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Immunohistochemical detection of p16INK4a in liquid-based cytology specimens on cell block sections†
Version of Record online: 28 FEB 2007
Copyright © 2007 American Cancer Society
Volume 111, Issue 2, pages 74–82, 25 April 2007
How to Cite
Liu, H., Shi, J., Wilkerson, M., Huang, Y., Meschter, S., Dupree, W. and Lin, F. (2007), Immunohistochemical detection of p16INK4a in liquid-based cytology specimens on cell block sections. Cancer, 111: 74–82. doi: 10.1002/cncr.22577
Presented in part at the 54th American Society of Cytopathology Annual Scientific Meeting in Toronto, Ontario, Canada, November 3–8, 2006.
- Issue online: 12 APR 2007
- Version of Record online: 28 FEB 2007
- Manuscript Accepted: 4 JAN 2007
- Manuscript Revised: 28 NOV 2006
- Manuscript Received: 31 OCT 2006
- cervical smears;
- liquid-based thin layer;
- cell blocks;
- squamous intraepithelial lesions
Colposcopy biopsy procedure is a standard recommendation for atypical squamous cell cannot exclude high-grade lesion (ASC-H) in abnormal Papanicolaou smears. p16 (p16INK4a), a cell cycle regulator, has been shown to be overexpressed in squamous dysplasia. To further improve the diagnostic accuracy of the ASC-H Papanicolaou smear and to reduce unnecessary procedures, the authors evaluated the utility of immunodetection of p16 in liquid-based cytology specimens on cell blocks.
Seventy-five liquid-based (SurePath; TriPath Imaging, Inc. Burlington, NC) cytology specimens were prepared for cell blocks. Three groups (G1, G2, and G3) of cases were included: G1 comprised 44 cases of ASC-H; G2, 14 cases of high-grade dysplasia; and G3, 17 negative/reactive cases. All cases in G1 were confirmed by cervical biopsy or Digene Hybrid Capture 2 (Digene, Gaithersburg, Md) human papilloma virus (HPV) testing. Immunodetection for p16 was performed on cell blocks.
In G1, 26 of 44 (59%) cases showed squamous dysplasia, with 14 high-grade squamous intraepithelial lesion (HSIL) cases. Twenty-two of 28 (79%) p16-positive cases were confirmed by surgical biopsy or HPV testing, with a diagnostic sensitivity of 85%, specificity of 67%, positive predictive value (PPV) of 79%, and negative predictive value (NPV) of 75%. Four cases with false-negative staining for p16 were identified. All 28 cases of HSIL (14 from G1 and 14 from G2) were positive for p16.
1) p16 is a sensitive marker to confirm the diagnosis of ASC-H on a cell block; 2) Multiple unstained slides with adequate cellularity can be obtained from each cell block; and 3) Additional markers can be used to further increase diagnostic sensitivity and specificity. Cancer (Cancer Cytopathol) 2007. © 2007 American Cancer Society.