Details

Autor(en) / Beteiligte

• Gustinucci, Daniela
• Passamonti, Basilio
• Cesarini, Elena
• Butera, Daniela
• Palmieri, Emiliano Antonio
• Bulletti, Simonetta
• Carlani, Angela
• Staiano, Maria
• D’Amico, Maria Rosaria
• D’Angelo, Valentina
• Di Dato, Eugenio
• Martinelli, Nadia
• Malaspina, Morena
• Spita, Nicoletta
• Tintori, Beatrice
• Fulciniti, Franco

Titel

Role of p16INK4a Cytology Testing as an Adjunct to Enhance the Diagnostic Specificity and Accuracy in Human Papillomavirus-Positive Women within an Organized Cervical Cancer Screening Program

Ist Teil von

• Acta cytologica, 2012-01, Vol.56 (5), p.506-514

Ort / Verlag

Basel, Switzerland

Erscheinungsjahr

2012

Link zum Volltext

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• Objective: We evaluated the performance of cytologic p16INK4a (p16) immunostaining within a cervical cancer screening program for the categories of atypical squamous cells of undetermined significance (ASC-US) and low-grade squamous intraepithelial lesion (LS after triage with high-risk human papillomavirus (HR-HPV) testing and atypical squamous cells, cannot exclude high-grade intraepithelial squamous lesion (ASC-H) and high-grade squamous intraepithelial lesion (HSIL). We also verified whether the routine introduction of p16 staining might enhance the specificity and positive predictive value (PPV) for cervical intraepithelial neoplasia grade 2 or higher (CIN2+) lesions predicted by a cytological screening test. Study Design: Performance of the p16 cytology test was estimated in 578 cytological samples, of which 213 were HR-HPV+ ASC-US, 186 were HR-HPV+ LSIL, 74 were ASC-H, 56 were HSIL-CIN2 and 49 were HSIL-CIN3. All samples had histological follow-up. Results: In the ASC-US category, p16 sensitivity was 91% for CIN2+ and 100% for CIN3, while specificity was 64 and 58%, respectively, negative predictive value (NPV) was 96 and 100%, respectively, and PPV was 39%. In the LSIL category, sensitivity was 77 and 75%, respectively, for CIN2+ and CIN3, while specificity was 64 and 57%, NPV was 93 and 98% and PPV was 30%. Sensitivity for ASC-H and HSIL-CIN3 was 100% for CIN2+ and CIN3, while for HSIL-CIN2 it was 91 and 95%, respectively; NPV for ASC-H was 100%, and for HSIL-CIN2 it was 43 and 86%, respectively. Follow-up examinations of 8 cases diagnosed as p16+ ASC-H and HSIL-CIN3, but histologically negative or CIN1 on the first biopsy, showed 4 CIN2 and 4 CIN3 lesions. Conclusions: Sensitivity, specificity, PPV and NPV confirm the importance of the utilization of p16 in the categories ASC-US and LSIL after triage with an HR-HPV test. In the ASC-H and HSIL-CIN3 lesions, p16 was shown to be an excellent marker for picking up CIN2+ lesions, especially in cases with cytohistological discordance.