Journal List > Korean J Obstet Gynecol > v.54(4) > 1088264

Kim, Lee, Lee, Kim, and Lee: THE PROGNOSTIC SIGNIFICANCE OF P16, KI-67, P63, AND CK17 EXPRESSION DETERMINED BY IMMUNOHISTOCHEMICAL STAINING IN CERVICAL INTRAEPITHELIAL NEOPLASIA 1

Abstract

Objective

To evaluate the prognostic significance of p16, Ki-67, p63, and cytokeratin (CK) 17 expression determined by immunohistochemical staining in cervical intraepithelial neoplasia (CIN) 1.

Methods

Biopsy tissue samples from 33 patients diagnosed with CIN 1 were stained immunohistochemically for p16, Ki-67, p63, and CK17. The staining results were correlated with the clinical course of the disease.

Results

Seventeen of 18 (94.4%) p16-negative patients experienced regression, and only 1 patient (5.6%) developed persistent disease. Fifteen of the 16 (93.8%) Ki-67-negative patients experienced regression, and 1 patient (6.3%) developed persistent disease. Negative p16 and Ki-67 expression correlated significantly with disease regression (P=0.004 and P=0.017, respectively). Fourteen of 15 (93.3%) patients negative for both p16 and Ki-67 experienced regression, and 1 patient negative for both p16 and Ki-67 (6.7%) developed persistent disease. The expression levels of p63 and CK17 were not significantly associated with disease regression or persistence (P=0.149 and P=0.642, respectively). Ten of the 13 (76.9%) p16-positive patients had a high-risk HPV infection. High-risk HPV infection was significantly associated with p16 expression (P=0.049).

Conclusion

CIN 1 with p16- or Ki-67-negative immunohistochemical staining was associated with spontaneous disease regression. The p63 and CK17 expression patterns were not related to the behavior of CIN 1.

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Fig. 1.
(A) H&E, ×100, (B) H&E, ×200. The expression of p16 (C, D), Ki-67 (E, F), and p63 (G, H) in the lower one third of the cervical epithelium (×100, ×200). Note the loss of the CK17 expression in the lower one third of the cervical epithelium (I, J) ×100, ×200. (C-J) immunohistochemical stain.
kjog-54-184f1.tif
Fig. 2.
The association of positive P16, Ki-67, p63, and CK17 immunohistochemical expressions with high risk HPV infection. aPearson's chi-square test, bFisher's exact test.
kjog-54-184f2.tif
Table 1.
The behavior of CIN 1 and the expressions of p16, Ki-67, p63, and CK17
Patient no. CIN 1 behavior HPV test results p16 Ki-67 p63 CK17
1 Regression 31 - + + -
2 Regression 31 - - + +
3 Regression Not taken - - - -
4 Regression Negative - + + -
5 Regression Hybrid capture II positive - - + +
6 Regression Hybrid capture II positive - - - +
7 Regression Negative - - - +
8 Regression Negative - - - -
9 Regression Hybrid capture II positive - - + +
10 Regression Negative - - - -
11 Regression Negative - - + -
12 Regression 18, 33, 53 - - + -
13 Regression 56 + + + -
14 Regression 58 + + + -
15 Regression Not taken + + + -
16 Regression Low risk 55 positive + - + -
17 Regression Not taken + + + -
18 Regression 16 + + + -
19 Regression Hybrid capture II positive + + + -
20 Regression Hybrid capture II negative + + + -
21 Regression 58 + + + -
22 Regression 16, 33 + + + -
23 Regression Negative + + + -
24 Regression Negative + + + +
25 Maintenance Low risk 54 positive - + + -
26 Maintenance Low risk 53, 44 positive - - - +
27 Maintenance Low risk 66 positive - - - -
28 Maintenance Hybrid capture II positive - - + -
29 Maintenance Not taken + + + -
30 Maintenance 33, 58 + + + -
31 Progression Not taken - - + -
32 Progression Hybrid capture II positive - - + -
33 Progression Hybrid capture II positive + + + -

CIN, cervical intraepithelial neoplasia 1; HPV, human papillomavirus; CK17, cytokeratin 17.

Table 2.
The behavior of CIN 1 as related to the expression statuses of p16, Ki-67, p63 and CK17
Behavior Total (n) p16 Ki‐67 p63 CK17 p16/Ki‐67
- + - + - + - + -/- -/+, +- +/+
Regression 24 17 (94.4) 7 (46.7) 15 (93.8) 9 (52.9) 7 (100) 17 (65.4) 18 (69.2) 6 (85.7) 14 (93.3) 4 (100) 6 (42.9)
Persistence 9 1 (5.6) 8 (53.3) 1 (6.3) 8 (47.1) 0 9 (34.6) 8 (30.8) 1 (14.3) 1 (6.7) 0 8 (57.1)
Total 33 18 (54.6) 15 (45.4) 16 (48.5) 17 (51.5) 7 (21.2) 26 (78.8) 26 (78.8) 7 (21.2) 15 (45.4) 4 (12.1) 14 (42.4)
P-valuea   0.004 0.017 0.149 0.642      

Values are presented as number (%). CIN, cervical intraepithelial neoplasia 1; CK17, cytokeratin 17.

a Fisher's exact test.

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