CLINICAL VALUE OF P16/KI-67 IMMUNOHISTOCHEMICAL DUAL-STAINING IN THE GRADING DIAGNOSIS OF PATIENTS WITH ABNORMAL CERVICAL THINPREP CYTOLOGIC TEST SCREENING

Meina Bian, Nan Wang, Qing Liu^*

Department of Gynecology, Beijing Youan Hospital, Capital Medical University, Beijing 100069, PR China

Introduction: To explore the clinical value of cervical P16/Ki-67 immunohistochemical dual-staining in the grading diagnosis of patients with abnormal liquid-based thinprep cytologic test (TCT) screening. 

Materials and methods: A total of 672 patients with abnormal TCT screening presenting to our hospital from January 2019 to July 2021 were retrospectively included. According to the results of histopathological examination, the patients were divided into inflammation group (392 cases), cervical intraepithelial neoplasia (CIN) I group (112 cases), CIN II group (104 cases) and CIN III group (64 cases). The positivity in cervical P16 and Ki-67 immunohistochemical examination was recorded, the diagnostic agreement of two methods for the severity of cervical lesions was evaluated, and the relationship between human papilloma virus (HPV) infection and cervical P16 expression was further analyzed. 

Results: There were significant differences among all groups in the positive rates of P16 and Ki-67 expressions (P<0.05). Pearson correlation analysis showed that the expressions of P16 and Ki-67 were positively correlated with the severity of cervical lesions (P<0.05). The expressions of P16 and Ki-67 in the inflammation group were all negative, the expressions of P16 and Ki-67 in CIN II and CIN III groups were all positive, and the expressions of P16 and Ki-67 in CIN III group were stronger. Compared with histopathological HE examination, the Kapp value for diagnostic agreement of P16 combined with Ki-67 immunohistochemistry in the severity of cervical lesions was 0.98, indicating a high agreement between the results of the two examinations. There was a significant difference in HPV infection rate between subgroups with different cervical P16 expression intensity (P<0.05). Pearson correlation analysis indicated that the cervical P16 expression intensity was positively correlated with the risk of cervical HPV infection (P<0.05). The proportions of HPV-16, HPV-18, HPV-58 and high-risk mixed subtypes in P16-positive group were significantly higher than those in P16-negative group (P<0.05). 

Conclusion: P16/ KI-67 immunohistochemical dual-staining can be used for grading diagnosis of patients with ab-normal cervical TCT screening. The stronger expressions of P16/ KI-67, the more severe the lesions. At the same time, cli-nicians should intensify the prevention and control of high-risk HPV infection.