European Journal of Molecular & Clinical Medicine

Abstract

Background: Cervical cancer is the world's fourth most prevalent malignancy among women. This study examines cervical cancer incidence and mortality in India and its states over the past three decades to follow the success of preventative and control efforts. Cervical cancer is highest among 15-29-year-old women. India, HPV 16 and 18 cause it. One of the outcomes of viral genomic integration (E7) into the host cell (RB) is increased expression of p16INK4A, a cyclin-dependent kinase inhibitor. E6 suppresses p53-mediated apoptosis, prolonging the survival of injured and altered cells and raising Ki-67 (a proliferation marker). p16INK4A and Ki 67 may be employed as surrogate markers in identifying and evaluating cervical neoplasms.
Objectives
1)      Study the histo-morphological features of cervical punch biopsies with the help of immune markers P16 and Ki 67.
2)      To assess the utility value of p16 and ki 67 in diagnosing and grading the cervical neoplasm.
Materials and Methods: The study included 80 cervical punch biopsy specimens (22 normal cervical tissue samples, 25 low-grade squamous intraepithelial lesions (LSIL), 13 high-grade squamous intraepithelial neoplasia lesions (HSIL), 17 squamous cell carcinomas and 3 adenocarcinomas). 80 formalin-fixed, paraffin-embedded, H&E-stained tissue slides were histopathologically evaluated. After antigen retrieval, p16INK4A expression and Ki 67 were analysed using mouse monoclonal antibodies. P16INK4A staining was scored 0-8 and Ki 67 0-3. Statistical analysis was done.
Results: P16INK4A immunoreactivity was absent in all normal cervical tissues examined and Ki 67 was basally positive. There is upregulation of these biomarkers in SILs and cervical carcinoma. 16/25 cases of CIN I (LSIL) showed positivity of p16, 19/25 for ki 67. All cases of HSIL (10/10 CIN II and 3/3 CIN III) and invasive cervical carcinoma (17/17SCC and 3/3 adenocarcinoma) were positive for p16INK4A expression and Ki 67 and exhibited a higher score.
Conclusion: These studies indicate that p16INK4a and Ki 67 are specific biomarkers that can detect dysplastic and malignant cervical epithelium in sections of cervical biopsy samples, which helps in the identifying and grading of cervical neoplasms.