Diagnostic role of p16/INK4A protein in Human Papillomavirus (HPV) induced cervical dysplasia |
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Authors: | Július Raj?áni Marián Adamkov Jana Hybenova Jaroslav Jackuliak Marian Ben?at |
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Institution: | (1) Department of Pathology, The Johns Hopkins Medical Institutions, Cancer Research Building II, Rm 309, 1550 Orleans Street, Baltimore, MD, USA;(2) Department of Obstetrics and Gynecology, The Johns Hopkins Medical Institutions, Baltimore, MD, USA;(3) Department of Molecular Microbiology and Immunology, The Johns Hopkins Medical Institutions, Orleans Street, Baltimore, MD, USA;(4) Department of oncology, The Johns Hopkins Medical Institutions, Baltimore, MD, USA; |
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Abstract: | The p16/INK4A protein is a cellular regulatory polypeptide over-expressed in the presence of high levels of the Human Papillomavirus
(HPV) coded E7 protein. This review outlines the use of p16 antigen staining in cervical biopsies as well as in PAP smears
summarizing the corresponding literature and commenting the authors’ own experience. The p16 antigen is a reliable marker
for dysplastic cells in CINII/CINIII (HSIL) lesions as viewed in cervical biopsies. When PAP smears were examined at large
scale screening for p16 antigenreactive and atypical cells, considerable variations could be found especially in ASCUS graded
lesions. Therefore, the presence of p16-reactive atypical cells in PAP smears should be interpreted together with the cytological
signs of dysplasia, such as the altered N/C ratio. In addition, women revealing p16-positive ASCUS/LSIL specimens should be
examined for the presence of HPV DNA. Detection of HPV DNA alone, i.e. in the absence of cytological screening has a low predictive value, since the clearance of HPV may occur even in the absence
of morphological alterations. Combined cytological as well as molecular follow up contributes to the efficiency of diagnostic
and increases the probability of correct interpretation of the pre-cancerous lesions by non-invasive techniques. |
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