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CC BY-NC-ND 4.0 · Rev Bras Ginecol Obstet 2017; 39(01): 21-25
DOI: 10.1055/s-0037-1598042
Original Article
Thieme-Revinter Publicações Ltda Rio de Janeiro, Brazil

Immunohistochemical Expression of the Tumor Suppressor Protein p16INK4a in Cervical Adenocarcinoma

Expressão imunhistoquímica da proteína de supressão tumoral p16INK4a em adenocarcinoma cervical
José Eleutério Jr
1   Department of Pathology, Faculty of Medicine, Universidade Federal do Ceará (UFC), Fortaleza, CE, Brazil
,
Thiago Silva Lima
1   Department of Pathology, Faculty of Medicine, Universidade Federal do Ceará (UFC), Fortaleza, CE, Brazil
,
Maria do Perpétuo Socorro Cunha
2   Department of Surgical Pathology, Instituto do Câncer do Ceará, Fortaleza, CE, Brazil
,
Diane Isabelle Magno Cavalcante
1   Department of Pathology, Faculty of Medicine, Universidade Federal do Ceará (UFC), Fortaleza, CE, Brazil
,
Angélica Maria Holanda Silva
1   Department of Pathology, Faculty of Medicine, Universidade Federal do Ceará (UFC), Fortaleza, CE, Brazil
› Author Affiliations
Further Information

Publication History

02 May 2016

23 November 2016

Publication Date:
28 February 2017 (online)

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Abstract

Objective To evaluate the diagnostic utility of the p16ink4a protein expression as a marker for adenocarcinoma of the cervix.

Methods In a cross-sectional study, p16ink4a expression was evaluated in 30 cervical biopsies from patients diagnosed with invasive adenocarcinoma from 2 reference clinics in Brazil, and compared with 18 biopsies of endocervical polyps (control cases). The performance of the tests for p16ink4a was evaluated using a conventional contingency table, and the Kappa (κ) index was used to evaluate the agreement of the marker with the tissue diagnosis.

Results In total, 66% of the invasive adenocarcinoma cases were positive for p16ink4a. All of the adenomatous polyps cases used as negative controls were shown to be negative for p16ink4a. The marker showed a high sensitivity and a high negative predictive value. The Kappa index was good for p16ink4a (κ = 0.6).

Conclusion Considering the strong association between the p16ink4a marker and the cervical adenocarcinoma, its use represents an important tool for reducing incorrect diagnoses of adenocarcinoma and thereby avoiding overtreatment.

Resumo

Objetivo Avaliar a utilidade diagnóstica da expressão da proteína p16ink4a como marcador de adenocarcinoma do colo.

Métodos Em estudo transversal, a expressão de p16ink4a foi avaliada em 30 biópsias cervicais de pacientes diagnosticadas com adenocarcinoma invasivo de colo uterino provenientes de dois serviços de referência no Brasil, comparando com achados em 18 biópsias de pólipos endocervicais (grupo de controle). Para avaliar a performance do teste, foi utilizada tabela de contingência convencional, e para avaliar a concordância com o diagnóstico, foi aplicado o índice de Kappa (κ).

Resultados No total, 66% dos casos de adenocarcinoma invasivo foram positivos para p16ink4a. Todos os pólipos adenomatosos foram negativos para p16ink4a. O marcador mostrou uma alta sensibilidade e alto valor preditivo negativo. O índice de Kappa foi bom para p16ink4a (κ = 0.6).

Conclusion Considerando a forte associação entre o marcador p16ink4a e o adenocarcinoma cervical, seu uso representa uma ferramenta importante para reduzir o risco de diagnóstico incorreto de adenocarcinoma e, por conseguinte, evitar o excesso de tratamentos.

Keywords

p16INK4a - adenocarcinoma - cervix - immunohistochemistry

Palavras-chave

p16INK4a - adenocarcinoma - colo uterino - imunoistoquímica
 

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