Sakunthala, P (2016) Analysis of Immunohistochemical Expression of p16ink4a in Preneoplastic and Neoplastic Squamous cell lesions of Cervix. Masters thesis, Chengalpattu Medical College, Chennai.
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Abstract
BACKGROUND: Cervical cancer is the fourth most common cancer affecting women worldwide. Pap smear screening and histopathological interpretation of cervical biopsy has significantly reduced the number of deaths due to cervical cancer. However, they provide little or no information regarding the association of HPV in precancerous lesion and invasive cervical cancer. Hence the need to use biomarker to know the association of HPV in those lesions in order to predict the risk of progression or regression and prognosis. P16INKa is a surrogate marker of HPV which fulfils all the above criteria. OBJECTIVES: 1. To evaluate the results of expression of p16INK4A in preneoplastic and neoplastic lesions of cervix in order to assess the association of HPV infection in those lesions. 2. To study the pattern of expression of p16 in various histological types of cervical squamous cell lesions by p16 immunohistochemistry. 3. To compare p16 expression in various histological types of cervical squamous cell lesions. MATERIALS AND METHODS: Immunohistochemical analysis of p16expression was performed on 60 paraffin embedded tissue samples, obtained from cervical biopsy including 25CIN I, 5CIN II, 4CIN III and 26 SCC. Two parameters were evaluated in p16 expression: Percentage ofp16 positive cells and reaction intensity of p16 immunostaining. The p16 expression was graded as Negative, Grade 1, 2, 3 and its reaction intensity was graded as Negative, Weak, Moderate, Strong. RESULTS: In the present study out of 60 cases, the incidence of squamous cell carcinoma constituted majority (44%). Among CIN group , CIN I constituted majority of the preneoplstic lesions of cervix.p16 expression was seen in 28% of CIN I, 80% of CIN II, all CIN III and all SCC cases. Only one CIN I case show showed grade3 staining and strong reaction intensity, but most of the CIN II(60%), CIN III(100%) and SCC(96.15%) cases showed grade 3 staining. In our study there was a statistically significant correlation between p16 expression, reaction intensity and lesion severity. CONCLUSION: In the present study out of 60 cases, 68.33% of cases showed p16 positivity. In preneoplastic lesions, totally 44.12% of cases showed p16 positivity. In invasive squamous cell carcinoma cases, 100% cases showed p16 positivity. So p16 may be useful as an adjunct in histological sections to know the association of HPV in preneoplastic lesions lesions to predict the risk of progression of the disease and to plan proper treatment and in neoplastic lesions to predict the prognosis, since HPV negative SCC showed poor prognosis in literatures. In our study p16 expression was correlated well with increasing grade of CIN. So p16 has significant implication in diagnostic, prognostic and preventive aspects of cervical cancer.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | P16INK4A ; Cervical intraepithelial neoplasia ; Immunohistochemistry ; Human papilloma virus. |
| Subjects: | MEDICAL > Pathology |
| Depositing User: | Laksham S |
| Date Deposited: | 11 Jul 2017 09:35 |
| Last Modified: | 13 Jun 2018 01:41 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/1451 |
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