European Journal of Molecular & Clinical Medicine

Abstract

Cervical cancer is the second leading cause of female cancer mortalities, worldwide and 5,00,000 new cases are diagnosed annually in developing and developed countries. The epidemiological profile of the disease shows that Cervical cancer is related to sexual activity and associated with Human papillomavirus (HPV) infection.The high risk HPV types 16 and 18 are the most prevelant, representing 69.8% and 15% respectively in cases of invasive cancer. A persistent high-risk HPV infection is also a prerequisite for the development of Cervical cancer. Genomic integration of the viral genome can disrupt several cellular proteins resulting in the upregulation of the tumour suppressor gene P16INK4A which is a cyclin-dependent kinase inhibitor.  Thus over-expression of p16 indicates an already advanced interference of the viral oncoproteins with cellular proteins involved in cell cycle regulation. The protein P16INK4 serves as a surrogate marker for the oncogenic activities of HPV in replication–competent cells of cervical epithelial and its over-expression is well established in Cervical intraepithelial neoplasia(CIN) and Invasive Squamous cell carcinoma(SCC) by many studies.
Aims and objectives
The study was a prospective study done from October 2013 to October 2015.The surgical biopsy specimens of uterine cervix were included in study.The main objective was to classify histopathological sections of uterine cervix by latest WHO criteria and study its association with P16INK4A immunostaining.Also to establish P16INK4A as marker of dysplastic and neoplastic epithelium and to correlate present study with results of other authors.
Results
       A total uterine cervix specimens received and studied were 365.Hysterectomy
specimen were 237 and cervical biopsy specimen were 128. Out 128 cases of
Cervical biopsy ,sixty five cases were Chronic non specific cervitis ,sixteen cases were
CIN1,seven cases were CIN2,five cases were CIN3 and thirty seven cases were SCC.
For immunohistochemistry, all  cases of CIN lesion ,twelve cases of SCC,ten cases of 
CNSC  were subjected to IHC .Out of sixteen cases in CIN1, thirteen cases showed
patchy staining intensity and three case showed diffuse basal positivity.In CIN2 out of
seven  cases ,four cases were patchy positive ,three cases showed diffuse  basal
positivity .In CIN3 out of five cases,one case was diffuse basal positive and four cases
were diffuse full thickness positive , in SCC all the twelve cases showed diffuse full
thickness positivity and in CNSC all the ten cases were negative.
CONCLUSION
  In conclusion ,the current study shows the efficacy of P16INK4A as a marker for
screening cervical malignancies. Increasing staining intensity of P16INK4A from CIN1 to
SCC,makes it a marker of choice for cervical dyskaryosis.