Prognostic relevance of Ki-67 and P16/INK4a markers in histological diagnosis of cervical dysplasia

Purpose of the study. To determine the quantitative parameters of the molecular markers Ki‑67 and p16/INK4a at CIN 1–3 and to establish the possibility of using them to improve the quality of diagnosis by histological samples.Patients and methods. Biopsy material of the cervix was studied in 71 pati...

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Main Authors: T. A. Dimitriadi, D. V. Burtsev, E. A. Dzhenkova, T. N. Gudtskova, K. V. Dvadnenko
Format: Article
Language:Russian
Published: QUASAR, LLC 2020-03-01
Series:Исследования и практика в медицине
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Online Access:https://www.rpmj.ru/rpmj/article/view/495
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author T. A. Dimitriadi
D. V. Burtsev
E. A. Dzhenkova
T. N. Gudtskova
K. V. Dvadnenko
author_facet T. A. Dimitriadi
D. V. Burtsev
E. A. Dzhenkova
T. N. Gudtskova
K. V. Dvadnenko
author_sort T. A. Dimitriadi
collection DOAJ
description Purpose of the study. To determine the quantitative parameters of the molecular markers Ki‑67 and p16/INK4a at CIN 1–3 and to establish the possibility of using them to improve the quality of diagnosis by histological samples.Patients and methods. Biopsy material of the cervix was studied in 71 patients who were carriers of HPV infection. Immunohistochemical method (IHC) in biopsy specimens determined the expression of Ki‑67 and p16/INK4a markers.Results. According to the results of a standard histological examination, the distribution of patientsinto groups occurred as follows: CIN 1–18, in CIN 2–39, in CIN 3–14 patients. It was found that the expression of the studied markers is associated with the severity of dysplastic changes in the tissue of the cervix. By the studied marker, the most characteristic molecular profiles for the degrees of dysplasia were determined: CIN1 – Ki‑67–15–25%, p16/INK4a 10–15%; CIN2 – Ki‑67–70–80%, p16/INK4a – 65–70%; CIN3 – Ki‑67–85–90%, p16/INK4a – 90–95%. Heterogeneity was revealed in the expression of these markersin the CIN 2 group: in 7 cases (22,6%), the molecular profile corresponded to CIN 1, in 1 case (3,6%) to CIN 3. Clinical examples of using the IHC profile to clarify the degree of CIN are given.Conclusion. The use of an IHC study with Ki‑67 and p16/INK4a, in addition to the standard histological examination, makes it possible to objectify the initial diagnosis of the degree of CIN, as well as to identify patients with a high and low risk of developing severe injuries. This is especially true for the CIN2 group, the most problematic in terms of histological evaluation and tactics of clinical management of patients. The use of IHC in the initial diagnosis will contribute to: improving the information content of multiple aimed and loop excisional biopsies; reduction in relapse due to inadequate treatment; eliminating the unreasonable use of such a traumatic method as conization (especially in women of childbearing age).
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spelling doaj-art-6849e3f8a5cc48dfaa7c7588241c37982025-02-03T00:57:39ZrusQUASAR, LLCИсследования и практика в медицине2410-18932020-03-017181510.17709/2409-2231-2020-7-1-1306Prognostic relevance of Ki-67 and P16/INK4a markers in histological diagnosis of cervical dysplasiaT. A. Dimitriadi0D. V. Burtsev1E. A. Dzhenkova2T. N. Gudtskova3K. V. Dvadnenko4Regional Advisory and Diagnostic Centre; Rostov State Medical UniversityRegional Advisory and Diagnostic Centre; National Medical Research Centre for Oncology; Rostov State Medical UniversityNational Medical Research Centre for Oncology of the Ministry of Health of RussiaNational Medical Research Centre for Oncology of the Ministry of Health of RussiaRegional Advisory and Diagnostic CentrePurpose of the study. To determine the quantitative parameters of the molecular markers Ki‑67 and p16/INK4a at CIN 1–3 and to establish the possibility of using them to improve the quality of diagnosis by histological samples.Patients and methods. Biopsy material of the cervix was studied in 71 patients who were carriers of HPV infection. Immunohistochemical method (IHC) in biopsy specimens determined the expression of Ki‑67 and p16/INK4a markers.Results. According to the results of a standard histological examination, the distribution of patientsinto groups occurred as follows: CIN 1–18, in CIN 2–39, in CIN 3–14 patients. It was found that the expression of the studied markers is associated with the severity of dysplastic changes in the tissue of the cervix. By the studied marker, the most characteristic molecular profiles for the degrees of dysplasia were determined: CIN1 – Ki‑67–15–25%, p16/INK4a 10–15%; CIN2 – Ki‑67–70–80%, p16/INK4a – 65–70%; CIN3 – Ki‑67–85–90%, p16/INK4a – 90–95%. Heterogeneity was revealed in the expression of these markersin the CIN 2 group: in 7 cases (22,6%), the molecular profile corresponded to CIN 1, in 1 case (3,6%) to CIN 3. Clinical examples of using the IHC profile to clarify the degree of CIN are given.Conclusion. The use of an IHC study with Ki‑67 and p16/INK4a, in addition to the standard histological examination, makes it possible to objectify the initial diagnosis of the degree of CIN, as well as to identify patients with a high and low risk of developing severe injuries. This is especially true for the CIN2 group, the most problematic in terms of histological evaluation and tactics of clinical management of patients. The use of IHC in the initial diagnosis will contribute to: improving the information content of multiple aimed and loop excisional biopsies; reduction in relapse due to inadequate treatment; eliminating the unreasonable use of such a traumatic method as conization (especially in women of childbearing age).https://www.rpmj.ru/rpmj/article/view/495cervixcervical intraepithelial neoplasia (cin)immunohistochemistry (ihc)ki-67p16/ink4ahuman papillomavirus (hpv)
spellingShingle T. A. Dimitriadi
D. V. Burtsev
E. A. Dzhenkova
T. N. Gudtskova
K. V. Dvadnenko
Prognostic relevance of Ki-67 and P16/INK4a markers in histological diagnosis of cervical dysplasia
Исследования и практика в медицине
cervix
cervical intraepithelial neoplasia (cin)
immunohistochemistry (ihc)
ki-67
p16/ink4a
human papillomavirus (hpv)
title Prognostic relevance of Ki-67 and P16/INK4a markers in histological diagnosis of cervical dysplasia
title_full Prognostic relevance of Ki-67 and P16/INK4a markers in histological diagnosis of cervical dysplasia
title_fullStr Prognostic relevance of Ki-67 and P16/INK4a markers in histological diagnosis of cervical dysplasia
title_full_unstemmed Prognostic relevance of Ki-67 and P16/INK4a markers in histological diagnosis of cervical dysplasia
title_short Prognostic relevance of Ki-67 and P16/INK4a markers in histological diagnosis of cervical dysplasia
title_sort prognostic relevance of ki 67 and p16 ink4a markers in histological diagnosis of cervical dysplasia
topic cervix
cervical intraepithelial neoplasia (cin)
immunohistochemistry (ihc)
ki-67
p16/ink4a
human papillomavirus (hpv)
url https://www.rpmj.ru/rpmj/article/view/495
work_keys_str_mv AT tadimitriadi prognosticrelevanceofki67andp16ink4amarkersinhistologicaldiagnosisofcervicaldysplasia
AT dvburtsev prognosticrelevanceofki67andp16ink4amarkersinhistologicaldiagnosisofcervicaldysplasia
AT eadzhenkova prognosticrelevanceofki67andp16ink4amarkersinhistologicaldiagnosisofcervicaldysplasia
AT tngudtskova prognosticrelevanceofki67andp16ink4amarkersinhistologicaldiagnosisofcervicaldysplasia
AT kvdvadnenko prognosticrelevanceofki67andp16ink4amarkersinhistologicaldiagnosisofcervicaldysplasia