Follow-up study of patients with cervical intraepithelial neoplasia grade 1 overexpressing p16Ink4a

Stefania Cortecchia, Giuseppe Galanti, Cecilia Sgadari, Silvano Costa, Margherita De Lillo, Licia Caprara, Giovanni Barillari, Paolo Monini, Roberto Nannini, Barbara Ensoli, Lauro Bucchi

Research output: Contribution to journalArticle

Abstract

Objective: The p16Ink4a (p16) tumor-suppressor protein is a biomarker for activated expression of human papillomavirus oncogenes. However, data are insufficient to determine whether p16 overexpression predicts the risk for progression of low-grade cervical intraepithelial neoplasia (CIN). This study was aimed at evaluating the risk for progression to CIN2 or worse during a 3-year follow-up of an unselected series of 739 patients with CIN1 biopsy specimens tested for p16 expression. Methods: Positivity of p16 was defined as a diffuse overexpression in the basal/parabasal cell layers. Selection biases were ruled out using a control group of 523 patients with CIN1 biopsies not tested for p16 expression. Analysis was based on the ratio of progression rates. Results: In the first year of follow-up, the 216 patients (29%) with p16-positive CIN1 had a higher progression rate (12.3%) than did the 523 patients with p16-negative CIN1 (2.2%) (rate ratio, 5.5; 95% confidence interval [CI], 2.59-11.71). In the second and third years, differences were smaller (rate ratio, 1.32 and 1.14, respectively) and not significant. The patients with p16-positive CIN1 also had a lower risk for regression to normal in the first year of follow-up (rate ratio, 0.55; 95% confidence interval, 0.42-0.71) and nonsignificant changes in the second and third years (rate ratio, 0.81 and 0.84, respectively). Conclusions: The patients with p16-positive CIN1 had an increased risk for progression that was concentrated in the first year of follow-up. Immunostaining of p16 could have a role in short-term surveillance of patients with CIN1. Further research should focus on midterm/ long-term outcomes of p16-positive CIN1.

Original languageEnglish
Pages (from-to)1663-1669
Number of pages7
JournalInternational Journal of Gynecological Cancer
Volume23
Issue number9
DOIs
Publication statusPublished - 2013

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Keywords

  • Cervical intraepithelial neoplasia
  • P16
  • Progression
  • Regression

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Oncology

Cite this

Cortecchia, S., Galanti, G., Sgadari, C., Costa, S., De Lillo, M., Caprara, L., Barillari, G., Monini, P., Nannini, R., Ensoli, B., & Bucchi, L. (2013). Follow-up study of patients with cervical intraepithelial neoplasia grade 1 overexpressing p16Ink4a . International Journal of Gynecological Cancer, 23(9), 1663-1669. https://doi.org/10.1097/IGC.0b013e3182a80b14