Role of P16(INK4A) expression in identifying CIN2 or more severe lesions among HPV-positive patients referred for colposcopy after abnormal cytology
Role of P16(INK4A) expression in identifying CIN2 or more severe lesions among HPV-positive patients referred for colposcopy after abnormal cytology
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DOI：
10.1002/cncr.21713
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发表时间：
2006-04-25
影响因子：
3.4
通讯作者：
Ciatto, S
中科院分区：
文献类型：
--
作者：
Carozzi, F;Cecchini, S;Ciatto, S
BACKGROUND: p16 is strongly overexpressed in dysplastic cervical cells because of the transforming activity of the E7 oncogene of all high-risk human papillomavirus (HR-HPV) types and may be easily revealed by immuno chemistry: p16 may, therefore, be considered a surrogate marker for the activated oncogene expression of HR-HPV in dysplastic cervical cells.METHODS: HPV and p16(INK4a) testing were performed in a consecutive series of 283 patients with abnormal cytology referred to colposcopy assessment or follow-up. Triage of patients to colposcopy by HPV or HPV and p16 testing was simulated, and the relative sensitivity, specificity, and positive predictive value (PPV) of HPV and p16 testing for > CIN2 lesions was determined as well as the cost balance of the two triage types.RESULTS: Compared to current protocol, triage by HPV testing reduced the number of colposcopies by 44.2%, but also reduced the > CIN2 detection rate by 10.7%, and was associated with a cost of EURO 54.16 per assessed woman and of EURO 613.20 per > CIN2 detected. Compared with current protocol, triage by HPV and p16 testing combined reduced the number of colposcopies by 73.1%, but reduced > CIN2 detection rate by 21.5%, and was associated with a cost of E 54.73 per woman assessed and of EURO 704.09 per > CIN2 detected.CONCLUSIONS: Triage byHPVand p16 improves considerablythe PPVofdiagnostic assessment, but decreases > CIN2 detection rate, and is associated with substantially higher costs. Further decrease of molecular immunochemistry testing due to technological progress may allow HPV and p16 testing to become a cost effective procedure in the future.
