Abstract

Cervical cancer is one of the most common cancers affecting women worldwide. Since the implementation of Pap smear screening, cervical cancer morbidity and mortality have declined drastically. The goal of this study was to evaluate the results of the expression of p16INK4a in normal uterine cervical epithelium, low-grade cervical intraepithelial neoplasia (CIN), high-grade CIN, squamous cell carcinoma (SCC), and adenocarcinoma of the cervix, in order to help draw a distinction between low risk and high risk patients with cervical lesions. Materials and methods: This is prospective and descriptive study conducted in the Department of Pathology, Tertiary Care Teaching Hospital over a period of 1 year. Archival, formalin fixed tumour specimens from patients were retrieved from the department of pathology for immunohistochemical staining done at IMS, BHU, Varanasi by means of an anti-p16 monoclonal antibody. In total, there were 90 patients. We evaluated p16 expression for its clinicopathological significance. Immunohistochemical (IHC) staining was carried out by means of an avidin–biotin complex (ABC) immunoperoxidase method. We used similar protocols to those used previously for the study of p16 expression. Result: HPV types and status in correlation with clinical parameters and expression of p16. Sixty out of 70 patients with PCV could be evaluated for HPV status. 16 were positive for high-risk HPV and 44 were HPV negative. The majority (11 out of 16, 68%) of HPV-positive patients were positive for HPV16. The others were positive for HPV45 (4 patients, 16.6%), HPV18 (2 patient, 8.3%), HPV35 (1 patient), HPV56 (1 patient), and HPV68 (1 patient). Human papillomavirus positivity was significantly correlated with strong p16 expression (p= 0.045). In all, 6 out of the 44 HPV-negative patients were negative for p16 immunostaining, while the remaining 86% showed varying expression: 31 out of 44 (70.5%) showed moderate or strong p16 expression. Conclusion: This study suggests that women with HPV- and p16- positive vaginal cancer have an improved prognosis compared with those with HPV- or p16- negative vaginal cancer. Results for p53 were varied, and no conclusion could be reached. Only 12 studies could be included in the review, of which most were based on small populations. Hence, further and larger studies on the prognostic impact of HPV, p16, and p53 in vaginal cancer are warranted

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