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Int J Clin Exp Pathol 2013;6(8):1549-1557

Original Article
Combined detection of p16INK4a and IMP3 increase the concordance rate between
cervical cytologic and histologic diagnosis

Qingzhu Wei, Bo Fu, Jianghuan Liu, Jiabao Xu, Tong Zhao

Department of Pathology, The Third Affiliated Hospital, Southern Medical University, Guangzhou, 510630, China

Received June 22, 2013; Accepted July 7, 2013; Epub July 15, 2013; Published August 1, 2013

Abstract: Currently, there are discrepancies in the interpretation between cervical liquid-based cytology (LBC) and histologic diagnoses. The
aim of our study was to evaluate the utility of p16INK4a (p16) and IMP3 staining of LBC specimens to increase the concordance rate. A total of
98 cell blocks with biopsy results, including 37 low-grade squamous intraepithelial lesions (LSIL), 36 high-grade squamous intraepithelial
lesions (HSIL), and 25 squamous cell carcinomas (SCC), were selected for the immunocytochemical analysis of p16 and IMP3. The LBC
diagnoses corresponded with histological diagnoses for 59.5% (22/37), 63.9% (23/36), and 88.0% (22/25) of LSIL, HSIL, and SCC lesions,
respectively. We found a high frequency of p16 positivity in HSIL (72.2%) and SCC (100%), but not LSIL (29.7%). IMP3 was frequently expressed
in SCC (84.0%), but rarely in LSIL (8.1%) and HSIL (25.0%). Cervical intraepithelial neoplasia 1 (CIN1) was negative for both p16 and IMP3,
CIN2/3 tended to be positive for p16 and negative for IMP3, and SCC was positive for both p16 and IMP3. The combination of p16 and IMP3
immunostaining had a higher sensitivity and specificity for detecting CIN1 and CIN2/3 than cytology. For detecting SCC, p16/IMP3 had a higher
sensitivity than cytology, but a lower specificity. IMP3 is a useful diagnostic immunomarker that can be used to identify SCC and the
combination of p16/IMP3 expression was found to improve the discrepant results between cytologic and histologic diagnoses.

Keywords: Liqui-PREP, cell blocks, immunocytochemistry, p16INK4a, IMP3

Address correspondence to: Dr. Tong Zhao, Department of Pathology, The Third Affiliated Hospital Southern Medical University, Guangzhou
510630, China. Phone: +86-020-62784800; E-mail: zhaotongketizu@126.com