK4a Biomarker

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Citation

Citation: Kusuma Venkatesh., et al. “Study of p16INK4a Immunostaining as Specific Biomarker in the diagnosis of Cervical Intraepithelial Neoplasia and Invasive Cancer: It is High Time to Prevent Cervical Cancer than to Cure”.Acta Scientific Cancer Biology 8.1 (2024): 05-14.

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Copyright: © 2024 Kusuma Venkatesh., et al. “Study of p16INK4a Immunostaining as Specific Biomarker in the diagnosis of Cervical Intraepithelial Neoplasia and This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.