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CC BY-NC-ND 4.0 · Rev Bras Ginecol Obstet 2017; 39(06): 288-293
DOI: 10.1055/s-0037-1598643
Original Article
Thieme-Revinter Publicações Ltda Rio de Janeiro, Brazil

Evaluation of the p16 and Ki-67 Biomarkers as Predictors of the Recurrence of Premalignant Cervical Cancer Lesions after LEEP Conization

Avaliação dos biomarcadores p16 e Ki-67 como preditores de recidivas de lesões pré-cancerígenas do colo do útero após conização por cirurgia de alta frequência
Paulo Macêdo de Oliveira Leite
1   Instituto de Ensino e Pesquisa, Santa Casa Belo Horizonte (IEP/SCBH), Belo Horizonte, Minas Gerais, Brazil
,
Luciene Tafuri
1   Instituto de Ensino e Pesquisa, Santa Casa Belo Horizonte (IEP/SCBH), Belo Horizonte, Minas Gerais, Brazil
,
Maria Zélia de Oliveira Costa
2   Hospital São João de Deus, Fundação Geraldo Corrêa, Divinópolis, Minas Gerais, Brazil
,
Maria Inês de Miranda Lima
1   Instituto de Ensino e Pesquisa, Santa Casa Belo Horizonte (IEP/SCBH), Belo Horizonte, Minas Gerais, Brazil
,
Renata Toscano Simões
1   Instituto de Ensino e Pesquisa, Santa Casa Belo Horizonte (IEP/SCBH), Belo Horizonte, Minas Gerais, Brazil
› Author Affiliations
Further Information

Publication History

12 June 2016

15 December 2016

Publication Date:
23 February 2017 (online)

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Abstract

Objective To evaluate the expressions of biomarkers p16 and Ki-67 in low-grade (LG) or high-grade (HG) lesions, and to relate them to risk factors and the recurrence of these lesions.

Methods A retrospective case-control study of 86 patients with LG and HG lesions who underwent a loop electrosurgical excision procedure (LEEP) between 1999 and 2004. The control group was composed of 69 women with no recurrence, and the study group, of 17 patients with recurrence. All patients were followed-up over a two-year period after surgery, and screened every six months, including cytology and colposcopy. Biopsy samples collected from LEEP were submitted to immunohistochemical analysis for p16 and Ki-67. The statistical analysis was performed using the Statistical Package for the Social Sciences software (SPSS, IBM-SPSS, Inc., Chicago, IL, US), with a significant p ​​< 0.05.

Results The biomarkers p16 and Ki-67, separately or combined, showed no relation to recurrence on the total analysis. However, evaluating specifically HG lesions, the positive expression (2+ and 3+) of p16/Ki-67 was associated with recurrence (0.010). In addition, p16 isolated was also more expressive in HG lesions (2+ and 3 + , p = 0.018), but it was unrelated to recurrence.

Conclusion Proteins p16 and Ki-67, both isolated and combined, are not reliable primary markers for the recurrence of cervical lesions in the majority of LG lesions. However, analyzing only the group with prior diagnosis of HG lesions, the expressions of p16 and of p16/Ki-67 were associated with recurrence, and they may be useful in monitoring these cases.

Resumo

Objetivo Avaliar as positividades dos biomarcadores p16 e Ki-67 em lesões de baixo grau (BG) ou de alto grau (AG), e relacioná-las com os fatores de risco e com a recidiva dessas lesões.

Métodos Estudo retrospectivo caso-controle, com 86 pacientes com lesões de BG e AG, submetidas à conização por cirurgia de alta frequência entre 1999 e 2004. O grupo de controle foi constituído de 69 mulheres sem recidivas, e o grupo de estudo, de 17 pacientes que recidivaram. Todas as pacientes foram acompanhadas durante dois anos após a cirurgia, com controle a cada seis meses, incluindo citologia e colposcopia. As peças provenientes de cirurgia de alta frequência (CAF) foram submetidas a imuno-histoquímica para p16 e Ki-67. A análise estatística foi realizada com o programa Statistical Package for the Social Sciences (SPSS, IBM-SPSS, Inc., Chicago, IL, EUA), com p significante quando < 0,05.

Resultados Isoladamente ou em conjunto, p16 e Ki-67 não se relacionaram com as recidivas quando analisados na totalidade dos casos. Entretanto, avaliando especificamente as lesões de AG, a positividade (2+ e 3 + ) do conjunto p16/Ki-67 foi relacionada com recidiva (0,010). No mais, p16, isoladamente, foi também mais expresso nas lesões de AG (2+ e 3 + , p = 0,018), mas sem relação com recidiva.

Conclusão Quando testadas na totalidade dos casos, as proteínas p16 e Ki-67, separadas ou em conjunto, se mostraram ineficientes como marcadores primários de recidiva de lesões precursoras. Entretanto, quando avaliadas somente no grupo diagnóstico prévio de lesão de AG, as expressões das proteínas p16 e p16/Ki-67 têm relação com a recidiva, e podem ser úteis no acompanhamento desses casos.

Keywords

biomarkers - conization - cervical intraepithelial neoplasia - recurrence

Palavras-chave

biomarcadores - conização - neoplasia intraepitelial cervical - recidiva
 

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