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

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Author(s): Alcina F Nicol | Jonathan E Golub | José R Lapa e Silva | Cynthia B Cunha | Sergio M Amaro-Filho | Nathalia S Oliveira | Willker Menezes | Cecília Viana Andrade | Fabio Russomano | Aparecida Tristão | Beatriz Grinsztejn | Ruth Khalili Friedman | Marcia P Oliveira | Andrea Pires | Gerard J Nuovo

Journal: Memórias do Instituto Oswaldo Cruz.
ISSN 0074-0276

Volume: 107;
Issue: 5;
Start page: 571;
Date: 2012;
Original page

Keywords: CIN | p16INK4a | HPV | HIV | TMA | ROC

ABSTRACT
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.
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Tango Rapperswil
Tango Rapperswil