DIAGNOSTIC VALUE OF PROLIFERATION MARKERS IN DETERMINATION OF THE SEVERITY OF PRECANCEROUS CERVICAL CONDITIONS
DOI:
https://doi.org/10.11603/24116-4944.2018.1.8736Keywords:
cervix, proliferation markers, colposcopy, cytology.Abstract
The aim of the study – to evaluate the diagnostic value of P16/Ki-67 proliferation markers in determination of oncogenic transformation at various severity of cervical dysplasia.
Materials and Methods. 82 women aged 24–47 years with cervical dysplasia of varying severity were examined. In addition to general clinical examination, colposcopic, cytological, microbiological and histological studies were performed. P16/Ki-67 proliferation markers were examined by immunocytochemical method.
Results and Discussion. According to cytological examination CIN I was diagnosed in 59 (72.0 %), CIN II in 16 (19.5 %), CIN III in 7 (8.5 %) women. Atypical colposcopic pattern was revealed in all patients. According to the results of HPV test, the most common HPV type 16 (25.4 % to 100 %), common HPV types 18.31 and 33 at CIN of varying severity were observed. Positive P16/Ki-67 markers were found in 10 (16.9 %) women with CIN I, 9 (56.3 %) with CIN II and 6 (85.7 %) with CIN IІI. Comparisonof the cytological and histological results in patients with positive P16/Ki-67 markers showed that among 10 women with CIN I, 4 (40.0 %) had CIN II and 5 (50.0 %) CIN III; among 9 patients with CIN II, 6 (66.7 %) had CIN III; in 3 (50.0 %) women with CINIII their diagnosis was confirmed, Ca in situ in 1 (16.7 %) and invasive cancer in 2 (33.3 %) were diagnosed. Thus, the cytological method combined with HPV test did not allow to diagnose severe intraepithelial cervical lesions in 17.1 %.
Conclusions. The comprehensive examination with cytology and HPV test should be supplemented with determination of specific proliferation markers. Thus, an integrative stage of changes in the virus that has an oncogenic potential can be established and the severity of dysplastic changes in the cervical epithelium can be verified. This is important for early diagnosis of cervical cancer.
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