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Treatment guidelines differ for young women with Cervical Intraepithelial Neoplasia (CIN) 2 lesions on biopsy depending on their desire for future pregnancy. Therefore, we investigated the utility of using P16 and Ki-67 immunohistochemical stains on cervical biopsies diagnosed with CIN 2 to determine the outcome on subsequent excisional specimens. The study included 22 patients, with a mean age of 34 years and an age range from 20 to 51 years. Positive staining for p16 was identified in 21/22 patients. The subsequent excisional pathology of these 21 patients with strong diffuse staining showed that 1 had invasive squamous cell carcinoma, 9 had CIN 3, 6 had CIN 2 or CIN 1-2, 2 had CIN 1, and 3 had no CIN lesion. The only patient with patchy p16 staining on cervical biopsy had CIN 3 on cone biopsy. The Ki-67 index was negative in 18/22 patients and positive in 4/22 patients. The Ki-67 index was negative in 5/5 patients with CIN 1 or no CIN lesion on subsequent excisional pathology and 13/17 patients with CIN 2 or CIN 3 on follow up excisional pathology. The 4 patients with a positive Ki-67 index all had CIN 2 or CIN 3 on follow up excisional pathology. Thus, we conclude that P16 and Ki-67 immunostaining was not found to be useful in triaging women with CIN 2.

Utility of P16 and Ki-67 Expression in Cervical Biopsy with Cervical Intraepithelial Neoplasia 2 to Predict Diagnosis in Subsequent Cervical Excision Specimen