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Memórias do Instituto Oswaldo Cruz
Fundação Oswaldo Cruz, Fiocruz
ISSN: 1678-8060 EISSN: 1678-8060
Vol. 107, No. 5, 2012, pp. 571-577
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Bioline Code: oc12087
Full paper language: English
Document type: Research Article
Document available free of charge
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Memórias do Instituto Oswaldo Cruz, Vol. 107, No. 5, 2012, pp. 571-577
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An evaluation of p16INK4a expression in cervical intraepithelial neoplasia specimens, including women with HIV-1
Nicol, Alcina F; Golub, Jonathan E; e Silva, José R Lapa; Cunha, Cynthia B; Amaro-Filho, Sergio M; Oliveira, Nathalia S; Menezes, Willker; Andrade, Cecília Viana; Russomano, Fabio; Tristão, Aparecida; Grinsztejn, Beatriz; Friedman, Ruth Khalili; Oliveira, Marcia P; Pires, Andrea & Nuovo, Gerard J
Abstract
Although several studies have evaluated the role of p16INK4a as a diagnostic marker of cervical intraepithelial neoplasia (CIN) and its association with disease progression, studies regarding the role of p16INK4a in human immunodeficiency virus (HIV)-infected patients remain scarce. The present study was designed to determine the potential utility of p16INK4a as a diagnostic marker for CIN and invasive cervical cancer in HIV-positive and negative cervical specimens. An immunohistochemical analysis of p16INK4a was performed in 326 cervical tissue microarray specimens. Performance indicators were calculated and compared using receiving operating characteristics curve (ROC)/area under the curve. In HIV-1-negative women, the percentage of cells that was positive for p16INK4a expression was significantly correlated with the severity of CIN (p < 0.0001). A ROC curve with a cut-off value of 55.28% resulted in a sensitivity of 89%, a specificity of 81%, a positive predictive value of 91% and a negative predictive value of 78%. HIV-seropositive women exhibited decreased expression of p16INK4a in CIN2-3 specimens compared with HIV-negative specimens (p = 0.031). The ROC data underscore the potential utility of p16INK4a under defined conditions as a diagnostic marker for CIN 2-3 staging and invasive cervical cancer. HIV-1 infection, however, is associated with relatively reduced p16INK4a expression in CIN 2-3.
Keywords
CIN - p16INK4a - HPV - HIV - TMA - ROC
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