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Year : 2021  |  Volume : 10  |  Issue : 6  |  Page : 312-317

Role of p16INK4A/Ki-67 dual immunostaining on cell blocks in detecting high-grade cervical intraepithelial lesions

1 Department of Pathology, Aleppo University, Aleppo, Syria
2 Department of Obstetrics and Gynecology, Aleppo University, Aleppo, Syria
3 Department of Internal Medicine, Aleppo University, Aleppo, Syria

Correspondence Address:
Lina Ghabreau
Departments of Pathology/Aleppo University, Aleppo
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ccij.ccij_42_21

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Background: P16/Ki-67 dual immunostaining has been confirmed as a sensitive and specific test for human papillomavirus positive women. In the present study, we evaluated cell blocks (CBs) with p16INK4A/Ki-67 biomarkers to detect high-grade cervical intraepithelial neoplasia (CIN). Materials and Methods: Samples for CB preparation were taken from females with abnormal Pap smears, who also underwent colposcopic guided biopsies, P16INK4A and Ki-67 staining were performed on CBs and tissue biopsies, histopathology with p16INK4A expression was considered the gold standard. Sixty-five specimens were included in the study. Results: The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy (AC) of CB + p16INK4A/Ki-67 in detecting CIN2 when considering only cytology specimens with the low-grade squamous intraepithelial lesion (LSIL) were 86.67%, 100%, 66.67%, 89.66%, and 82.93%, respectively. The sensitivity, specificity, PPV, NPV, and AC of CB + p16INK4A/Ki-67 in detecting CIN2 when considering only cytology specimens with atypical squamous cells of uncertain significance/LSIL were 75%, 85%, 60%, 91.89%, 82.69%, respectively. Rates of positive staining for p16 INK4A/ki-67 were enhanced according to increased pathologic grade and differed statistically between CIN1 and CIN2 as well as squamous cell carcinoma. Conclusion: CB preparation technique with p16INK4A and Ki-67 immunostainings have improved the diagnostic AC of Pap smear in detecting high-grade CIN.

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