View Case

Back

Questions
Discussion
References

Show the short figure legend

Show the complete figure description

1250) This is a lesion of the uterine cervix in a 24-year-old patient with lesional cells strongly positive for p16ink4a. Which statement regarding anti-p16ink4a staining and cervical dysplasia is INCORRRECT?

Squamous metaplasia of the endocervix is negative for p16ink4a and high grade cervical dysplasia is commonly strongly positive for p16ink4a. For cytology specimens multiplex staining of p16ink and a proliferation marker (e.g., Ki-67) increases the specificity for detecting high grade dysplasia. The p16ink4a target antigen can be found either in cell nuclei or the cytoplasm. The p16ink4a protein level correlates with the level of E7 protein in cells infected by human papillomavirus. The p16ink4a stain should be used in those cases, for which it is impossible to distinguish between low grade and high grade cervical dysplasia by histology.

Show Diagnosis/Topic

• Between 40% to 70% of low grade cervical dysplasia cases show strong staining for p16ink4a, which decreases its value as biomarker to distinguish between low grade and high grade dysplasia.

• It has been suggested, however, that strongly p16ink4a positive low grade lesions have a higher tendency to progress to high grade dysplasia.

Bao H and Wu Y: p16INK4A and Ki-67 immunostaining on cell blocks from residual ThinPrep material is helpful in identifying significant preneoplastic cervical lesions. Pathol Res Pract 2011;207:216-219.

Zhang Q, Kuhn L, Denny LA, De Souza M, Taylor S, Wright TC Jr: Impact of utilizing p16INK4A immunohistochemistry on estimated performance of three cervical cancer screening tests. Int J Cancer 2007;120:351-356.

Back

Anatomic Pathology: Immunopathology

1250) This is a lesion of the uterine cervix in a 24-year-old patient with lesional cells strongly positive for p16ink4a. Which statement regarding anti-p16ink4a staining and cervical dysplasia is INCORRRECT?

View Notes

Add a Note