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HPV 16 genotype, p16/Ki‐67 dual staining and koilocytic morphology as potential predictors of the clinical outcome for cervical low‐grade squamous intraepithelial lesions
Author(s) -
VrdoljakMozetič D.,
Krašević M.,
Verša Ostojić D.,
ŠtembergerPapić S.,
RubešaMihaljević R.,
BubonjaŠonje M.
Publication year - 2015
Publication title -
cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.512
H-Index - 48
eISSN - 1365-2303
pISSN - 0956-5507
DOI - 10.1111/cyt.12121
Subject(s) - medicine , ki 67 , squamous intraepithelial lesion , koilocyte , staining , gastroenterology , hpv infection , cervical intraepithelial neoplasia , cytology , lesion , pathology , cervical cancer , cancer , immunohistochemistry
Objective To evaluate the association of human papillomavirus ( HPV ) 16 and non‐16 genotype, p16/Ki‐67 dual staining and koilocytosis and their role in the prediction of the clinical outcome of low‐grade squamous intraepithelial lesion ( LSIL ) cytology. Methods One hundred and fifty‐five patients with LSIL were followed up and recorded as progression, persistence or regression. HPV genotyping was performed for high‐risk HPV (hr HPV ) DNA ‐positive cases. Koilocytosis was reviewed and p16/Ki‐67 dual staining was performed on reprocessed conventional cytology slides. Results HPV 16 was the most frequent genotype found in 16.3% of cases. p16/Ki‐67 dual staining was positive in 36.1% of all cases. Progression, including concurrent cervical intraepithelial lesion grade 2 or above ( CIN 2+), was recorded in 13.8% of cases. A statistically significant difference between progressive and non‐progressive cases was shown by the following: hr HPV ‐positive versus hr HPV ‐negative ( P = 0.022), HPV 16‐positive versus non‐16 HPV ‐positive ( P < 0.001) and p16/Ki‐67‐positive versus p16/Ki‐67‐negative ( P < 0.001) cases. Cases with combined HPV 16 and p16/Ki‐67 positivity showed the highest progression rate (58.3%). Non‐koilocytic HPV 16‐positive cases showed a 50% progression rate compared with 10.1% for koilocytic non‐16 HPV ‐positive cases ( P = 0.010). The sensitivity of p16/Ki‐67 dual staining for the detection of CIN 2+ lesions was 80%, comparable with hr HPV (85%). The specificity of p16/Ki‐67 dual staining was 71% and of hr HPV 42%. The highest specificity was found for HPV 16 genotype presence (91%), but with low sensitivity (50%). Conclusion HPV genotyping, p16/Ki‐67 dual staining and koilocytic morphology can be useful in the prediction of clinical outcome in women initially diagnosed with LSIL cytology.