<![CDATA[Objective: To evaluate clinical value of p16INK4a biomarker
level, by doing p16INK4a immunocytochemistry staining, as a predictor of progressivity of precancerous cervical lesion.
Method: Design of this research is case-control study which will
be stratified. Research was conducted in Cytology Laboratorium,
Gynecology Specialistic Division, Department of Obstetrics and
Gynecology, Dr. Cipto Mangunkusumo Hospital from August 2007
to September 2008. Immunocytochemistry examination was conducted in Anatomic Pathology Department, Dr. Hasan Sadikin Hospital. We divided the sample into two categories; patients with and
without cervical intraepithelial neoplasia (CIN). This research will
evaluate HPV infection and p16INK4a biomarker by doing p16INK4a
immunocytochemistry (ICC) staining.
Results: We have done immunocytochemistry examination in
130 patients, 26 without CIN and 104 with CIN. Immunocytochemistry cut-off point level is 50, which means value < 50 means low (L) p16INK4a expression and in reverse, value ⥠50 means high (H) p16INK4a expression. The bivariate analysis of our study were p16INK4a (H) expression has the risk of CIN 1 with OR 8.4, for CIN 2 with OR 13 and for CIN 3 with OR 21, greater than p16INK4a (L) with all p values are significant. ICC p16INK4a (H) expression, age, number of sexual partners, and education are contributory to the risk of progressivity in CIN. The multivariate analysis demonstrates, ICC expression of p16INK4a (H) has a risk (OR) of CIN 1 17.19 times greater than p16INK4a (L); p16INK4a (H) expressionâs OR for CIN 2 is 25.56; and for OR CIN 3 is 37.32. The expression of p16INK4a has a significant p value and high OR, thus ICC expression of p16INK4a is suggested to be included in the algorithm of precancerous cervical lesion guidelines and scoring of probability of CIN as an alternative to HPV DNA considering less cost of the test. In this research, we found a scoring model to determine probability of progressivity in precancerous cervical lesion.
Conclusion: The expression of p16INK4a has a diagnostic value
in predicting the progressivity of precancerous cervical lesion.
[Indones J Obstet Gynecol 2010; 34-3: 125-30]
Keywords: p16INK4a expression, immunocytochemistry, predictor
of progressivity, precancerous cervical lesion]]>
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