P16 ink4a expression in preinvasive cervical lesions and invasive cancer, and its clinicial value

Although there is an important progress in cervical cancer screening methods, cervical cancer stil is an important health problem worldwide. Like every malign tumors, early diagnosis is important for the successful treatment and good prognosis in cervical carcinoma. Therefore, early diagnosis with screening methods is essential for the cervical cancer precurcors and invasive cervical neoplasias prevention and early diagnosis. The ideal screening test should distinguish women with non-progressive mild neoplasia from those with oncogenic transformation and at women with risk of developing invasive cancer in order to faciliate desicion on therapy and need of follow-up. p16 INK4a is one of the new diagnostic and screening marker. The aim of this study was to evaluate the p16 expression in cervical preinvasive neoplasias and invasive squamouse cell carcinomas (SCC). 38 patients with low grade cervical lesions (LSIL) and 46 patients high grade cervical lesions (HSIL) and 30 patients who treated for invasive squamous cell cervical carcinoma were compared with respect to p16INK4a expression .We also assessed the relationship between p16INK4a and HPV. Presence of HPV was determined PCR method. Strong and diffuse p16INK4a expression were seen in HSIL and SCC group. Most of the patients with LSIL showed weak expression of p16INK4a. However, p16INK4a was also strong positive in patients with LSIL lesion which was caused by high risk HPV (p<0.001). In conclusion, we showed a statistical significant relationship between p16INK4a overexpression in high grade cervical lesions and HPV infection. p16INK4a overexpression might be a useful marker for the prediction of low grade lesion progression into the high grade lesions. However, further studies with larger samples size and longer follow up are needed to reach clear conclusions.